1
|
McDonald C, El Yaakoubi NA, Lennon O. Brain (EEG) and muscle (EMG) activity related to 3D sit-to-stand kinematics in healthy adults and in central neurological pathology - A systematic review. Gait Posture 2024; 113:374-397. [PMID: 39068871 DOI: 10.1016/j.gaitpost.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/29/2024] [Accepted: 07/15/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND The sit-to-stand transfer is a fundamental functional movement during normal activities of daily living. Central nervous system disorders can negatively impact the execution of sit-to-stand transfers, often impeding successful completion. Despite its importance, the neurophysiological basis at muscle (electromyography (EMG)) and brain (electroencephalography (EEG)) level as related to the kinematic movement is not well understood. OBJECTIVES This review synthesises the published literature addressing central and peripheral neural activity during 3D kinematic capture of sit-to-stand transfers. METHODS A pre-registered systematic review was conducted. Electronic databases (PubMed, CINAHL Plus, Web of Science, Scopus and EMBASE) were searched from inception using search operators that included sit-to-stand, kinematics and EMG and/or EEG. The search was not limited by study type but was limited to populations comprising of healthy individuals or individuals with a central neurological pathology. RESULTS From a total of 28,770 identified papers, 59 were eligible for inclusion. Ten of these 59 studies received a moderate quality rating; with the remainder rated as weak using the Effective Public Health Practice Project tool. Fifty-eight studies captured kinematic data of sit-to-stand with associated EMG activity only and one study captured kinematics with co-registered EMG and EEG data. Fifty-six studies examined sit-to-stand transfer in healthy individuals, reporting four dynamic movement phases and three muscle synergies commonly used by most individuals to stand-up. Pre-movement EEG activity was reported in one study with an absence of data during execution. Eight studies examined participants following stroke and two examined participants with Parkinson's disease, both reporting no statistically significant differences between their kinematics and muscle activity and those of healthy controls. SIGNIFICANCE Little is known about the neural basis of the sit-to-stand transfer at brain level with limited focus in central neurological pathology. This poses a barrier to targeted mechanistic-based rehabilitation of the sit-to-stand movement in neurological populations.
Collapse
Affiliation(s)
- Caitlin McDonald
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
| | | | - Olive Lennon
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| |
Collapse
|
2
|
Palmisano C, Farinelli V, Camuncoli F, Favata A, Pezzoli G, Frigo CA, Isaias IU. Dynamic evaluation of spine kinematics in individuals with Parkinson's disease and freezing of gait. Gait Posture 2024; 108:199-207. [PMID: 37993298 DOI: 10.1016/j.gaitpost.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/23/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Freezing of gait (FoG) is an episodic failure of gait exposing people with Parkinson's disease (PD) to a high risk of falling. Despite growing evidence of the interconnection between impaired trunk control and FoG, a detailed description of spinal kinematics during walking is still lacking in this population. RESEARCH QUESTION Do spinal alterations impact gait performance in individuals with PD and FoG? METHODS We analyzed kinematic data of 47 PD participants suffering (PD-FOG, N = 24) or not suffering from FoG (PD-NFOG, N = 23) and 15 healthy controls (HCO) during quiet standing and unperturbed walking. We estimated the main spinal variables (i.e., spinal length, lordosis and kyphosis angles, trunk inclination), the pelvis angles, and the shoulder-pelvis angles during gait and standing. We studied differences across conditions and groups and the relationships between postural and gait parameters using linear regression methods. RESULTS During standing and walking, both PD groups showed increased trunk inclination and decreased lordosis angle with respect to HCO, as well as a decreased range in variation of kyphosis angle, pelvic obliquity, and shoulder-pelvis angles. Only PD-FOG participants showed reduced range of lordosis angle and spinal length compared to HCO. PD-FOG individuals were also not able to straighten their spine during walking compared to standing. Stride length and velocity were decreased in both patient groups compared to HCO, while swing duration was reduced only in the PD-FOG group. In individuals with FoG, trunk inclination and lordosis angle showed moderate but significant positive correlations with all gait alterations. SIGNIFICANCE Spine alterations impacted gait performance in individuals with PD suffering from FoG. Excessive trunk inclination and poor mastering of the lordosis spinal region may create an unfavourable postural precondition for forward walking. Physical therapy should target combined spinal and stepping alterations in these individuals.
Collapse
Affiliation(s)
- C Palmisano
- Department of Neurology, University Hospital of Würzburg and Julius Maximilian University of Würzburg, Würzburg, Germany.
| | - V Farinelli
- Human Physiology Section of the DePT, Università degli Studi di Milano, Milano, Italy
| | - F Camuncoli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - A Favata
- Biomechanical Engineering Lab, Department of Mechanical Engineering and Research Centre for Biomedical Engineering, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - G Pezzoli
- Parkinson Institute Milan, ASST G. Pini-CTO, Milano, Italy
| | - C A Frigo
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - I U Isaias
- Department of Neurology, University Hospital of Würzburg and Julius Maximilian University of Würzburg, Würzburg, Germany; Parkinson Institute Milan, ASST G. Pini-CTO, Milano, Italy
| |
Collapse
|
3
|
Baizabal-Carvallo JF, Alonso-Juarez M, Fekete R. The Role of Muscle Strength in the Sit-to-Stand Task in Parkinson's Disease. PARKINSON'S DISEASE 2023; 2023:5016802. [PMID: 37908843 PMCID: PMC10615572 DOI: 10.1155/2023/5016802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/04/2023] [Accepted: 10/14/2023] [Indexed: 11/02/2023]
Abstract
Background Rising from a chair or the sit-to-stand (STS) task is frequently impaired in individuals with Parkinson's disease (PD). These patients commonly attribute such difficulties to weakness in the lower extremities. However, the role of muscle strength in the STS transfer task has not been fully elucidated. Objective We aim at determining the role of muscle strength in the STS task. Methods We studied 90 consecutive patients with PD and 52 sex- and age-matched controls. Lower limb strength was determined in both legs by clinical examination using the Medical Research Council Scale, dynamometric (leg flexion) and weighting machine (leg pressure) measures. Patients were interrogated regarding the presence of subjective lower limb weakness or allied sensations. Results There were 20 patients (22.2%) with abnormal STS task (item 3.9 of the MDS-UPDRS-III ≥2 points). These patients had higher modified Hoehn and Yahr stage (P < 0.001) and higher total motor scores of the MDS-UPDRS(P < 0.001), compared with 70 PD patients with normal STS task. Patients with abnormal STS task endorsed lower limb weakness more frequently and had lower muscle strength in the proximal lower extremities, compared to PD patients with normal STS task and normal controls. The presence of perceived lower limb weakness increased the risk of an abnormal STS task, OR: 11.93 (95% C.I. 1.51-94.32), whereas a hip extension strength ≤9 kg/pressure also increased the risk of abnormal STS task, OR: 4.45 (95% C.I. 1.49-13.23). In the multivariate regression analysis, bradykinesia and decreased hip strength were related to abnormal STS task. Conclusions Patients with PD and abnormal STS task complain more commonly of lower limb weakness and have decreased proximal lower limb strength compared to patients with PD and normal STS task, likely contributing to abnormalities in performing the STS task.
