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Dynamic Balance in Spinal and Bulbar Muscular Atrophy: Relationship between Strength and Performance of Forward Lunge, Step Up and Over, and Step Quick Turn. Rehabil Res Pract 2021; 2021:2540324. [PMID: 34725572 PMCID: PMC8557083 DOI: 10.1155/2021/2540324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/28/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Spinal and bulbar muscular atrophy (SBMA) is a neuromuscular disorder that leads to progressive weakness of bulbar and extremity muscles. Dynamic balance during functional tasks has not been reported in people with SBMA. Objectives (1) To evaluate the ability to safely complete a forward lunge (FL), step quick turn (SQT), and step up and over (SUO), (2) to determine the presence and severity of dynamic balance impairments by comparing performance to normative data, and (3) to investigate the relationship between lower extremity strength and ability to complete each task. Design Cross-sectional analysis. Participants. Fifty-three people with SBMA were included in a cross-sectional analysis. Normative datasets provided by the NeuroCom manufacturer and isometric strength literature facilitated patient comparisons. Outcome Measures. Force plate-based dynamic balance measures included FL (distance, impact index, contact time, and force impulse), SQT (turn time and turn sway), and SUO (lift up index, movement time, and impact index). Maximal isometric contractions of knee extensors, ankle dorsiflexors, ankle plantar flexors, and hip extensors were measured with fixed frame dynamometry. Results The most difficult test, per completion rate, was SUO (52%), followed by FL (57%) and SQT (65%). t-tests revealed significant abnormalities in eight of nine balance variables (p < 0.05) accompanied by large Cohen′s D effect sizes ≥ 0.8. Receiver operating characteristics analysis showed knee extensor (SUO 95% CI =0.78–1.00, SQT 95% CI =0.64-0.92) and ankle plantar flexor strength (SUO 95%CI = 0.75–0.99, SQT 95%CI = 0.64 − 0.92) significantly discriminated the ability to perform SUO and SQT tests with acceptable to excellent areas under the curve. Conclusions Considerable dynamic balance abnormalities were observed. Lower extremity strength helps explain low test completion rates. Patients modified task movement patterns, enabling safe task performance. Study results can help direct patient care and future protocol design for people with SBMA.
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Li YJ, Niu XR, Hu S. Efficacy evaluation of different forms of traditional Chinese health-preservation exercises for osteoporosis: a network meta-analysis. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2021. [DOI: 10.1007/s11726-021-1256-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Porciuncula F, Wasserman P, Marder KS, Rao AK. Quantifying Postural Control in Premanifest and Manifest Huntington Disease Using Wearable Sensors. Neurorehabil Neural Repair 2020; 34:771-783. [PMID: 32672492 DOI: 10.1177/1545968320939560] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Impairments in postural control in Huntington disease (HD) have important consequences for daily functioning. This observational study systematically examined baseline postural control and the effect of sensory attenuation and sensory enhancement on postural control across the spectrum of HD. Methods. Participants (n = 39) included healthy controls and individuals in premanifest (pHD) and manifest stages (mHD) of HD. Using wearable sensors, postural control was assessed according to (1) postural set (sit vs stand), (2) sensory attenuation using clinical test of sensory integration, and (3) sensory enhancement with gaze fixation. Outcomes included sway smoothness, amplitude, and frequency. Results. Based on postural set, pHD reduced postural sway in sitting relative to standing, whereas mHD had pronounced sway in standing and sitting, highlighting a baseline postural deficit. During sensory attenuation, postural control in pHD deteriorated relative to controls when proprioceptive demands were high (eyes closed on foam), whereas mHD had significant deterioration of postural control when proprioception was attenuated (eyes open and closed on foam). Finally, gaze fixation improved sway smoothness, amplitude, and frequency in pHD; however, no benefit was observed in mHD. Conclusions. Systematic examination of postural control revealed a fundamental postural deficit in mHD, which further deteriorates when proprioception is challenged. Meanwhile, postural deficits in pHD are detectable when proprioceptive challenge is high. Sensory enhancing strategies using gaze fixation to benefit posture may be useful when introduced well before motor diagnosis. These findings encourage further examination of wearable sensors as part of routine clinical assessments in HD.
