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do Amaral CMS, de Almeida SB, de Almeida RP, do Nascimento SL, Ribeiro RM, Braga-Neto P. Effectiveness of vestibular rehabilitation on postural balance in Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials. BMC Neurol 2024; 24:161. [PMID: 38745275 PMCID: PMC11092171 DOI: 10.1186/s12883-024-03649-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 04/22/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Postural balance impairment can affect the quality of life of patients with Parkinson's disease. Previous studies have described connections of the vestibular system with postural functions, suggesting a potential participation of the basal ganglia in receiving vestibular stimuli. This systematic review aims to summarize the evidence on the effectiveness of vestibular rehabilitation on postural balance in patients with Parkinson's disease. METHODS A systematic review was conducted using the electronic databases: PubMed, Embase, Scopus and PEDro. The study selection was independently conducted by two reviewers, and disagreements were evaluated by a third reviewer. The included studies had no restrictions on publication dates or languages and the last update occurred in July 2023. RESULTS From the 485 studies found in the searches, only 3 studies were deemed eligible for the systematic review involving a total of 130 participants. The Berg Balance Scale was described as the tool for evaluation of postural balance in all studies. The meta-analysis showed statistically significant results in favor of vestibular rehabilitation (MD = 5.35; 95% CI = 2.39, 8.31; P < 0.001), regardless of the stage of Parkinson's disease. Although the effect size was suggested as a useful functional gain, the analysis was done with caution, as it only included 3 randomized controlled trials. The risk of bias using the RoB-2 was considered as being of "some concern" in all studies. Furthermore, the quality of the evidence based on the Grading of Recommendations Assessment Development and Evaluation system, produced by pooling the included studies was considered very low. CONCLUSION Compared to other interventions, vestibular rehabilitation has potential to assist the postural balance of patients with Parkinson's disease. However, the very low quality of the evidence demonstrates uncertainty about the impact of this clinical practice. More robust studies are needed to confirm the benefits of this therapy in patients with Parkinson's disease. This study was prospectively registered in PROSPERO: CRD42020210185.
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Affiliation(s)
- Carla Marineli Saraiva do Amaral
- Division of Neurology, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Rodolfo Teófilo - Fortaleza - Ceará, R.Prof. Costa Mendes Street - 4th floor, Fortaleza, 1608, Brazil
| | - Samuel Brito de Almeida
- Division of Neurology, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Rodolfo Teófilo - Fortaleza - Ceará, R.Prof. Costa Mendes Street - 4th floor, Fortaleza, 1608, Brazil
| | - Renata Parente de Almeida
- Department of Health Sciences, Faculty of Phonoaudiology, University of Fortaleza, Fortaleza, Brazil
| | | | - Rodrigo Mariano Ribeiro
- Division of Neurology, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Rodolfo Teófilo - Fortaleza - Ceará, R.Prof. Costa Mendes Street - 4th floor, Fortaleza, 1608, Brazil
| | - Pedro Braga-Neto
- Division of Neurology, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Rodolfo Teófilo - Fortaleza - Ceará, R.Prof. Costa Mendes Street - 4th floor, Fortaleza, 1608, Brazil.