Collapse
Affiliation(s)
| | | | - Robert Fekete
- New York Medical College, Valhalla, New York, NY, USA
| |
Collapse
|
4
|
Herzog M, Krafft FC, Stetter BJ, d'Avella A, Sloot LH, Stein T. Rollator usage lets young individuals switch movement strategies in sit-to-stand and stand-to-sit tasks. Sci Rep 2023; 13:16901. [PMID: 37803010 PMCID: PMC10558536 DOI: 10.1038/s41598-023-43401-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 09/22/2023] [Indexed: 10/08/2023] Open
Abstract
The transitions between sitting and standing have a high physical and coordination demand, frequently causing falls in older individuals. Rollators, or four-wheeled walkers, are often prescribed to reduce lower-limb load and to improve balance but have been found a fall risk. This study investigated how rollator support affects sit-to-stand and stand-to-sit movements. Twenty young participants stood up and sat down under three handle support conditions (unassisted, light touch, and full support). As increasing task demands may affect coordination, a challenging floor condition (balance pads) was included. Full-body kinematics and ground reaction forces were recorded, reduced in dimensionality by principal component analyses, and clustered by k-means into movement strategies. Rollator support caused the participants to switch strategies, especially when their balance was challenged, but did not lead to support-specific strategies, i.e., clusters that only comprise light touch or full support trials. Three strategies for sit-to-stand were found: forward leaning, hybrid, and vertical rise; two in the challenging condition (exaggerated forward and forward leaning). For stand-to-sit, three strategies were found: backward lowering, hybrid, and vertical lowering; two in the challenging condition (exaggerated forward and forward leaning). Hence, young individuals adjust their strategy selection to different conditions. Future studies may apply this methodology to older individuals to recommend safe strategies and ultimately reduce falls.
Collapse
Affiliation(s)
- Michael Herzog
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Engler-Bunte Ring 15, 76131, Karlsruhe, Germany.
- HEiKA-Heidelberg Karlsruhe Strategic Partnership, Heidelberg University, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany.
| | - Frieder C Krafft
- HEiKA-Heidelberg Karlsruhe Strategic Partnership, Heidelberg University, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Optimization, Robotics, and Biomechanics, Institute of Computer Engineering, Heidelberg University, Heidelberg, Germany
- Center of Prevention, Diagnostic and Performance, Center of Orthopaedics Hohenlohe, Künzelsau, Germany
| | - Bernd J Stetter
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Engler-Bunte Ring 15, 76131, Karlsruhe, Germany
- Sports Orthopedics, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Andrea d'Avella
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia, Rome, Italy
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Università di Messina, Messina, Italy
| | - Lizeth H Sloot
- HEiKA-Heidelberg Karlsruhe Strategic Partnership, Heidelberg University, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Optimization, Robotics, and Biomechanics, Institute of Computer Engineering, Heidelberg University, Heidelberg, Germany
| | - Thorsten Stein
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Engler-Bunte Ring 15, 76131, Karlsruhe, Germany
- HEiKA-Heidelberg Karlsruhe Strategic Partnership, Heidelberg University, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| |
Collapse
|
5
|
Cao S, Cui Y, Jin J, Li F, Liu X, Feng T. Prevalence of axial postural abnormalities and their subtypes in Parkinson's disease: a systematic review and meta-analysis. J Neurol 2023; 270:139-151. [PMID: 36098837 DOI: 10.1007/s00415-022-11354-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE Axial postural abnormalities, mainly involving the spinal deformities, are disabling symptoms of Parkinson's disease (PD). However, the prevalence of axial postural abnormalities in PD and their clinical correlates remain unclear. The present study aimed to conduct a systematic review and meta-analysis of the prevalence of overall and subtypes of axial postural abnormalities in PD. METHODS PubMed, Embase, Web of Science and Cochrane databases were searched up to 31st March, 2022. We identified studies that reported the prevalence of axial postural abnormalities in PD. The pooled estimate of prevalence was calculated using a random effect model. Subgroup analysis and meta-regression were performed. RESULTS There were 19 studies met the inclusion criteria. The overall prevalence of axial postural abnormalities in PD was 22.1% (95% CI 19.7-24.5%). The prevalence of each subtype of axial postural abnormalities was 19.6% for scoliosis (95% CI 10.6-28.7%), 10.2% for camptocormia (95% CI 7.7-12.7%), 8% for Pisa syndrome (95% CI 4.7-11.4%), and 7.9% for antecollis (95% CI 3.9-11.9%). Subgroup analysis showed that the measuring method of axial postural abnormalities exerted significant effects on prevalence estimates. Axial postural abnormalities in PD were associated with older age, longer disease duration, higher H-Y stage, greater levodopa equivalent daily dose, more severe motor symptoms, motor fluctuations, and akinetic-rigid subtype. CONCLUSIONS Axial postural abnormalities, which include scoliosis, camptocormia, Pisa syndrome, and antecollis, are not uncommon in patients with PD. Future research on axial postural abnormalities should be based on uniform diagnostic criteria and measuring methods.
Collapse
Affiliation(s)
- Shuangshuang Cao
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Neurology, Yidu Central Hospital of Weifang, Shandong, China
| | - Yusha Cui
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jianing Jin
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Fangfei Li
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Xin Liu
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Tao Feng
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, China.
| |
Collapse
|
6
|
Da Cunha CP, Rao PT, Karthikbabu S. Clinical features contributing to the sit-to-stand transfer in people with Parkinson’s disease: a systematic review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00396-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
The aim of this systematic review is to present the existing literature on the clinical motor, and non-motor factors contributing to sit-to-stand transfer in individuals with Parkinson's disease.
Data synthesis
Five databases (PubMed, PEDro, Cochrane, SCOPUS, and Ovid) were searched for literature on the contributing factors to sit-to-stand performance in Parkinson's disease. A quality check of these observational studies was done using the 'strengthening the reporting of observational studies in epidemiology' (STROBE) statement and the tool of the 'National Heart, Lung, and Blood Institute' (NHLBI). Descriptive and quantitative data were extracted and compiled, and a meta-analysis was performed to compute the standardised mean difference.
Results
Thirteen studies were selected; a majority of them provided a high-to-moderate level of evidence. Ten were cross-sectional, while the other three were case–control studies. Collectively, individuals with Parkinson's disease had a prolonged transfer time than those of age-matched healthy peers, particularly from peak horizontal velocity phase to seat-off phase, implying bradykinesia. A reduction in peak and rate to peak joint torques was also related to the decreased pace and stability of the sit-to-stand movement in individuals with Parkinson's disease. Additionally, they demonstrated exaggerated trunk flexion as a postural stabilisation strategy, allowing them to maintain and manoeuvre the relative positions of their centre of mass through the transitional phase of the transfer.
Conclusion
As per the existing literature, an alteration in strength, overall body bradykinesia, balance, posture, as well as cognition may result in an impaired sit-to-stand transfer in individuals with Parkinson's disease.
Collapse
|
7
|
Cano-de-la-Cuerda R, Vela-Desojo L, Moreno-Verdú M, Ferreira-Sánchez MDR, Macías-Macías Y, Miangolarra-Page JC. Trunk Range of Motion Is Related to Axial Rigidity, Functional Mobility and Quality of Life in Parkinson's Disease: An Exploratory Study. SENSORS (BASEL, SWITZERLAND) 2020; 20:E2482. [PMID: 32349394 PMCID: PMC7248848 DOI: 10.3390/s20092482] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/15/2020] [Accepted: 04/25/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND People with Parkinson's disease (PD) present deficits of the active range of motion (ROM), prominently in their trunk. However, if these deficits are associated with axial rigidity, the functional mobility or health related quality of life (HRQoL), remains unknown. The aim of this paper is to study the relationship between axial ROM and axial rigidity, the functional mobility and HRQoL in patients with mild to moderate PD. METHODS An exploratory study was conducted. Non-probabilistic sampling of consecutive cases was used. Active trunk ROM was assessed by a universal goniometer. A Biodex System isokinetic dynamometer was used to measure the rigidity of the trunk. Functional mobility was determined by the Get Up and Go (GUG) test, and HRQoL was assessed with the PDQ-39 and EuroQol-5D questionnaires. RESULTS Thirty-six mild to moderate patients with PD were evaluated. Significant correlations were observed between trunk extensors rigidity and trunk flexion and extension ROM. Significant correlations were observed between trunk flexion, extension and rotation ROM and GUG. Moreover, significant correlations were observed between trunk ROM for flexion, extension and rotations (both sides) and PDQ-39 total score. However, these correlations were considered poor. CONCLUSIONS Trunk ROM for flexion and extension movements, measured by a universal goniometer, were correlated with axial extensors rigidity, evaluated by a technological device at 30°/s and 45°/s, and functional mobility. Moreover, trunk ROM for trunk flexion, extension and rotations were correlated with HRQoL in patients with mild to moderate PD.