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Affiliation(s)
- Franchino Porciuncula
- Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, USA
| | - Paula Wasserman
- G.H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Karen S Marder
- G.H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Department of Neurology, Psychiatry, G.H. Sergievsky Center and Taub Institute for Research on Alzheimer's Disease and the Aging Brain; Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Ashwini K Rao
- G.H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Department of Rehabilitation and Regenerative Medicine (Program in Physical Therapy), G.H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Matheis T, Evinger C, Schubert R, Mazzola S, Fels M, Kemper N, Reilmann R, Muratori L. Biological Motion Perception in Huntington's Disease. J Huntingtons Dis 2020; 8:311-321. [PMID: 31033464 DOI: 10.3233/jhd-180337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The ability of healthy individuals to detect biological motion by using a small number of moving points is well established in animals and humans. Perception of human movements may depend on internal models that drive self-generated movements and influence motion discrimination (Reed CL et al. 1995 and 2007). As a person's motor repertoire deteriorates, the accuracy of these models may also decrease. OBJECTIVE Determine if people with symptomatic Huntington's disease (HD) have difficulty perceiving movements. METHODS In this study point-light displays were created with a Vicon Motion Capture System by recording one individual with (impaired) and one individual without (healthy) Parkinson's disease using a 13 joint marker set. Participants were asked to distinguish between three movements and determine if the movement was impaired or healthy. The ability of participants with and without HD to distinguish movement patterns and the time to perception were recorded. RESULTS Analyses found participants with HD had a decreased ability to correctly detect movements and point-light image type. The stair climbing motion showed the largest effect as participants with HD had more difficulty correctly identifying both the movement and whether it was impaired or healthy. In addition, the participants without HD showed an improvement as trials progressed which could not be observed in the HD cohort. CONCLUSIONS As people with symptomatic HD have difficulty perceiving movements further investigations using point-light displays should be done to determine if these impairments might serve as an easily administered, non-invasive marker of disease state.
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Affiliation(s)
- Tamara Matheis
- George-Huntington-Institute, Technology-Park, Muenster, Germany.,Institute for Animal Hygiene, Animal Welfare and Farm Animal Behaviour, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Craig Evinger
- Department of Neurobiology & Behavior, Stony Brook University, Stony Brook, NY, USA
| | - Robin Schubert
- George-Huntington-Institute, Technology-Park, Muenster, Germany
| | - Steven Mazzola
- Department of Mechanical Engineering, Stony Brook University, Stony Brook, NY, USA
| | - Michaela Fels
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behaviour, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Nicole Kemper
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behaviour, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Ralf Reilmann
- George-Huntington-Institute, Technology-Park, Muenster, Germany.,Department of Clinical Radiology, University of Muenster, Muenster, Germany.,Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Lisa Muratori
- George-Huntington-Institute, Technology-Park, Muenster, Germany.,Department of Physical Therapy, School of Health Technology and Management, Stony Brook University, Stony Brook, NY, USA
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Huffman C. Exercise Interventions for the Management of Huntington's Disease. Strength Cond J 2019. [DOI: 10.1519/ssc.0000000000000479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Purcell NL, Goldman JG, Ouyang B, Bernard B, O'Keefe JA. The Effects of Dual-Task Cognitive Interference and Environmental Challenges on Balance in Huntington's Disease. Mov Disord Clin Pract 2019; 6:202-212. [PMID: 30949551 PMCID: PMC6417749 DOI: 10.1002/mdc3.12720] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/05/2018] [Accepted: 12/07/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Huntington's disease (HD) is characterized by chorea, balance and gait impairments, and cognitive deficits, which increase fall risk. Dual task (DT) and environmentally challenging paradigms reflect balance related to everyday life. Furthermore, the impact of cognitive deficits on balance dysfunction and falls in HD is unknown. OBJECTIVE To determine the impact of DT interference, sensory feedback, and cognitive performance on balance and falls in HD. METHODS Seventeen participants with HD (55 ± 9.7 years) and 17 age-matched controls (56.5 ± 9.3 years) underwent quantitative balance testing with APDM inertial sensors. Postural sway was assessed during conditions of manipulated stance, vision, proprioception, and cognitive demand. The DT was a concurrent verbal fluency task. Neuropsychological assessments testing multiple cognitive domains were also administered. RESULTS HD participants exhibited significantly greater total sway area, jerk, and variability under single-task (ST) and DT conditions compared to controls (P = 0.0002 - < 0.0001). They also demonstrated greater DT interference with vision removed for total sway area (P = 0.01) and variability (P = 0.02). Significantly worse postural control was observed in HD with vision removed and reduced proprioception (P = 0.001 - 0.01). Decreased visuospatial performance correlated with greater total sway and jerk (P = 0.01; 0.009). No balance parameters correlated with retrospective falls in HD. CONCLUSIONS HD participants have worse postural control under DT, limited proprioception/vision, and greater DT interference with a narrowed base and no visual input. These findings may have implications for designing motor and cognitive strategies to improve balance in HD.
