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Abit Kocaman A, Aydoğan Arslan S, Bozkurt YE, Coşkun E. The Dubousset Functional Test: a reliable and valid test in early stage Parkinson's disease patients. Neurol Sci 2024; 45:3137-3146. [PMID: 38296881 PMCID: PMC11176096 DOI: 10.1007/s10072-024-07359-1] [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: 11/25/2023] [Accepted: 01/22/2024] [Indexed: 02/02/2024]
Abstract
INTRODUCTION Dubousset Functional Test (DFT) is an assessment test evaluating the functional capacity and dynamic balance. The study aimed to examine the reliability, validity, and responsiveness of the DFT in early stage Parkinson's disease (PD) patients. METHODS This was a cross-sectional study. Thirty-three early stage PD patients were recruited. The DFT was performed along with the Timed Up and Go (TUG) test, dual-task TUG, Functional Reach Test (FRT), 3-m backward walk test (3MBWT), Tinetti Performance-Oriented Mobility Assessment (POMA), and Berg Balance Scale (BBS). RESULTS The test-retest reliability of the subcomponents of the DFT was excellent. The ICCs were as follows: 0.952, 0.955, 0.917, and 0.919, respectively. The correlation with subcomponents of DFT and TUG, dual-task TUG, FRT, 3MBWT, BBS, and POMA was found to be statistically significant (p < 0.05). The standard measurement errors of the subcomponents of the DFT were 1.45, 1.39, 1.70, and 1.57, respectively. The minimal clinically important difference (MCID) of the subcomponents was 2.05, 1.97, 2.41, and 2.22, respectively. CONCLUSION The DFT is a reliable, valid, and easy-to-administer tool in assessing the balance and physical function of early stage PD patients.
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Affiliation(s)
- Ayşe Abit Kocaman
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey.
| | - Saniye Aydoğan Arslan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - Yusuf Emre Bozkurt
- Samsun Physical Medicine and Rehabilitation Diseases Hospital, Samsun, Turkey
| | - Erdal Coşkun
- Department of Physical Medicine and Rehabilitation, Sincan Medical Center, Ankara, Turkey
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Nicoli G, Pavon G, Grayson A, Emerson A, Mitra S. Touch may reduce cognitive load during assisted typing by individuals with developmental disabilities. Front Integr Neurosci 2023; 17:1181025. [PMID: 37600233 PMCID: PMC10434793 DOI: 10.3389/fnint.2023.1181025] [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: 03/06/2023] [Accepted: 07/20/2023] [Indexed: 08/22/2023] Open
Abstract
Many techniques have attempted to provide physical support to ease the execution of a typing task by individuals with developmental disabilities (DD). These techniques have been controversial due to concerns that the support provider's touch can influence the typed content. The most common interpretation of assisted typing as an ideomotor phenomenon has been qualified recently by studies showing that users with DD make identifiable contributions to the process. This paper suggests a neurophysiological pathway by which touch could lower the cognitive load of seated typing by people with DD. The required sensorimotor processes (stabilizing posture and planning and executing manual reaching movements) and cognitive operations (generating and transcribing linguistic material) place concurrent demands on cognitive resources, particularly executive function (EF). A range of developmental disabilities are characterized by deficits in sensorimotor and EF capacity. As light touch has been shown to facilitate postural coordination, it is proposed that a facilitator's touch could assist the seated typist with sensorimotor and EF deficits by reducing their sensorimotor workload and thereby freeing up shared cognitive resources for the linguistic elements of the task. This is the first theoretical framework for understanding how a facilitator's touch may assist individuals with DD to contribute linguistic content during touch-assisted typing.