Collapse
Affiliation(s)
- Roberto Cano-de-la-Cuerda
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain; (R.C.-d.-l.-C.); (J.C.M.-P.)
| | - Lydia Vela-Desojo
- Neurology Service. Division of Movements Disorders, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, 28922 Madrid, Spain; (L.V.-D.); (Y.M.-M.)
| | - Marcos Moreno-Verdú
- Asociación Parkinson Madrid, 28014 Madrid, Spain
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain;
| | | | - Yolanda Macías-Macías
- Neurology Service. Division of Movements Disorders, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, 28922 Madrid, Spain; (L.V.-D.); (Y.M.-M.)
| | - Juan Carlos Miangolarra-Page
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain; (R.C.-d.-l.-C.); (J.C.M.-P.)
- Rehabilitation Unit, Hospital Universitario de Fuenlabrada, Fuenlabrada, 28942 Madrid, Spain
| |
Collapse
|
8
|
Motor adjustments during time-constrained sit-to-walk in people with Parkinson's disease. Exp Gerontol 2019; 124:110654. [DOI: 10.1016/j.exger.2019.110654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/30/2019] [Accepted: 07/05/2019] [Indexed: 11/22/2022]
|
9
|
Raccagni C, Nonnekes J, Bloem BR, Peball M, Boehme C, Seppi K, Wenning GK. Gait and postural disorders in parkinsonism: a clinical approach. J Neurol 2019; 267:3169-3176. [PMID: 31119450 PMCID: PMC7578144 DOI: 10.1007/s00415-019-09382-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/13/2019] [Accepted: 05/16/2019] [Indexed: 02/07/2023]
Abstract
Disturbances of balance, gait and posture are a hallmark of parkinsonian syndromes. Recognition of these axial features can provide important and often early clues to the nature of the underlying disorder, and, therefore, help to disentangle Parkinson’s disease from vascular parkinsonism and various forms of atypical parkinsonism, including multiple system atrophy, progressive supranuclear palsy, and corticobasal syndrome. Careful assessment of axial features is also essential for initiating appropriate treatment strategies and for documenting the outcome of such interventions. In this article, we provide an overview of balance, gait and postural impairment in parkinsonian disorders, focusing on differential diagnostic aspects.
Collapse
Affiliation(s)
- Cecilia Raccagni
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Jorik Nonnekes
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Marina Peball
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Christian Boehme
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Gregor K Wenning
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| |
Collapse
|
10
|
Kataoka H, Sugie K. Recent advancements in lateral trunk flexion in Parkinson disease. Neurol Clin Pract 2019; 9:74-82. [PMID: 30859010 DOI: 10.1212/cpj.0000000000000574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 09/13/2018] [Indexed: 11/15/2022]
Abstract
Purpose of review Understanding the pathophysiologic underpinnings of lateral trunk flexion (LTF) in Parkinson disease (PD) has been growing. Adjusting antiparkinsonian medications, botulinum toxin, or surgical intervention has been found efficacious in some patients. Nevertheless, these treatments remain limited, often resulting in inadequate outcomes. We review patients with LTF with PD, including recent advancements in treatment and neuroimaging examination. Recent findings The basal ganglia system is a major contributing factor to LTF, and the therapeutic intervention also targets the basal ganglia system, including dystonic contraction. The perceptions of the postural verticality or spatial cognition of the correct body orientation promote the severity of LTF or result in a chronic condition with irreversible structural deformities. Conclusion The combination of pharmacologic interventions with nonpharmacologic interventions, such as rehabilitation, might be needed to manage LTF, and the initiation of these treatments should be started as early as possible.
Collapse
Affiliation(s)
- Hiroshi Kataoka
- Department of Neurology, Nara Medical University, Nara Medical University, Kashihara, Nara, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University, Nara Medical University, Kashihara, Nara, Japan
| |
Collapse
|
11
|
Fietzek UM, Schroeteler FE, Hahn L, Ziegler K, Ceballos-Baumann AO. Body height loss characterizes camptocormia in Parkinson's disease. J Neural Transm (Vienna) 2018; 125:1473-1480. [PMID: 30083816 DOI: 10.1007/s00702-018-1912-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022]
Abstract
Axial deformities such as camptocormia or Pisa syndrome in people with Parkinson's disease (PwP) are poorly understood. The scarcity of information may result from the shortage of reliable and responsive evaluation instruments. We evaluated the body height loss (BHL) as a new measure for PwP with axial deformities. 50 PwP with axial deformity defined by an UPDRS item 28 value of at least 2 were included in this mono-center study. We measured body height while lying supine and after 1 min of standing, providing a percentage value of BHL, and compared this measure to other clinical variables. BHL depended on the Hoehn and Yahr clinical stage and correlated with clinical scales for function and mobility, but not with timely measures of the axial disorder such as age at diagnosis or duration of disease. ANOVA showed that only lumbar flexion explained the variability of BHL (F = 21.0, p < 0.0001), but not kyphosis (F = 0.4, p = 0.74) or lateroflexion (F = 0.6, p = 0.6). Re-test reliability of BHL was good with к = 0.76 (p < 0.0001). BHL resulted from the lumbar spine and the hip joint and not from the thoracic spine or lateroflexion. This observation conforms to the concept of upper-type and lower-type camptocormia with only the latter leading to a BHL. The assessment of the BHL is shown to be a well defined, easy to perform, and reliable measure for the clinical evaluation of lower-type camptocormia.
Collapse
Affiliation(s)
- Urban M Fietzek
- Department of Neurology and Clinical Neurophysiology, Centre for Parkinson's Disease and Movement Disorders, Schön Klinik München Schwabing, Parzivalplatz 4, 80804, Munich, Germany.