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Milne SC, Roberts M, Ross HL, Robinson A, Grove K, Modderman G, Williams S, Chua J, Grootendorst AC, Massey L, Szmulewicz DJ, Delatycki MB, Corben LA. Interrater Reliability of the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, and Functional Independence Measure Motor Domain in Individuals With Hereditary Cerebellar Ataxia. Arch Phys Med Rehabil 2023; 104:1646-1651. [PMID: 37268274 DOI: 10.1016/j.apmr.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/02/2023] [Accepted: 05/06/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To determine the interrater reliability of the Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Scale (BBS), and motor domain of the FIM (m-FIM) administered by physiotherapists in individuals with a hereditary cerebellar ataxia (HCA). DESIGN Participants were assessed by 1 of 4 physiotherapists. Assessments were video-recorded and the remaining 3 physiotherapists scored the scales for each participant. Raters were blinded to each other's scores. SETTING Assessments were administered at 3 clinical locations in separate states in Australia. PARTICIPANTS Twenty-one individuals (mean age=47.63 years; SD=18.42; 13 male and 8 female) living in the community with an HCA were recruited (N=21). MAIN OUTCOME MEASURES Total and single-item scores of the SARA, BBS, and m-FIM were examined. The m-FIM was conducted by interview. RESULTS Intraclass coefficients (2,1) for the total scores of the m-FIM (0.92; 95% confidence interval [CI], 0.85-0.96), SARA (0.92; 95% CI, 0.86-0.96), and BBS (0.99; 95% CI, 0.98-0.99) indicated excellent interrater reliability. However, there was inconsistent agreement with the individual items, with SARA item 5 (right side) and item 7 (both sides) demonstrating poor interrater reliability and items 1 and 2 demonstrating excellent reliability. CONCLUSIONS The m-FIM (by interview), SARA, and BBS have excellent interrater reliability for use when assessing individuals with an HCA. Physiotherapists could be considered for administration of the SARA in clinical trials. However, further work is required to improve the agreement of the single-item scores and to examine the other psychometric properties of these scales.
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Affiliation(s)
- Sarah C Milne
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia; Physiotherapy Department, Monash Health, Cheltenham, Australia; School of Primary and Allied Health Care, Monash University, Frankston, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Australia.
| | - Melissa Roberts
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia; Physiotherapy Department, Monash Health, Cheltenham, Australia
| | - Hannah L Ross
- Physiotherapy Department, Monash Health, Cheltenham, Australia
| | | | - Kristen Grove
- Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, Australia; Physiotherapy Department, Royal Perth Hospital, Perth, Australia
| | - Gabrielle Modderman
- Rehabilitation Services, Royal Darwin and Palmerston Regional Hospital, Darwin, Australia
| | - Shannon Williams
- Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, Australia; Physiotherapy Department, Royal Perth Hospital, Perth, Australia
| | | | | | - Libby Massey
- MJD Foundation, Darwin, Australia; College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - David J Szmulewicz
- Balance Disorders & Ataxia Service, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Monash Medical Centre, Monash Health, Clayton, Australia; The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - Martin B Delatycki
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Australia; Victorian Clinical Genetics Services, Melbourne, Australia
| | - Louise A Corben
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Australia; Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
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Kashif M, Ahmad A, Bandpei MAM, Gilani SA, Iram H, Farooq M. Psychometric Properties of the Urdu Translation of Berg Balance Scale in People with Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042346. [PMID: 35206533 PMCID: PMC8872175 DOI: 10.3390/ijerph19042346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
Background: The most common assessment tool used in clinical settings to detect changes in balance performance is the Berg Balance Scale (BBS). Thus, the purpose of this study was to translate the BBS into Urdu and investigate the psychometric properties (acceptability, internal consistency reliability, interrater reliability, construct validity) for individuals with Parkinson’s disease (PD). Methods: Eighty patients of either gender with idiopathic Parkinson’s disease, stages I–III on the modified Hoehn–Yahr (H&Y) scale, with intact cognition according to the Mini Mental Score Examination (MMSE) score (greater than or equal to 24) and independent of transfers, were included in this study. The BBS was translated according to international guidelines based on forward and backward translation processes. The test-retest reliability as well as intra- and inter-observer reliability was assessed by calculating the intra-class correlation coefficient (ICC). The internal consistency of the entire BBS score was assessed by calculating Cronbach’s α. The convergent validity was assessed by correlating the scale with the Unified Parkinson Disease Rating Scale (UPDRS) parts II and III and the Activity-specific Balance Confidence Scale (ABCS). The construct validity was assessed using a factor analysis. Results: The mean age of the subjects was 62.35 ± 5.74 in years (range: 60–87 years). The ICC for intra- and inter-observer reliability was 0.95 (p < 0.0001) and 0.99 (p < 0.001), respectively. Cronbach’s α was calculated as 0.81, which showed acceptable internal consistency of the Urdu version of the BBS. The test-retest reliability (ICC) of the Urdu version of the BBS was determined as 0.97 for the total score, and ranged from 0.66–0.95 for individual items. In terms of validity, the Urdu version of the BBS was correlated with the ABCS (in the positive direction) and UPDRS-II and III (in the negative direction) (r = 0.53, p < 0.001; r = −0.68, p < 0.001, r = −0.78, p < 0.0001), respectively. Conclusion: The Urdu version of the BBS is a reliable and valid scale to be used in balance assessment of population diagnosed with PD with excellent psychometric properties.