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Affiliation(s)
- Giovanni Nicoli
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Giulia Pavon
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Andrew Grayson
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Anne Emerson
- Faculty of Social Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Suvobrata Mitra
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
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López-Liria R, Vega-Tirado S, Valverde-Martínez MÁ, Calvache-Mateo A, Martínez-Martínez AM, Rocamora-Pérez P. Efficacy of Specific Trunk Exercises in the Balance Dysfunction of Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. SENSORS (BASEL, SWITZERLAND) 2023; 23:1817. [PMID: 36850413 PMCID: PMC9959840 DOI: 10.3390/s23041817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative pathology classified as a movement disorder. Physical exercise within a physiotherapy program is an important element to improve postural stability, balance and mobility in order to reduce falls in people with PD. The aim of this work was to determine the efficacy of specific balance and trunk mobility exercises, as well as their benefits for and effects on patients with idiopathic PD. A systematic review and meta-analysis was conducted according to PRISMA standards. The search was performed in five databases: Cochrane Library, SciELO, PEDro, Scopus and PubMed, in February 2022 with the following descriptors: Parkinson's disease, trunk, exercise, therapy and physical therapy. The inclusion criteria were randomized controlled trials (RCTs) over the last ten years. A meta-analysis on static and dynamic balance was conducted with the software Review Manager. Nine articles met the objectives and inclusion criteria, with a total of 240 participants. The trials had moderate methodological quality according to the PEDro scale. The studies included differed with regard to intervention protocol and outcome measures. Finally, eight studies were included in a quantitative analysis in which it was shown that trunk-specific exercises interventions did not significantly improve static balance (SMD = -0.10, 95% CI = -0.29, 0.08; p = 0.28) or dynamic balance (SMD = 0.64 95% CI = -0.24, 1.52; p = 0.15). However, significant differences were found in static balance measured subjectively using the Berg Balance Scale (SMD = -0.52, 95% CI = -1.01, -0.02; p = 0.04). Although some differences were not significant, the studies included in this systematic review consider that specific trunk exercises or balance training combined with muscle strengthening in patients with idiopathic PD should be a complement to pharmacological treatment for improving balance dysfunction and postural instability, preventing falls and promoting wellness.
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Affiliation(s)
- Remedios López-Liria
- Health Research Centre, Department of Nursing, Physiotherapy and Medicine, University of Almería, Carretera del Sacramento s/n, 04120 La Cañada de San Urbano, Almería, Spain
| | - Sofía Vega-Tirado
- Hum-498 Research Team, University of Almería, 04120 La Cañada de San Urbano, Almería, Spain
| | - María Ángeles Valverde-Martínez
- Health Research Centre, Department of Nursing, Physiotherapy and Medicine, University of Almería, Carretera del Sacramento s/n, 04120 La Cañada de San Urbano, Almería, Spain
| | - Andrés Calvache-Mateo
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av. De la Ilustración 60, 18016 Granada, Granada, Spain
| | | | - Patricia Rocamora-Pérez
- Health Research Centre, Department of Nursing, Physiotherapy and Medicine, University of Almería, Carretera del Sacramento s/n, 04120 La Cañada de San Urbano, Almería, Spain
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Pitts J, Bhatt T. Effects of mentally induced fatigue on balance control: a systematic review. Exp Brain Res 2023; 241:13-30. [PMID: 36329316 DOI: 10.1007/s00221-022-06464-x] [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: 05/03/2022] [Accepted: 09/07/2022] [Indexed: 11/06/2022]
Abstract
The relationship between cognitive demands and postural control is controversial. Mental fatigue paradigms investigate the attentional requirements of postural control by assessing balance after a prolonged cognitive task. However, a majority of mental fatigue research has focused on cognition and sports performance, leaving balance relatively underexamined. The purpose of this paper was to systematically review the existing literature on mental fatigue and balance control. We conducted a comprehensive search on PubMed and Web of Science databases for studies comparing balance performance pre- to post-mental fatigue or between a mental fatigue and control group. The literature search resulted in ten relevant studies including both volitional (n = 7) and reactive (n = 3) balance measures. Mental fatigue was induced by various cognitive tasks which were completed for 20-90 min prior to balance assessment. Mental fatigue affected both volitional and reactive balance, resulting in increased postural sway, decreased accuracy on volitional tasks, delayed responses to perturbations, and less effective balance recovery responses. These effects could have been mediated by the depletion of attentional resources or impaired sensorimotor perception which delayed appropriate balance-correcting responses. However, the current literature is limited by the number of studies and heterogeneous mental fatigue induction methods. Future studies are needed to confirm these postulations and examine the effects of mental fatigue on different populations and postural tasks. This line of research could be clinically relevant to improve safety in occupational settings where individuals complete extremely long durations of cognitive tasks and for the development of effective fall-assessment and fall-prevention paradigms.