| | - Frauke E Schroeteler
- Department of Neurology and Clinical Neurophysiology, Centre for Parkinson's Disease and Movement Disorders, Schön Klinik München Schwabing, Parzivalplatz 4, 80804, Munich, Germany
| | - Lisa Hahn
- Department of Neurology and Clinical Neurophysiology, Centre for Parkinson's Disease and Movement Disorders, Schön Klinik München Schwabing, Parzivalplatz 4, 80804, Munich, Germany
| | - Kerstin Ziegler
- Department of Neurology and Clinical Neurophysiology, Centre for Parkinson's Disease and Movement Disorders, Schön Klinik München Schwabing, Parzivalplatz 4, 80804, Munich, Germany
| | - Andres O Ceballos-Baumann
- Department of Neurology and Clinical Neurophysiology, Centre for Parkinson's Disease and Movement Disorders, Schön Klinik München Schwabing, Parzivalplatz 4, 80804, Munich, Germany.,Department of Neurology, Klinikum Rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| |
Collapse
|
12
|
Ozturk EA, Kocer BG. Predictive risk factors for chronic low back pain in Parkinson’s disease. Clin Neurol Neurosurg 2018; 164:190-195. [DOI: 10.1016/j.clineuro.2017.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 10/09/2017] [Accepted: 12/09/2017] [Indexed: 01/01/2023]
|
13
|
González Rojas HA, Cuevas PC, Zayas Figueras EE, Foix SC, Sánchez Egea AJ. Time measurement characterization of stand-to-sit and sit-to-stand transitions by using a smartphone. Med Biol Eng Comput 2017; 56:879-888. [PMID: 29063366 DOI: 10.1007/s11517-017-1728-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 10/04/2017] [Indexed: 11/26/2022]
Abstract
The aim of this study is to analyze a common method to measure the acceleration of a daily activity pattern by using a smartphone. In this sense, a numerical approach is proposed to transform the relative acceleration signal, recorded by a triaxial accelerometer, into an acceleration referred to an inertial reference. The integration of this acceleration allows to determine the velocity and position with respect to an inertial reference. Two different kinematic parameters are suggested to characterize the profile of the velocity during the sit-to-stand and stand-to-sit transitions for Parkinson and control subjects. The results show that a dimensionless kinematic parameter, which is linked to the time of sit-to-stand and stand-to-sit transitions, has the potential to differentiate between Parkinson and control subjects.
Collapse
Affiliation(s)
- Hernán A González Rojas
- Department of Mechanical Engineering (EPSEVG), Universitat Politécnica de Catalunya, Av. de Víctor Balaguer 1, Vilanova i la Geltrú, 08800, Barcelona, Spain.
| | - Pedro Chaná Cuevas
- Centro de Trastornos del Movimiento (CETRAM), Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Belisario Prats, 1597 B, Independencia, Santiago, Chile
| | - Enrique E Zayas Figueras
- Department of Mechanical Engineering (ETSEIB), Universitat Politécnica de Catalunya, Av. Diagonal, 647, 08028, Barcelona, Spain
| | - Salvador Cardona Foix
- Department of Mechanical Engineering (ETSEIB), Universitat Politécnica de Catalunya, Av. Diagonal, 647, 08028, Barcelona, Spain
| | - Antonio J Sánchez Egea
- Department of Mechanical Engineering (EPSEVG), Universitat Politécnica de Catalunya, Av. de Víctor Balaguer 1, Vilanova i la Geltrú, 08800, Barcelona, Spain
| |
Collapse
|
14
|
Silva PFDS, Quintino LF, Franco J, Rodrigues-de-Paula F, Albuquerque de Araújo P, Faria CDCDM. Trunk kinematics related to generation and transfer of the trunk flexor momentum are associated with sit-to-stand performance in chronic stroke survivors. NeuroRehabilitation 2017; 40:57-67. [DOI: 10.3233/nre-161390] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
15
|
Tinazzi M, Geroin C, Gandolfi M, Smania N, Tamburin S, Morgante F, Fasano A. Pisa syndrome in Parkinson's disease: An integrated approach from pathophysiology to management. Mov Disord 2016; 31:1785-1795. [PMID: 27779784 DOI: 10.1002/mds.26829] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/09/2016] [Accepted: 09/11/2016] [Indexed: 12/26/2022] Open
Abstract
Pisa syndrome was first described in 1972 in patients treated with neuroleptics. Since 2003, when it was first reported in patients with Parkinson's disease (PD), Pisa syndrome has progressively drawn the attention of clinicians and researchers. Although emerging evidence has partially clarified its prevalence and pathophysiology, the current debate revolves around diagnostic criteria and assessment and the effectiveness of pharmacological, surgical, and rehabilitative approaches. Contrary to initial thought, Pisa syndrome is common among PD patients, with an estimated prevalence of 8.8% according to a large survey. Furthermore, it is associated with the following specific patient features: more severe motor phenotype, ongoing combined pharmacological treatment with levodopa and dopamine agonists, gait disorders, and such comorbidities as osteoporosis and arthrosis. The present literature on treatment outcomes is scant, and the uneven effectiveness of specific treatments has produced conflicting results. This might be because of the limited knowledge of Pisa syndrome pathophysiology and its variable clinical presentation, which further complicates designing randomized clinical trials on this condition. However, because some forms of Pisa syndrome are potentially reversible, there is growing consensus on the importance of its early recognition and the importance of pharmacological adjustment and rehabilitation. © 2016 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Christian Geroin
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Marialuisa Gandolfi
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Morgante
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alfonso Fasano
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, UHN, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto, Ontario, Canada
| |
Collapse
|
16
|
Artigas NR, Franco C, Leão P, Rieder CRM. Postural instability and falls are more frequent in Parkinson’s disease patients with worse trunk mobility. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:519-23. [DOI: 10.1590/0004-282x20160074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 04/06/2016] [Indexed: 11/21/2022]
Abstract
ABSTRACT Postural instability and axial rigidity are frequent symptoms of the Parkinson’s disease (PD). Objective Correlate the occurrence of falls and the activity of rolling over in bed with performance on the Trunk Mobility Scale (TMS) in patients with PD, and determine whether this instrument score can predict the risk of falls. Method This is a cross-sectional study. Assessed patients reported the frequency of falls in the previous year and whether they had difficulties rolling over in bed. Then, the following scales were applied: TMS, Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III and Schwab and England Activities of Daily Living. Results Eighty-five patients were analyzed. Patients with a history of falling showed worse performance in the TMS (p < 0.01). There is a significant correlation between TMS and the activity of rolling over in bed (p < 0.01). Conclusion PD fallers present worse scores in TMS, and there is a significant correlation between difficulty rolling over in bed and TMS score.
Collapse
Affiliation(s)
| | | | - Paula Leão
- Centro Universitário Metodista do IPA, Brasil
| | | |
Collapse
|
17
|
Hendershot BD, Wolf EJ. Persons with unilateral transfemoral amputation have altered lumbosacral kinetics during sitting and standing movements. Gait Posture 2015; 42:204-9. [PMID: 26050872 DOI: 10.1016/j.gaitpost.2015.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/30/2015] [Accepted: 05/18/2015] [Indexed: 02/02/2023]
Abstract
Increases in spinal loading have been related to altered movements of the lower back during gait among persons with lower limb amputation, movements which are self-perceived by these individuals as contributing factors in the development of low back pain. However, the relationships between altered trunk kinematics and associated changes in lumbosacral kinetics during sit-to-stand and stand-to-sit movements in this population have not yet been assessed. Three-dimensional lumbosacral kinetics (joint moments and powers) were compared between 9 persons with unilateral transfemoral amputation (wearing both a powered and passive knee device), and 9 uninjured controls, performing five consecutive sit-to-stand and stand-to-sit movements. During sit-to-stand movements, lumbosacral joint moments and powers were significantly larger among persons with transfemoral amputation relative to uninjured controls. During stand-to-sit movements, lumbosacral joint moments and powers were also significantly larger among persons with transfemoral amputation relative to uninjured controls, with the exception of sagittal joint powers. Minimal differences in kinetic measures were noted between the powered and passive knee devices among persons with transfemoral amputation across all conditions. Altered lumbosacral kinetics during sitting and standing movements, important activities of daily living, may play a biomechanical role in the onset and/or recurrence of low back pain or injury among persons with lower-limb amputation.
