 |
 |
Dear Phil, My comments are not addressed to you specifically, as I don't know you , but rather to the issue you raised. Also I don't want to give the impression that I am preaching the gospel here - this is a speculative opinion. You may indeed have vestibular balance problems. My remarks are what I believe is generally true of most PD'ers so here goes an attempt at clarification=85 In general I believe there are two separate areas of PD that impact on balance and gait. One is vision mediataed (see below) the other is a kin= d of autonomic nervous system problem which results in excess muscle tone (which is augmented by normally occurring tone as in postural tone) and clinically appears as stiffness, bradykinesia and the "my feet feel like they're glued to the ground" syndrome. In regards to vision and gait I would suggest there are two categories of= vision. One is seeing in the ordinary sense, the other is unconscious visual processing of information. The latter is similar to the visual processing that occurs while on a ship at sea or in a moving car . We ar= e not conscious of this type of vision but it can impact on our motor performance for example motion sickness. We monitor the apparent motion= of the environment as we walk through it with this type of vision. Whe= n there is pathology in this type of visual perception walking is very difficult and if severe enough can result in akinesia. Dyskinetic gait i= s the body's attempt to conform to similar perceptive pathology while in th= e "on" state. Both, not coincidentally, can be normalized by VISUAL cues. = I agree vision is not the exclusive means by which we monitor gait (and indirectly balance) but it is the principle means. And when there is pathology in vision our bodies cannot ignore it and focus on alternative feedback. Does anyone know a blind person with PD, I feel much could be learned fr= om such a person. Regards, Tom