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Affiliation(s)
- Muhammad Kashif
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore 42000, Pakistan; (M.A.M.B.); (S.A.G.)
- Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Faisalabad 38000, Pakistan; (H.I.); (M.F.)
- Correspondence: (M.K.); (A.A.)
| | - Ashfaq Ahmad
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore 42000, Pakistan; (M.A.M.B.); (S.A.G.)
- Correspondence: (M.K.); (A.A.)
| | - Muhammad Ali Mohseni Bandpei
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore 42000, Pakistan; (M.A.M.B.); (S.A.G.)
| | - Syed Amir Gilani
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore 42000, Pakistan; (M.A.M.B.); (S.A.G.)
| | - Humaira Iram
- Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Faisalabad 38000, Pakistan; (H.I.); (M.F.)
| | - Maryam Farooq
- Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Faisalabad 38000, Pakistan; (H.I.); (M.F.)
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Adams RB, Dudley JT, Struessel TS. Physical therapy to address fall risk in an individual with neurofibromatosis. Physiother Theory Pract 2021; 38:1823-1831. [PMID: 33497265 DOI: 10.1080/09593985.2021.1875523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: While physical therapy may help improve function and quality of life in patients with neurofibromatosis (NF), a standard of care remains to be established. This case report describes the physical therapy management of an individual with NF who was at high fall risk.Case Description: A 61-year-old male with NF and multiple comorbidities was determined to be at high fall risk by the Dynamic Gait Index, Berg Balance Scale, and Modified Falls Efficacy Scale. Deficits included coordination and strength which limited his ability to ascend and descend stairs or walk on uneven terrain. This reduced his independence at home and in his rural community. Interventions incorporated components of hip and trunk coordination, and addressed balance, strength, and functional mobility.Outcomes: The patient scored above the cutoff for high fall risk on all outcome assessments.Discussion: This case report describes physical therapy management to reduce fall risk for an individual with NF. Due to the limited research on NF, the treatment plan was developed using evidence-based practice for fall-risk reduction in other neurological disorders.
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Affiliation(s)
- Robert B Adams
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Justin T Dudley
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Cascade Sports Injury Prevention & Physical Therapy, Lakewood, CO, USA
| | - Tamara S Struessel
- Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Dominguez-Olivan P, Gasch-Gallen A, Aguas-Garcia E, Bengoetxea A. Validity and reliability testing of the Spanish version of the BESTest and mini-BESTest in healthy community-dwelling elderly. BMC Geriatr 2020; 20:444. [PMID: 33148216 PMCID: PMC7640432 DOI: 10.1186/s12877-020-01724-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 08/19/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The Balance Evaluation Systems Test (BESTest) and its abbreviated version, the Mini-BESTest are clinical examination of balance impairment, but its psychometric properties have not yet been tested in European Spanish. We aimed to assess the psychometric properties of BESTest and Mini-BESTest in Spanish in community-dwelling elderly people. METHODS We designed a cross-sectional transcultural adaptation and validation study. Convenience sample of thirty (N-30) adults aged 65 to 89 years old without balance problems were recruited. Two physiotherapists assessed participants at the same time. Internal consistency of Spanish BESTest and Mini-BESTest was carried out by obtaining the Cronbach Alpha. The reproducibility between raters was studied with the Intraclass Correlation Coefficient. The Pearson correlation coefficient was calculated by comparing the relationship between the BESTest, mini-BESTest, Berg Balance Scale (BBS) and Falls Efficacy Scale-International (FES-I). RESULTS BESTest and Mini-BESTest showed good internal consistency. BESTest and Mini-BESTest total scores showed an excellent inter-rater agreement. There was a significant correlation between total score of the BESTest and the Mini-BESTest (r = 0.65; p < 0.001). BESTest had a moderate association with BBS and a strong association with FES-I. Mini-BESTest had a fair correlation with BBS and FES-I. Total scores obtained by women at BESTest and at Mini-BESTest were significantly lower than those reached by men. The differences observed in all the test when disaggregating data by sex require further research. CONCLUSIONS Spanish versions of BESTest and Mini-BESTest are comprehensible for new raters. They are reliable tools to provide information on which particular balance systems show impairment in community dwelling older adults. Elderly women had a worse quality of balance and a greater perception of their risk of falling. TRIAL REGISTRATION This study was registered in ClinicalTrials.gov with NCT03403218 on 2018/01/17.