Collapse
Affiliation(s)
- Brad D Hendershot
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA; Department of Physical Medicine and Rehabilitation, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA.
| | - Erik J Wolf
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA; Department of Physical Medicine and Rehabilitation, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA; DOD/VA Extremity Trauma and Amputation Center of Excellence, JBSA-Fort Sam Houston, TX, USA
| |
Collapse
|
18
|
Frykberg GE, Häger CK. Movement analysis of sit-to-stand – research informing clinical practice. PHYSICAL THERAPY REVIEWS 2015. [DOI: 10.1179/1743288x15y.0000000005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
19
|
Asai H, Tsuchiyama H, Hatakeyama T, Inaoka PT, Murata K. Relationship between the ability to perform the sit-to-stand movement and the maximum pelvic anteversion and retroversion angles in patients with stroke. J Phys Ther Sci 2015; 27:985-8. [PMID: 25995538 PMCID: PMC4434029 DOI: 10.1589/jpts.27.985] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 11/28/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the relationship between the
ability to perform the sit-to-stand movement and the maximum pelvic anteversion and
retroversion angles of patients. [Subjects] Thirty-two stroke patients (66.7±7.6 years)
(>3 months post-stroke) who were able to sit unsupported and 50 age-matched healthy
subjects participated in this study. The stroke patients were classified into two groups
according to the sit-to-stand movement test: the group that was able to stand up (the
stand-able group) (18 persons) and the group that was unable to stand up (the stand-unable
group) (14 persons). [Methods] Pelvic anteversion and retroversion maximum angles were
measured by a manual goniometer attached to an inclinometer. [Results] The maximum pelvic
anteversion angles were −1.6 ± 5.0°, 1.2 ± 2.8°, and −12.4 ± 6.1° in the control group,
the stand-able stroke group, and the stand-unable stroke group, respectively. A
significant main effect of group was found. An angle discriminating between the two stroke
groups was found: the maximum anteversion angles in the stand-able group were distributed
above −5°. [Conclusion] The maximum pelvic anteversion angle was significantly smaller in
the stand-unable group than in the stand-able and control groups.
Collapse
Affiliation(s)
- Hitoshi Asai
- Department of Physical Therapy, Graduate Course of Rehabilitation Science, Kanazawa University, Japan
| | | | | | - Pleiades Tiharu Inaoka
- Department of Physical Therapy, Graduate Course of Rehabilitation Science, Kanazawa University, Japan
| | - Kanichirou Murata
- Department of Rehabilitation, Fukui College of Health Sciences, Japan
| |
Collapse
|
20
|
Early postural changes in individuals with idiopathic Parkinson's disease. PARKINSONS DISEASE 2015; 2015:369454. [PMID: 25922785 PMCID: PMC4397425 DOI: 10.1155/2015/369454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 03/15/2015] [Indexed: 11/17/2022]
Abstract
Background and Objectives. Postural changes are frequent and disabling complications of Parkinson's disease (PD). Many contributing factors have been evident either related to disease pathology or to adaptive changes. This study aimed at studying the postural changes in subjects with Parkinson's disease and its relation to duration of illness and disease severity. Methods. Eighteen patients with PD and 18 healthy matched volunteers represented the sample of the study. The patients were at stage 1 or 1.5 according to the Modified Hoehn and Yahr Staging with duration of illness between 18 and 36 months. Three-dimensional analysis of the back surface was conducted to explore the postural changes in the sagittal and frontal planes in both the patients and the healthy subjects. Results. Kyphotic angle, lordotic angle, fleche cervicale, fleche lombaire, scoliotic angle, and associated vertebral rotation and pelvic obliquity were significantly increased in patients with PD compared to the healthy subjects (P ≤ 0.05). There was no association between the measured postural changes and duration of illness as well as the severity of the IPD (P ≤ 0.05). Conclusion. Postural changes start in the early stages of idiopathic PD and they have no relationship to the duration of illness and disease severity.
Collapse
|
21
|
Mizrahi J. Mechanical Impedance and Its Relations to Motor Control, Limb Dynamics, and Motion Biomechanics. J Med Biol Eng 2015; 35:1-20. [PMID: 25750604 PMCID: PMC4342527 DOI: 10.1007/s40846-015-0016-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 08/28/2014] [Indexed: 11/27/2022]
Abstract
The concept of mechanical impedance represents the interactive relationship between deformation kinematics and the resulting dynamics in human joints or limbs. A major component of impedance, stiffness, is defined as the ratio between the force change to the displacement change and is strongly related to muscle activation. The set of impedance components, including effective mass, inertia, damping, and stiffness, is important in determining the performance of the many tasks assigned to the limbs and in counteracting undesired effects of applied loads and disturbances. Specifically for the upper limb, impedance enables controlling manual tasks and reaching motions. In the lower limb, impedance is responsible for the transmission and attenuation of impact forces in tasks of repulsive loadings. This review presents an updated account of the works on mechanical impedance and its relations with motor control, limb dynamics, and motion biomechanics. Basic questions related to the linearity and nonlinearity of impedance and to the factors that affect mechanical impedance are treated with relevance to upper and lower limb functions, joint performance, trunk stability, and seating under dynamic conditions. Methods for the derivation of mechanical impedance, both those for within the system and material-structural approaches, are reviewed. For system approaches, special attention is given to methods aimed at revealing the correct and sufficient degree of nonlinearity of impedance. This is particularly relevant in the design of spring-based artificial legs and robotic arms. Finally, due to the intricate relation between impedance and muscle activity, methods for the explicit expression of impedance of contractile tissue are reviewed.
Collapse
Affiliation(s)
- Joseph Mizrahi
- Department of Biomedical Engineering, Technion - Israel Institute of Technology, 32000 Haifa, Israel
| |
Collapse
|
22
|
Wang Z, Myers KG, Guo Y, Ocampo MA, Pang RD, Jakowec MW, Holschneider DP. Functional reorganization of motor and limbic circuits after exercise training in a rat model of bilateral parkinsonism. PLoS One 2013; 8:e80058. [PMID: 24278239 PMCID: PMC3836982 DOI: 10.1371/journal.pone.0080058] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 10/09/2013] [Indexed: 01/30/2023] Open
Abstract
Exercise training is widely used for neurorehabilitation of Parkinson's disease (PD). However, little is known about the functional reorganization of the injured brain after long-term aerobic exercise. We examined the effects of 4 weeks of forced running wheel exercise in a rat model of dopaminergic deafferentation (bilateral, dorsal striatal 6-hydroxydopamine lesions). One week after training, cerebral perfusion was mapped during treadmill walking or at rest using [(14)C]-iodoantipyrine autoradiography. Regional cerebral blood flow-related tissue radioactivity (rCBF) was analyzed in three-dimensionally reconstructed brains by statistical parametric mapping. In non-exercised rats, lesions resulted in persistent motor deficits. Compared to sham-lesioned rats, lesioned rats showed altered functional brain activation during walking, including: 1. hypoactivation of the striatum and motor cortex; 2. hyperactivation of non-lesioned areas in the basal ganglia-thalamocortical circuit; 3. functional recruitment of the red nucleus, superior colliculus and somatosensory cortex; 4. hyperactivation of the ventrolateral thalamus, cerebellar vermis and deep nuclei, suggesting recruitment of the cerebellar-thalamocortical circuit; 5. hyperactivation of limbic areas (amygdala, hippocampus, ventral striatum, septum, raphe, insula). These findings show remarkable similarities to imaging findings reported in PD patients. Exercise progressively improved motor deficits in lesioned rats, while increasing activation in dorsal striatum and rostral secondary motor cortex, attenuating a hyperemia of the zona incerta and eliciting a functional reorganization of regions participating in the cerebellar-thalamocortical circuit. Both lesions and exercise increased activation in mesolimbic areas (amygdala, hippocampus, ventral striatum, laterodorsal tegmental n., ventral pallidum), as well as in related paralimbic regions (septum, raphe, insula). Exercise, but not lesioning, resulted in decreases in rCBF in the medial prefrontal cortex (cingulate, prelimbic, infralimbic). Our results in this PD rat model uniquely highlight the breadth of functional reorganizations in motor and limbic circuits following lesion and long-term, aerobic exercise, and provide a framework for understanding the neural substrates underlying exercise-based neurorehabilitation.