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Affiliation(s)
| | - Jennifer G. Goldman
- Department of Neurological Sciences, Section of Parkinson Disease and Movement DisordersRush University Medical CenterChicagoILUSA
| | - Bichun Ouyang
- Department of Neurological Sciences, Section of Parkinson Disease and Movement DisordersRush University Medical CenterChicagoILUSA
| | - Bryan Bernard
- Department of Neurological Sciences, Section of Parkinson Disease and Movement DisordersRush University Medical CenterChicagoILUSA
| | - Joan A. O'Keefe
- Department of Cell and Molecular MedicineRush University Medical CenterChicagoILUSA
- Department of Neurological Sciences, Section of Parkinson Disease and Movement DisordersRush University Medical CenterChicagoILUSA
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Srivastava A, Ahmad OF, Pacia CP, Hallett M, Lungu C. The Relationship between Saccades and Locomotion. J Mov Disord 2018; 11:93-106. [PMID: 30086615 PMCID: PMC6182301 DOI: 10.14802/jmd.18018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 04/26/2018] [Indexed: 12/11/2022] Open
Abstract
Human locomotion involves a complex interplay among multiple brain regions and depends on constant feedback from the visual system. We summarize here the current understanding of the relationship among fixations, saccades, and gait as observed in studies sampling eye movements during locomotion, through a review of the literature and a synthesis of the relevant knowledge on the topic. A significant overlap in locomotor and saccadic neural circuitry exists that may support this relationship. Several animal studies have identified potential integration nodes between these overlapping circuitries. Behavioral studies that explored the relationship of saccadic and gait-related impairments in normal conditions and in various disease states are also discussed. Eye movements and locomotion share many underlying neural circuits, and further studies can leverage this interplay for diagnostic and therapeutic purposes.
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Affiliation(s)
- Anshul Srivastava
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Omar F Ahmad
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Christopher Pham Pacia
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, USA
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Codrin Lungu
- Division of Clinical Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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A Classification System to Guide Physical Therapy Management in Huntington Disease: A Case Series. J Neurol Phys Ther 2018. [PMID: 28628549 DOI: 10.1097/npt.0000000000000188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Individuals with Huntington disease (HD), a rare neurological disease, experience impairments in mobility and cognition throughout their disease course. The Medical Research Council framework provides a schema that can be applied to the development and evaluation of complex interventions, such as those provided by physical therapists. Treatment-based classifications, based on expert consensus and available literature, are helpful in guiding physical therapy management across the stages of HD. Such classifications also contribute to the development and further evaluation of well-defined complex interventions in this highly variable and complex neurodegenerative disease. The purpose of this case series was to illustrate the use of these classifications in the management of 2 individuals with late-stage HD. CASE DESCRIPTION Two females, 40 and 55 years of age, with late-stage HD participated in this case series. Both experienced progressive declines in ambulatory function and balance as well as falls or fear of falling. Both individuals received daily care in the home for activities of daily living. INTERVENTION Physical therapy Treatment-Based Classifications for HD guided the interventions and outcomes. Eight weeks of in-home balance training, strength training, task-specific practice of functional activities including transfers and walking tasks, and family/carer education were provided. OUTCOMES Both individuals demonstrated improvements that met or exceeded the established minimal detectible change values for gait speed and Timed Up and Go performance. Both also demonstrated improvements on Berg Balance Scale and Physical Performance Test performance, with 1 of the 2 individuals exceeding the established minimal detectible changes for both tests. Reductions in fall risk were evident in both cases. DISCUSSION These cases provide proof-of-principle to support use of treatment-based classifications for physical therapy management in individuals with HD. Traditional classification of early-, mid-, and late-stage disease progression may not reflect patients' true capabilities; those with late-stage HD may be as responsive to interventions as those at an earlier disease stage.Video Abstract available for additional insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A172).