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Affiliation(s)
- Pilar Dominguez-Olivan
- IIS Aragón, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain.
- Hospital Universitario Miguel Servet, Zaragoza, Spain.
| | - Angel Gasch-Gallen
- IIS Aragón, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | | | - Ana Bengoetxea
- Unité de Recherche en Sciences de l'Ostéopathie (URSO). Faculté des Sciences de la Motricité, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Instituto de Investigación Sanitaria Biocruces Bizkaia, Barakaldo, Spain
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Lanzola G, Bagarotti R, Sacchi L, Salvi E, Alloni A, Picardi M, Sterpi I, Boninsegna R, Corbo M, Quaglini S. Bringing spatiotemporal gait analysis into clinical practice: Instrument validation and pilot study of a commercial sensorized carpet. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 188:105292. [PMID: 31923818 DOI: 10.1016/j.cmpb.2019.105292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/01/2019] [Accepted: 12/20/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE We illustrate a low-cost platform easing the estimation of spatio-temporal parameters (GA-STP) ready for large-scale deployment in fall prevention. METHODS We used a commercial sensorized carpet with a limited cost and a very coarse resolution. An instrument validation test was accomplished: the Wilcoxon test for paired samples and the correlation test with Spearman method were used to compare the values computed by the platform with reference ones. Hierarchical clustering using Ward's method and ROC curves have been used to assess the performance in a pilot study enrolling patients. RESULTS Validation shows no significant difference between computed and reference values of gait speed (ρ-value:0.99; p-value:2.2E-16), step number (ρ-value:0.91; p-value:5.8E-16) and stride-length (ρ-value:0.92; p-value:7.5E-9). The clinical pilot study confirms that the platform may also be used to track the improvements occurring during a rehabilitation program. CONCLUSIONS We believe that the use of a commercial carpet makes the solution proposed ready to be deployed on a large scale for effectively bringing GA into the clinical practice.
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Affiliation(s)
- Giordano Lanzola
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.