Collapse
Affiliation(s)
- Zhuo Wang
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Kalisa G. Myers
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Yumei Guo
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Marco A. Ocampo
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Raina D. Pang
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Michael W. Jakowec
- Department of Neurology, University of Southern California, Los Angeles, California, United States of America
| | - Daniel P. Holschneider
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, United States of America
- Department of Neurology, University of Southern California, Los Angeles, California, United States of America
- Department of Cell and Neurobiology, University of Southern California, Los Angeles, California, United States of America
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, United States of America
- * E-mail:
| |
Collapse
|
23
|
The PIT: SToPP Trial-A Feasibility Randomised Controlled Trial of Home-Based Physiotherapy for People with Parkinson's Disease Using Video-Based Measures to Preserve Assessor Blinding. PARKINSONS DISEASE 2011; 2012:360231. [PMID: 22046578 PMCID: PMC3199203 DOI: 10.1155/2012/360231] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 08/22/2011] [Indexed: 11/25/2022]
Abstract
Purpose. To trial four-week's physiotherapy targeting chair transfers for people with Parkinson's disease (PwPD) and explore the feasibility of reliance on remote outcome measurement to preserve blinding. Scope. We recruited 47 PwPD and randomised 24 to a focused home physiotherapy programme (exercise, movement strategies, and cueing) and 23 to a control group. We evaluated transfers (plus mobility, balance, posture, and quality of life) before and after treatment and at followup (weeks 0, 4, 8, and 12) from video produced by, and questionnaires distributed by, treating physiotherapists. Participants fed back via end-of-study questionnaires. Thirty-five participants (74%) completed the trial. Excluding dropouts, 20% of questionnaire data and 9% of video data were missing or unusable; we had to evaluate balance in situ. We noted trends to improvement in transfers, mobility, and balance in the physiotherapy group not noted in the control group. Participant feedback was largely positive and assessor blinding was maintained in every case. Conclusions. Intense, focused physiotherapy at home appears acceptable and likely to bring positive change in those who can participate. Remote outcome measurement was successful; questionnaire followup and further training in video production would reduce missing data. We advocate a fully powered trial, designed to minimise dropouts and preserve assessor blinding, to evaluate this intervention.
Collapse
|
24
|
|
25
|
Fritz B, Rombach S, Godau J, Berg D, Horstmann T, Grau S. The influence of Nordic Walking training on sit-to-stand transfer in Parkinson patients. Gait Posture 2011; 34:234-8. [PMID: 21640591 DOI: 10.1016/j.gaitpost.2011.05.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 04/19/2011] [Accepted: 05/07/2011] [Indexed: 02/02/2023]
Abstract
Neurodegenerative processes in Parkinson's disease (PD) particularly affect activities of daily living (ADL). Problems of patients with PD in sit-to-stand (STS) performance have been verified before, but not the effects of training on biomechanical measures of STS function. This pilot study aimed to analyse effects of 12 weeks of Nordic Walking training and severity of PD: healthy controls (CO), least (UPDRS A) and more severe (UPDRS B) affected PA on selected functional outcome measures. We expected improvements in PD similar to CO, with better performance of the unstable second phase and faster execution of the entire movement with higher velocities of centre of gravity (COG). 3D kinematics of 22 PD and 18 CO subjects before and after training, were recorded using a motion analysis system (Vicon, Oxford). We compared five outcome measures for STS in 11 PD and 11 CO, matched according to age, gender, height, and weight. Effects of Nordic Walking training were not statistically significant but indicated different patterns which depended on the values of patient's UPDRS score (part III, motor functions). Time required for STS performance increased and horizontal and vertical velocity of COG decreased in UPDRS B, which could be due to progression of PD during the training period. In contrast, UPDRS A showed similar effects as CO. The effects of Nordic Walking as an easy, economic and low-risk intervention on STS in PD depend on the degree of PD. Our findings may help scientists, patients, and therapists to adjust sport-physiological interventions.
Collapse
Affiliation(s)
- B Fritz
- Medical Clinic, Department of Sports Medicine, University of Tuebingen, Silcherstrasse 5, 72076 Tuebingen, Germany.
| | | | | | | | | | | |
Collapse
|
26
|
Zackrisson T, Holmberg B, Johnels B, Thorlin T. A new automated implementation of the Posturo-Locomotion-Manual (PLM) method for movement analysis in patients with parkinson's disease. Acta Neurol Scand 2011; 123:274-9. [PMID: 20880298 DOI: 10.1111/j.1600-0404.2010.01415.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The Posturo-Locomotion-Manual (PLM) test, which uses an optoelectronic laboratory system, has here been further developed into an automated, more user-friendly, standardized tool for movement analysis named the QbTestMotus. This paper compares the accuracy of QbTestMotus to the PLM test, in particular the automated data analysis. METHODS Both QbTestMotus and the PLM recorded data simultaneously from the same 61 patients. The correlation coefficients of movement time (MT), postural time (P), locomotion time (L), and manual time (M) were calculated between the systems. The absolute differences between the result parameters for each patient were also studied. Finally, the differences in MT between the systems were compared with the positive responses in the levodopa (L-dopa) challenges as measured in the PLM test for 11 patients. RESULTS The comparisons in all the 61 patients showed high correlation coefficients for all four parameters. The absolute differences between the parameters were small and had small standard deviations, and the decreases in MT because of L-dopa in the positive L-dopa responders were much larger than the absolute difference between the systems. CONCLUSION The PLM test and QbTestMotus are equivalent along all parameters, thus indicating that the test quality is equivalent between the PLM test and the automated QbTestMotus system.
Collapse
Affiliation(s)
- T Zackrisson
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Gothenburg, Sweden.
| | | | | | | |
Collapse
|
27
|
Guzmán RA, Porcel Melián H, Cordier B, Adul Silvestre R. [Differences in biomechanical parameters during sit to stand transfer between elderly with and without history of frequent falls]. Rev Esp Geriatr Gerontol 2010; 45:267-273. [PMID: 20650548 DOI: 10.1016/j.regg.2010.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 05/06/2010] [Accepted: 05/10/2010] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The phenomenon of frequent falls (FF) is a health problem in the older population, and is a reason why tools need to be designed for the objective assessment of the risk of FF. In this sense the use of biomechanical parameters could be of use in designing these. The aim of this work was to describe the biomechanical differences registered during a sit to stand transfer (STS) between subjects with and without a history of frequent falls. MATERIAL AND METHOD A sample of sixty voluntary older adults were assessed, divided in two groups of thirty subjects. The first group was composed of older adults without history of frequent falls (WoHFF) and the other group with history of frequent falls (WHFF). In both groups the velocity of the mass centre, the anterior flexion of the trunk, the joint and support moments of the lower extremity and the time of execution during the TSB was assessed. RESULTS The subjects WHFF generate a slower vertical velocity (P<0.001), lower slope (P<0.001), greater anterior trunk flexion (P<0.0001), lower support moment (P=0.001) and took longer in executing the STS (P=0.0001) than the group WoHFF. CONCLUSIONS Differences exist in the biomechanical parameters registered during the STS between the elderly WHFF and WoHFF. The results indicate that the function of the hip extensor muscles could have an important role in the execution of the STS in subjects WHFF. The biomechanical parameters assessed during the STS should be considered as useful tools to distinguish between subjects WHFF and WoHFF, and should be considered in the design of tools to determine the risk of frequent falls.
