Parkinsons Patients? How about textured insoles or walking barefoot more?

Is it at all surprising that increasing afferent input (in this case: textured insoles) to one of the areas in the brain (parasaggital sulcus in the post central gyrus) from one of the structures that has the greatest cortical representation (ie the feet) can improve gait on folks that have a disorder with their basal ganglia (which provides background positioning of joints)?

"After one week of insole wear, plantar sensation and stride length were significantly improved relative to baseline; the improvement in plantar sensation was maintained after another week of wearing conventional insoles."

Lirani-Silva E, Vitorio R, Barbieri FA, et al. Continuous use of textured insole improve plantar sensation and stride length of people with Parkinson disease: A pilot study. Gait Posture 2017;58:495-497.

A case of gait spasticity.

We have been saying it for a long time now. Gait is a huge window into the function of the human brain and nervous system. It is often the first presenting sign that something is wrong. In the case below, a 48 year old woman presented because of a gradually developing spastic gait. 
Lab testing showed mild increases of transaminase and total bilirubin. Blood manganese level was markedly elevated. 
MRI showed high signal intensities at the globus pallidus and cerebral peducles, and bilateral deep white matter, posterior limbs of the internal capsule and right upper cervical spinal cord. 
A diagnosis of Idiopathic portal hypertension was made. 
According to this article:

“Hepatic diseases often show high signal intensities at the basal ganglia on T1-weighted images, and this seemed to be due to accumulation of manganese in our case. Because demyelination or axonal injury of the spinal cord are found in hepatic disease, we speculate that the high signal intensities at the spinal cord on T2-weighted images of our case reflect hepatic myelopathy, which may also be caused by high blood levels of manganese.”

The Gait Guys say once again, “gait changes in a client may be the first clinical presentation of other pathology, not all the time, but enough that you should be looking for anomalies.

Rinsho Shinkeigaku. 2002 Sep;42(9):885-8.
[A case of idiopathic portal hypertension (IPH) with hypermanganemia presenting as spastic gait].
Obama R1, Tachikawa H, Yoshii F, Takeoka T, Shinohara Y.

It’s a “Dancing Queen” kind of Friday  here on The Gait Guys.  Enjoy !  Shake it like you wanna break it sweetie !

Human movement is a beautiful thing, in any form. So are uninhibited individuals like this sparky lady. Why stand when you can dance ?

“Neural circuits linking activity in anatomically segregated populations of neurons in subcortical structures and the neocortex throughout the human brain regulate complex behaviors such as walking, talking, language comprehension, and other cognitive functions associated with frontal lobes.”

Don’t you wanna become a Gait Guy Geek !?  (come on, you know you wanna !)

Leonard and Sheldon, The Gait Guys Theory

Front Syst Neurosci. 2014 Feb 13;8:16. eCollection 2014.

Cognitive-motor interactions of the basal ganglia in development.

Leisman G1, Braun-Benjamin O2, Melillo R3.