| | - Riccardo Bagarotti
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Lucia Sacchi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Elisa Salvi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | | | - Michela Picardi
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico (CCP), Milano, Italy
| | - Irma Sterpi
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico (CCP), Milano, Italy
| | - Rosangela Boninsegna
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico (CCP), Milano, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico (CCP), Milano, Italy
| | - Silvana Quaglini
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
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Mahdizadeh F, Mehraban AH, Faranoush M, Amini M, Mehdizadeh M. Fatigue in Children with Cancer: Reliability and Validity of the Persian Version of Child, Parent, and Staff Fatigue Scale. Asia Pac J Oncol Nurs 2020; 7:174-179. [PMID: 32478135 PMCID: PMC7233566 DOI: 10.4103/apjon.apjon_44_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/07/2019] [Indexed: 11/18/2022] Open
Abstract
CONTEXT The fatigue is reported as the most common and annoying symptom in patients with cancer, timely diagnosis, and treatment can significantly influence the treatment and rehabilitation. It is crucial to have an appropriate tool to accurately assess fatigue status. OBJECTIVES Our purpose was to assess psychometric properties of the Persian versions of fatigue scale by Original Scales from the viewpoint of children with cancer (Child Fatigue Scale [CFS]-24 h), their parents (Parent Fatigue Scale [PFS]-24 h), and staff (Staff Fatigue Scale FSF-24 h). METHODS Convenience sampling of the participants was conducted 100, including children with cancer within the age range of 7-12 years, their parents, and caregivers in medical staff. Test-retest reliability and internal consistency were evaluated using intraclass correlation (ICC) and Cronbach's alpha coefficient. Dimensionality was determined by factor analysis. The patients' fatigue was also assessed through visual analog scale-fatigue (VAS-F). RESULTS Test-retest (ICCCFS = 0.71, ICCPSF = 0.82, and ICCSFS = 0.78) was acceptable with a high level of internal consistency (αCFS = 0.80, αPFS = 0.83, and αSFS = 0.84). Factor analysis identified three, five, and two components for the CFS, PFS, and Staff Fatigue Scale (SFS), respectively. There was moderate correlation between CFS and VAS-F. CONCLUSIONS Results of the current study indicated that CFS in children with cancer, PFS in their parents, and SFS in medical staff were valid and reliable instruments to assess fatigue from the viewpoint of children with cancer along with their parents and medical staff.
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Affiliation(s)
- Fatemeh Mahdizadeh
- Neuromuscular Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Afsoon Hassani Mehraban
- Rehabilitation Research Center, Department of Occupational Therapy, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Faranoush
- Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
- MAHAK Pediatric Cancer Treatment and Research Center, Tehran, Iran
| | - Malek Amini
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran
| | - Maryam Mehdizadeh
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Neurosciences, Faculty of Advance Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
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Jung HJ, Lee YM, Kim M, Uhm KE, Lee J. Suggested Assessments for Sarcopenia in Patients With Stroke Who Can Walk Independently. Ann Rehabil Med 2020; 44:20-37. [PMID: 32130836 PMCID: PMC7056329 DOI: 10.5535/arm.2020.44.1.20] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/18/2019] [Indexed: 02/06/2023] Open
Abstract
Objective To investigate variables for assessment of stroke-related sarcopenia that are alternative options to the current assessment for sarcopenia, which focuses on age-related sarcopenia and also has limitations in addressing sarcopenia due to weakness resulting from stroke. Methods Forty patients (17 men, 23 women; mean age, 66.9±15.4 years) with first-ever stroke who can walk independently were included. Muscle mass was determined by measuring ultrasonographic muscle thickness of vastus intermedius, rectus femoris, tibialis anterior, medial gastrocnemius, and biceps brachii muscles in addition to using the skeletal muscle index (SMI) with bioelectrical impedance analysis. Muscle strength was assessed with the Medical Research Council (MRC) sum score as well as handgrip (HG) strength. Physical performance was measured by the Berg Balance Scale (BBS) along with 4-meter gait speed (4MGS). Correlations between each assessment in the three categories were analyzed and adjusted by stroke severity, comorbidity, and nutritional status. Results For muscle mass, SMI showed the highest correlation with the tibialis anterior muscle (r=0.783, p<0.001) among the other muscles. Regarding muscle strength, the MRC sum score correlated with the HG (r=0.660, p<0.001). For physical performance, the BBS correlated with the 4MGS (r=0.834, p<0.001). The same result was obtained after adjusting for factors of stroke severity, comorbidity, and nutritional status. Conclusion These results suggest that ultrasonographic muscle thickness of the tibialis anterior, the MRC sum score, and BBS might be alternatives to SMI, HG, and usual gait speed for sarcopenia in stroke patients.