Collapse
Affiliation(s)
- Rodrigo Antonio Guzmán
- Centro de Estudios del Movimiento Humano, Escuela de Kinesiología, Facultad de Medicina, Universidad Mayor, Santiago, Chile.
| | | | | | | |
Collapse
|
28
|
Can an accelerometer enhance the utility of the Timed Up & Go Test when evaluating patients with Parkinson's disease? Med Eng Phys 2009; 32:119-25. [PMID: 19942472 DOI: 10.1016/j.medengphy.2009.10.015] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 08/17/2009] [Accepted: 10/26/2009] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The Timed Up and Go (TUG) test is a widely used measure of mobility and fall risk in older adults and in Parkinson's disease (PD). We tested the hypothesis that body-fixed accelerometers can provide insight into TUG performance in PD patients. METHODS We examined 17 patients with PD (Hoehn and Yahr score: 2.7+/-0.7; ON state) and 15 age-matched healthy controls; mean ages were 66.8+/-5.9 years, 67.6+/-9.6 years, respectively. Subjects wore a 3D-accelerometer (ADXL330, Analog Devices) on the lower back while performing the TUG test. Sit-to-Stand and Stand-to-Sit times were extracted from the anterior-posterior (AP) signal. Parameters included Sit-to-Stand, Stand-to-Sit durations, amplitude range (Range) and slopes (Jerk). Acceleration median and standard deviation (SD) were also calculated. RESULTS Stopwatch-based TUG duration tended to be higher for the PD patients compared to the control group, although not significantly (p=0.08). In contrast, the TUG duration that was extracted from the acceleration signal was significantly (p<0.02) higher in the PD group compared to the control group. Many acceleration-parameters were also significantly different (p<0.05) between groups; most were not correlated with TUG duration. CONCLUSIONS Accelerometer-derived parameters are sensitive to group differences, indicating that PD patients have poorer mobility during specific aspects of the TUG. In addition to test duration, these measures may serve as complementary and objective bio-markers of PD to augment the evaluation of disease progression and the response to therapeutic interventions.
Collapse
|
29
|
Guzmán RA, Prado HE, Porcel Melián H, Cordier B. [Differences in momentum development when standing up from a chair between elderly with and without frequent falls history]. Rev Esp Geriatr Gerontol 2009; 44:200-204. [PMID: 19573951 DOI: 10.1016/j.regg.2009.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Revised: 11/27/2008] [Accepted: 02/09/2009] [Indexed: 05/28/2023]
Abstract
INTRODUCTION The momentum of the upper body (UB) during transfer sit-to-stand (STS) could be sensitive to the deterioration of dynamic postural control, and also the risk of falls. The aim of this study is to quantify the differences in the momentum development on UB during the STS in a sample of fall and no-fall elderly subjects. MATERIAL AND MEHODS: The sample consisted of twenty three voluntary elderly subjects (n=23), six elderly adults with antecedents of frequent falls (more than two within a year period) and seventeen without histories of frequent falls. Through a motion analysis system we registered the kinematics of UB during STS, from which we calculated the momentum of UB. The determined analysis variables were: the maximum values of the vertical (P(V)M) and horizontal (P(H)M) lineal momenta, the minimum (L(Max)) and maximum (L(Min)) values of the angular momentum and maximum trunk flexion (thetaM(UB)). RESULTS No difference was observed in P(H)M, L(Max) and L(Min) (P>0.05) between both groups. However, a significant difference was found for the variable P(V)M (P=0.03) and thetaM(UB) (P=0.03) between both groups. CONCLUSIONS We can conclude that, for the sample studied, the frequent fall condition relates to a smaller capacity to develop vertical momentum and increase flexion of the upper body.
Collapse
|
30
|
Buckley TA, Pitsikoulis C, Hass CJ. Dynamic postural stability during sit-to-walk transitions in Parkinson disease patients. Mov Disord 2008; 23:1274-80. [DOI: 10.1002/mds.22079] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
31
|
Gilleard W, Crosbie J, Smith R. Rising to stand from a chair: symmetry, and frontal and transverse plane kinematics and kinetics. Gait Posture 2008; 27:8-15. [PMID: 17166719 DOI: 10.1016/j.gaitpost.2006.11.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2004] [Revised: 09/13/2006] [Accepted: 10/24/2006] [Indexed: 02/02/2023]
Abstract
Although literature in relation to rising to stand from a chair is extensive, there is limited information on symmetry and motion in the frontal and transverse planes. Ground reaction forces (GRF), lower limb angular displacements and moments, and the thoracolumbar and cervicothoracic spine regions angular displacements around the vertical and antero-posterior axes (respectively, the transverse and frontal planes) were investigated in 12 females. Right to left symmetry and the trial-to-trial consistency of all variables was also investigated. Able-bodied participants demonstrated frontal and transverse plane displacement and moments in the lower limbs and the trunk, and mediolateral GRFs, during rising to stand from a chair. The results of this study also support the concept of a consistent individual strategy for frontal plane motion during rising to stand and highlight the strategies used to maintain side-to-side stability during the motion. The potential importance of this was reflected in the similar magnitudes of the GRFs required to stabilise the median plane orientation of the centre of mass and that required for the forward propulsion of the body. Asymmetrical net applied moments support the concept of side dominance in components of apparently symmetrical motor tasks.
Collapse
Affiliation(s)
- Wendy Gilleard
- Department of Exercise Science and Sport Management, Southern Cross University, Lismore, NSW, Australia.
| | | | | |
Collapse
|
32
|
Tully EA, Fotoohabadi MR, Galea MP. Sagittal spine and lower limb movement during sit-to-stand in healthy young subjects. Gait Posture 2005; 22:338-45. [PMID: 16274916 DOI: 10.1016/j.gaitpost.2004.11.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2004] [Revised: 07/22/2004] [Accepted: 11/19/2004] [Indexed: 02/02/2023]
Abstract
This study aimed to determine the sagittal movement relationships between thoracic, lumbar spine and hip joints during sit-to-stand (STS). Forty-seven healthy young adults were videotaped performing STS at their preferred speed from a chair set at 100% knee height. Forward trunk lean prior to buttock lift-off (LO) was accomplished by concurrent lumbar and hip flexion (1:3). As the lumbar spine flexed the thoracic spine extended, resulting in a LO trunk angle of 45.7 degrees (+/-5.8 degrees ) with respect to a horizontal reference. Following LO, the hip(s) and lumbar spine extended and the thoracic spine flexed, with the standing thoracic angle approximating the initial thoracic posture in sitting.
Collapse
Affiliation(s)
- Elizabeth A Tully
- School of Physiotherapy, The University of Melbourne, Parkville, Vic. 3010, Australia.
| | | | | |
Collapse
|
33
|
Vrancken AMPM, Allum JHJ, Peller M, Visser JE, Esselink RAJ, Speelman JD, Siebner HR, Bloem BR. Effect of bilateral subthalamic nucleus stimulation on balance and finger control in Parkinson's disease. J Neurol 2005; 252:1487-94. [PMID: 16021354 DOI: 10.1007/s00415-005-0896-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2005] [Revised: 03/20/2005] [Accepted: 04/08/2005] [Indexed: 10/25/2022]
Abstract
We aimed to quantify the effects of bilateral subthalamic nucleus (STN) stimulation in Parkinson's disease (PD) on stance and gait ("axial"motor control), and related this to effects on finger movements ("appendicular" motor control). Fourteen PD patients and 20 matched controls participated. Subjects completed several balance and gait tasks (standing with eyes open or closed, on a normal or foam surface; retropulsion test; walking with eyes closed; walking up and down stairs; Get Up and Go test). Postural control was quantified using trunk sway measurements (angle and angular velocity) in the roll and pitch directions. Subjects further performed a pinch grip reaction time task, where we measured isometric grip forces, as well as movement and reaction times. Patients were examined with STN stimulators switched on or off (order randomised across patients), always after a supramaximal levodopa dosage. STN stimulation improved postural control, as reflected by a reduced trunk sway tremor during stance, a reduced duration for all gait tasks, an increased trunk pitch velocity while rising from a chair, and improved roll stability. STN stimulation also improved finger control, as reflected by a reduced time to reach maximum grip force, without altering reaction times and maximum force levels. Improvements in finger control timing did not correlate with reduced task durations during gait. We conclude that STN stimulation affords improvement of postural control in PD, over and above optimal drug treatment. STN stimulation also provides a simultaneous effect on distal and axial motor control. Because improvements in distal and axial motor control were not correlated, we assume that these effects are mediated by stimulation of different structures within the STN.
