towards an understanding of falling

[THOMAS J RIESS <74244.1521@xxxxxxxxxxxxxx>]

Dear Dennis, =3D


I understand your objection to my use of the terms "off" and "on".   For =
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my
purposes the term "off" is defined as the absence of any clinical impact =
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of
Dopamine.  Clinically this means akinesia.  Festination and shuffling are=
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not examples of "failed" walking but rather are the body's attempt to
continue walking in the face of walk impairing pathology.  So shuffling a=
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nd
festination are manifestations of Dopamine impact though at less than
optimal amounts  (exogenous or endogenous).

There is much empirical evidence as well as neurophysiologic evidence  to=
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support the relationship between gait and vision.  The entire phenomenon =
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of
kinesia paradoxa is one example.  (Do you exhibit sensitivity to visul
cues?) Closing one's eyes for a step overcomes a freeze. Manipulating
various parameters  of vision can profoundly impact parkinsonian gait
performance.  But this is too large a subject for this forum.  If you wou=
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ld
like I could send you  my paper on tbe subject.

regards,

Tom