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Vuong K, Canning CG, Menant JC, Loy CT. Gait, balance, and falls in Huntington disease. HANDBOOK OF CLINICAL NEUROLOGY 2018; 159:251-260. [PMID: 30482318 DOI: 10.1016/b978-0-444-63916-5.00016-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Huntington disease (HD) is an autosomal-dominant, progressive, neurodegenerative disorder, characterized by involuntary movements and other motor impairments, cognitive/behavioral symptoms, and psychiatric disorders. Gait and balance impairments and falls greatly impact on the quality of life among people with HD, and being fall-prone is one of the strongest predictors of nursing-home placement. Gait impairment in HD is characterized by bradykinesia, reduced velocity, and increased variability in spatiotemporal features. Detrimental changes in symmetry, step length, stride time, balance measures, gait adaptability (external cues, dual tasking), and hypo/hyperkinesia have also been observed. Balance impairment is characterized by impairments of anticipatory balance without a change in base of support, anticipatory balance with a change in base of support, and reactive balance. In addition to gait and balance impairment, people with HD have a range of intrinsic and extrinsic factors that increase fall risk, including reduced cognitive reserve for dual tasking. Currently there is some evidence to suggest exercise interventions can address some HD-specific gait and balance deficits. However, no intervention studies to date have specifically targeted falls. Large, well-designed, randomized controlled trials are needed to guide future fall prevention interventions in people with HD.
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Affiliation(s)
- Kenny Vuong
- St. Joseph's Hospital, Auburn, Sydney, Australia
| | - Colleen G Canning
- Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Jasmine C Menant
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia
| | - Clement T Loy
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
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Vilas-Boas MDC, Cunha JPS. Movement Quantification in Neurological Diseases: Methods and Applications. IEEE Rev Biomed Eng 2016; 9:15-31. [PMID: 27008673 DOI: 10.1109/rbme.2016.2543683] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Quinn L, Debono K, Dawes H, Rosser AE, Nemeth AH, Rickards H, Tabrizi SJ, Quarrell O, Trender-Gerhard I, Kelson MJ, Townson J, Busse M. Task-specific training in Huntington disease: a randomized controlled feasibility trial. Phys Ther 2014; 94:1555-68. [PMID: 25012999 DOI: 10.2522/ptj.20140123] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Task-specific training may be a suitable intervention to address mobility limitations in people with Huntington disease (HD). OBJECTIVE The aim of this study was to assess the feasibility and safety of goal-directed, task-specific mobility training for individuals with mid-stage HD. DESIGN This study was a randomized, blinded, feasibility trial; participants were randomly assigned to control (usual care) and intervention groups. SETTING This multisite study was conducted in 6 sites in the United Kingdom. PATIENTS Thirty individuals with mid-stage HD (13 men, 17 women; mean age=57.0 years, SD=10.1) were enrolled and randomly assigned to study groups. INTERVENTION Task-specific training was conducted by physical therapists in participants' homes, focusing on walking, sit-to-stand transfers, and standing, twice a week for 8 weeks. Goal attainment scaling was used to individualize the intervention and monitor achievement of personal goals. MEASUREMENTS Adherence and adverse events were recorded. Adjusted between-group comparisons on standardized outcome measures were conducted at 8 and 16 weeks to determine effect sizes. RESULTS Loss to follow-up was minimal (n=2); adherence in the intervention group was excellent (96.9%). Ninety-two percent of goals were achieved at the end of the intervention; 46% of the participants achieved much better than expected outcomes. Effect sizes on all measures were small. LIMITATIONS Measurements of walking endurance were lacking. CONCLUSIONS The safety of and excellent adherence to a home-based, task-specific training program, in which most participants exceeded goal expectations, are encouraging given the range of motivational, behavioral, and mobility issues in people with HD. The design of the intervention in terms of frequency (dose), intensity (aerobic versus anaerobic), and specificity (focused training on individual tasks) may not have been sufficient to elicit any systematic effects. Thus, a larger-scale trial of this specific intervention does not seem warranted.