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Affiliation(s)
- Ho Joong Jung
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Yong Min Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Minsun Kim
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Kyeong Eun Uhm
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jongmin Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Korea.,International Healthcare Research Institute, Konkuk University, Seoul, Korea
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Szydlowski G, O'Neil J, Mrowczynski J, Inglis L, Ross M. Electroskip auditory biofeedback in a patient with Parkinson disease: a case report. J Exerc Rehabil 2019; 15:688-695. [PMID: 31723558 PMCID: PMC6834699 DOI: 10.12965/jer.1938374.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 07/28/2019] [Indexed: 11/22/2022] Open
Abstract
The purpose of this case study was to observe the effects of a rehabilitation program with an audio-biofeedback technology device called Electroskip in a patient with Parkinson disease. The patient was a 61-year-old man with moderate Parkinson disease (Hoehn and Yahr Parkinson’s scale stage III) and dementia who had progressive episodes of freezing of gait. The patient also had a history of recent falls. The patient completed a 6-week rehabilitation program focused on functional tasks, balance and gait training while using Electroskip technology, which is a wireless, wearable device that sends a discrete real-time generative audio-biofeedback signal when the user steps on either the heel or toe force sensors positioned under the innersoles. The outcome measures included the Timed Up and Go test, the modified Gait Abnormality Rating Scale, the modified Parkinson’s Activity Scale, and the Freezing of Gait Questionnaire. The patient completed 17 of the 18 scheduled training sessions and all testing sessions; no adverse events occurred during the rehabilitation program and high satisfaction levels were reported by the patient and family after completion of the 6-week rehabilitation program. Clinically significant improvements were seen in all measures at 6 weeks. The results of this report suggest that a rehabilitation program focused on functional tasks, balance, and gait training using the Electroskip technology may be beneficial for improving gait and balance in a patient with moderate Parkinson disease. Future work is needed to determine the effectiveness of Electroskip technology by means of randomized controlled trials.
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Affiliation(s)
- Garrett Szydlowski
- Department of Physical Therapy, Daemen College, East Amherst, NY, USA.,Canisius College, Buffalo, NY, USA
| | | | | | - Lisa Inglis
- Department of Physical Therapy, Daemen College, East Amherst, NY, USA
| | - Michael Ross
- Department of Physical Therapy, Daemen College, East Amherst, NY, USA
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Winser SJ, Kannan P, Bello UM, Whitney SL. Measures of balance and falls risk prediction in people with Parkinson's disease: a systematic review of psychometric properties. Clin Rehabil 2019; 33:1949-1962. [PMID: 31571503 PMCID: PMC6826874 DOI: 10.1177/0269215519877498] [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] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate the psychometric properties of measures of balance and falls risk prediction in people with Parkinson's disease (PD). DATA SOURCES PubMed, Embase, CINAHL, Ovid Medline, Scopus, and Web of Science were searched from inception to August 2019. REVIEW METHOD Studies testing psychometric properties of measures of balance and falls risk prediction in PD were included. The four-point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) assessed quality. RESULTS Eighty studies testing 68 outcome measures were reviewed; 43 measures assessed balance, 9 assessed falls risk prediction, and 16 assessed both. The measures with robust psychometric estimation with acceptable properties were the (1) Mini-Balance Evaluation Systems Test (Mini-BEST), (2) Berg Balance Scale, (3) Timed Up and Go test, (4) Falls Efficacy Scale International, and (5) Activities-Specific Balance Confidence scale. These measures assess balance and falls risk prediction at the body, structure and function level, falls risk and balance, and falls risk at the activity level. The motor examination of the Unified Parkinson's Disease Rating Scale (UPDRS-ME) with robust psychometric analysis is a condition-specific measure with acceptable properties. Except the UPDRS-ME and Mini-BESTest, the responsiveness of the other four measures has yet to be established. CONCLUSION Six of the 68 outcome measures have strong psychometric properties for the assessment of balance and falls risk prediction in PD. Measures assessing balance and falls risk prediction at the participatory level are limited in number with a lack of psychometric validation.
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Affiliation(s)
- Stanley J Winser
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Priya Kannan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Umar Muhhamad Bello
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Susan L Whitney
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
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