Collapse
|
34
|
Mak MKY, Hui-Chan CWY. The speed of sit-to-stand can be modulated in Parkinson's disease. Clin Neurophysiol 2005; 116:780-9. [PMID: 15792887 DOI: 10.1016/j.clinph.2004.12.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2004] [Revised: 11/03/2004] [Accepted: 12/09/2004] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate whether Parkinsonian patients could modify the speed of a sit-to-stand (STS) task to the same extent as that of healthy subjects. METHODS Twenty Parkinsonian patients and 20 control subjects were instructed to stand up at a natural and fast speed. Kinematic data and kinetic data were recorded. RESULTS Parkinsonian patients were significantly slower than healthy individuals during STS at a natural speed. When required to perform STS task at a fast speed, these patients could increase both peak horizontal and vertical velocities of the task, by significantly increasing hip and ankle dorsiflexion torques and the rate of torque production, just as the control subjects did. In fact, no difference was found for the percentage changes in both peak velocities and movement time between the two groups, though similar between-group differences during STS at a natural speed still existed at a fast speed. CONCLUSIONS Parkinsonian patients had problems in generating adequate lower limb joint torques and in the rate of torque production when performing STS at a natural speed. However, these patients were capable of increasing the speed of their STS with the same percentage changes as those of healthy subjects. SIGNIFICANCE The capability of Parkinsonian patients for increasing movement speed gives new insights to rehabilitation strategy.
Collapse
Affiliation(s)
- Margaret K Y Mak
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | | |
Collapse
|
35
|
Mathiyakom W, McNitt-Gray JL, Requejo P, Costa K. Modifying center of mass trajectory during sit-to-stand tasks redistributes the mechanical demand across the lower extremity joints. Clin Biomech (Bristol, Avon) 2005; 20:105-11. [PMID: 15567544 DOI: 10.1016/j.clinbiomech.2004.08.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2004] [Accepted: 08/26/2004] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Sit-to-stand tasks are commonly facilitated by modifying the initial position of the center of mass relative to the feet. It was hypothesized that modifications in the center of mass trajectory during sit-to-stand tasks altered the total body momentum at seat departure and redistributed the lower extremity net joint moments. DESIGN Between-task within-subject comparison was employed using a robust statistical method to accommodate for small sample size. METHODS Six individuals performed four sit-to-stand tasks with systematic modifications in the initial center of mass position by varying the orientation of the lower extremity segments. The momentum of the center of mass and lower extremity net joint moments were quantified and compared. RESULTS Reducing the horizontal center of mass displacement significantly reduced horizontal total body momentum required at seat departure. Sit-to-stand tasks initiated with more horizontal shank and thigh positions required significantly greater knee and hip extensor net joint moments than those with more vertical shank and thigh positions. Sit-to-stand tasks initiated with vertical shank positions also required significantly greater hip extensor net joint moments as compared to those with more horizontal shank orientations. INTERPRETATION When changes in initial center of mass position are made, alteration in center of mass horizontal momentum and the orientation of the lower extremity segments relative to the reaction force are observed. Consequently, mechanical demand imposed on the ankle, knee, and hip joint is redistributed. The magnitude of the net joint moments is dependent on the segment orientation, the reaction force, and the adjacent net joint moment.
Collapse
Affiliation(s)
- W Mathiyakom
- Biomechanics Research Laboratory, Department of Kinesiology, University of Southern California, 3560 Watt Way, PED 107, Los Angeles, CA 90089-0650, USA
| | | | | | | |
Collapse
|
36
|
Hoff JI, van der Meer V, van Hilten JJ. Accuracy of Objective Ambulatory Accelerometry in Detecting Motor Complications in Patients With Parkinson Disease. Clin Neuropharmacol 2004; 27:53-7. [PMID: 15252264 DOI: 10.1097/00002826-200403000-00002] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Shortcomings of existing assessment methods in Parkinson disease (PD) have led to the development of continuous ambulatory multichannel accelerometry for the assessment of the core features of PD. Although measures for hypokinesia, bradykinesia, and tremor have been validated in groups of patients with PD, it is unclear whether this method is able to detect "on" with or without dyskinesias, and "off" in individual PD patients. This study therefore addressed the accuracy of objective ambulatory accelerometry in detecting motor complications in 15 PD patients, using a self-assessment scale as gold standard. Measures for hypokinesia, bradykinesia, and tremor showed limited sensitivity (0.60-0.71) and specificity (0.66-0.76) for motor complications in individual PD patients. In the group of PD patients, comparing the "on" with the "off" state yielded statistically significant differences for tremor only. Objective dyskinesia measures correlated with time spent with dyskinesias (r = 0.89). Although validated for the measurement of hypokinesia, bradykinesia, and tremor, continuous ambulatory multichannel accelerometry currently cannot detect "on" and "off" in individual PD patients.
Collapse
Affiliation(s)
- J I Hoff
- Department of Neurology, Leiden University Medical Center, The Netherlands
| | | | | |
Collapse
|
37
|
Mak MKY, Levin O, Mizrahi J, Hui-Chan CWY. Joint torques during sit-to-stand in healthy subjects and people with Parkinson's disease. Clin Biomech (Bristol, Avon) 2003; 18:197-206. [PMID: 12620782 DOI: 10.1016/s0268-0033(02)00191-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To compare lower limb joint torques during sit-to-stand in normal elderly subjects and people with Parkinson's disease, using a developed biomechanical model simulating all phases of sit-to-stand.Design. A cross-sectional study utilizing a Parkinsonian and a control group. BACKGROUND Subjects with Parkinson's disease were observed to experience difficulty in performing sit-to-stand. The developed model was used to calculate the lower limb joint torques in normal elderly subjects and subjects with Parkinson's disease, to delineate possible causes underlying difficulties in initiating sit-to-stand task. METHODS Six normal elderly subjects and seven age-matched subjects with Parkinson's disease performed five sit-to-stand trials at their self-selected speed. Anthropometric data, two-dimensional kinematic and foot-ground and thigh-chair reactive forces were used to calculate, via inverse dynamics, the joint torques during sit-to-stand in both before and after seat-off phases. The difference between the control and Parkinson's disease group was analysed using independent t-tests. RESULTS Both control and Parkinson's disease groups had a similar joint kinematic pattern, although the Parkinson's disease group demonstrated a slower angular displacement. The latter subjects produced significantly smaller normalized hip flexion torque and presented a slower torque build-up rate than the able-bodied subjects (P<0.05). CONCLUSION Slowness of sit-to-stand in people with Parkinson's disease could be due to a reduced hip flexion joint torque and a prolonged rate of torque production.
Collapse
Affiliation(s)
- Margaret K Y Mak
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | | | | | | |
Collapse
|