The Effect of Visual Cue on Anticipatory Postural Adjustments During Gait Initiation in Individuals with Parkinson’s Disease

Introduction. Gait initiation (GI) difficulties in Parkinson's disease (PD) are often attributed to impaired anticipatory postural adjustments (APAs), a key pathophysiological factor. The aim of the study is to explore the effects of visual cues on anticipatory postural adjustments (APAs) alterations during gait initiation (GI) in individuals with and without Parkinson's disease (PD) in 18 patients with PD and 18 age-matched healthy controls. Methods: Eighteen patients with PD (PD group) and 18 age-matched healthy controls (HC group) performed self-generated gait initiation with two experimental GI conditions comprising a transverse visual cue and no visual cue. Characteristics of APAs were derived from monitoring the trajectory of the center of pressure (COP) during GI. The measure outcomes included lateral/posterior APA size, APA duration, APA velocity, and the frequency of trials with either missing or multiple APAs. Results: Visual cues significantly increased (P < .0001) both the lateral APA size and APA velocity in the PD groups only. The frequency of missing APAs was higher in the PD group, whereas the incidence of multiple APAs was similar between the PD and HC groups. Conclusion: The findings suggest that the visual cue significantly enhances the preparation for gait initiation in individuals with Parkinson’s disease. Further research and long-term studies are needed to fully explore the potential of visual cues as a therapeutic tool in managing postural instability in people with Parkinson’s.