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Affiliation(s)
- Lori Quinn
- L. Quinn, PT, PhD, School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
| | - Katy Debono
- K. Debono, BSc AnatomicalScience(Hons), BSc Physiotherapy, MCSP, School of Healthcare Sciences, Cardiff University
| | - Helen Dawes
- H. Dawes, PhD, MMedSci, Movement Science Group, Oxford Brookes University, Oxford, United Kingdom
| | - Anne Elizabeth Rosser
- A.E. Rosser, PhD, MB, BChir, BA(Hons), Schools of Medicine and Biosciences, Cardiff University
| | - Andrea H Nemeth
- A.H. Nemeth, MB, BS, DPhil, CCST, Department of Clinical Genetics, Churchill Hospital, Oxford
| | - Hugh Rickards
- H. Rickards, MB, ChB, MMedSci, MRCPsych, MD, FRCPsych, The Barberry Centre, Birmingham, United Kingdom
| | - Sarah J Tabrizi
- S.J. Tabrizi, FRCP, PhD, FMedSci, BSc(Hons), Department of Neurodegenerative Diseases, UCL Institute of Neurology, University College London, Queen Square, London, United Kingdom
| | - Oliver Quarrell
- O. Quarrell, MD, FRCP, BSc, Sheffield Children's Hospital, Sheffield, United Kingdom
| | - Iris Trender-Gerhard
- I. Trender-Gerhard, MD, Institute of Human Development, University of Manchester, Manchester, St Mary's Hospital/Central Manchester Foundation Trust
| | - Mark J Kelson
- M.J. Kelson, PhD, MSc, BSc, South East Wales Trial Unit, Cardiff University School of Medicine
| | - Julia Townson
- J. Townson, BA(JointHons), South East Wales Trial Unit, Cardiff University School of Medicine
| | - Monica Busse
- M. Busse, PhD, MSc(Med), BSc(Med)Hons, MCSP, BSc(Physiotherapy), School of Healthcare Sciences, Cardiff University, Ty Dewi Sant, Heath Park, Cardiff, CF14 4XN United Kingdom.
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Blanchet M, Prince F, Chouinard S, Messier J. Postural stability limits in manifest and premanifest Huntington’s disease under different sensory conditions. Neuroscience 2014; 279:102-12. [DOI: 10.1016/j.neuroscience.2014.07.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 07/16/2014] [Accepted: 07/28/2014] [Indexed: 10/24/2022]
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Cruickshank T, Reyes A, Peñailillo L, Thompson J, Ziman M. Factors that contribute to balance and mobility impairments in individuals with Huntington's disease. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.baga.2014.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Analysis of gait and balance through a single triaxial accelerometer in presymptomatic and symptomatic Huntington's disease. Gait Posture 2013; 37:49-54. [PMID: 22819009 DOI: 10.1016/j.gaitpost.2012.05.028] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 05/23/2012] [Accepted: 05/30/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the capacity of a single triaxial accelerometer sensor in detecting gait and balance impairments in pre-manifest and manifest Huntington's disease (HD) subjects. METHODS Fourteen manifest HD (MHD) (age: 51.83±14.8), ten pre-manifest HD (PHD) (age: 44.8±11.7) and ten healthy subjects (HLY) (age: 56.4±10.9) were recruited. The sensor was attached to the upper sternum as subjects completed gait and Romberg balance tests. An inverted pendulum model of the body's centre of mass and an unbiased autocorrelation procedure were employed to derive gait parameters from the triaxial accelerometer signal. The accuracy of the gait measurements was compared to those recorded by a computerized walkway. RESULTS Strong agreement was seen between the sensor and the walkway; cadence (ICC=0.95, CI=[0.75, 0.97]), velocity (ICC=0.94, CI=[0.75, 0.97]) and step length (ICC=0.89, CI=[0.77, 0.95]). Sensor derived velocity was significantly higher in HLY (p<0.001) and PHD (p<0.005) when compared to MHD. Step and stride length was significantly longer in HLY (p<0.05) and PHD (p<0.001) when compared to MHD. Significant differences between subject groups across all four balance tasks (p<0.001) were found. CONCLUSION An accelerometer based sensor may be an effective means of differentiating between pre-manifest and manifest Huntington's disease subjects.
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Quinn L, Busse M. Physiotherapy clinical guidelines for Huntington’s disease. Neurodegener Dis Manag 2012. [DOI: 10.2217/nmt.11.86] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Lori Quinn
- Department of Physiotherapy, School of Healthcare Studies, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Monica Busse
- Department of Physiotherapy, School of Healthcare Studies, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
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