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Affiliation(s)
- Jessica Pitts
- Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL, 60612, USA
| | - Tanvi Bhatt
- Department of Physical Therapy, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL, 60612, USA.
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Zawadka-Kunikowska M, Klawe JJ, Tafil-Klawe M, Bejtka M, Rzepiński Ł, Cieślicka M. Cognitive Function and Postural Control Strategies in Relation to Disease Progression in Patients with Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912694. [PMID: 36231994 PMCID: PMC9566250 DOI: 10.3390/ijerph191912694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/01/2023]
Abstract
AIM This study assessed the influence of performing an additional cognitive task on center of pressure (COP) displacement in the early and advanced stages of patients with Parkinson's disease (PD) compared to age-matched healthy controls (HCs). METHODS The study included 40 HCs and 62 patients with PD: early PD (n = 38) and advanced PD (n = 24). COP parameters were determined by static posturography during quiet standing with open eyes (ST, single task) and simultaneous performance of a cognitive task (DT, dual task). Cognitive functioning was examined with a Mini Mental State Examination, number-counting-backward test, and number of enunciated words during DT. RESULTS In the advanced-PD group, DT significantly reduced the sway radius (p = 0.009), area of stabilogram (p = 0.034), medio-lateral length (p = 0.027), and velocity (p = 0.033) compared to ST. In HCs, DT showed a significant increase in the sway radius (p = 0.006), total length (p = 0.039), sway velocity (p = 0.037), anterior-posterior length, and sway velocity. Both PD groups showed worse cognitive performance compared to HCs. CONCLUSIONS Both early and advanced patients with PD showed significant delay in cognitive performance associated with executive function compared to the HCs. During additional cognitive tasks, patients with advanced stages of PD may reduce stabilographic parameters in medio-lateral direction, and this is probably an adaptive strategy to restore balance.
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Affiliation(s)
- Monika Zawadka-Kunikowska
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Karłowicza 24, 85-092 Bydgoszcz, Poland
| | - Jacek J. Klawe
- Department of Hygiene, Epidemiology, Ergonomy and Postgraduate Education, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Małgorzata Tafil-Klawe
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Karłowicza 24, 85-092 Bydgoszcz, Poland
| | - Monika Bejtka
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Karłowicza 24, 85-092 Bydgoszcz, Poland
| | - Łukasz Rzepiński
- Department of Neurology, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland
- Sanitas-Neurology Outpatient Clinic, Dworcowa 110, 85-010 Bydgoszcz, Poland
| | - Mirosława Cieślicka
- Department of Human Physiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Karłowicza 24, 85-092 Bydgoszcz, Poland
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Dual task effect on upper and lower extremity skills in different stages of Parkinson's disease. Acta Neurol Belg 2022:10.1007/s13760-022-02007-x. [PMID: 35776407 DOI: 10.1007/s13760-022-02007-x] [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: 12/10/2021] [Accepted: 06/09/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND PURPOSE Loss of automaticity and deteriorated executive function give rise to dual task deficits in Parkinson's disease (PD). This study aimed to compare single task and dual task upper and lower extremity skills in people with PD (PwPD) at different stages of PD and to examine the dual task effect (DTE) on upper and lower extremity skills in PwPD at different stages of PD. The second aim was to investigate the relationship between the DTE and the quality of life in PwPD. METHODS 30 patients divided into 2 groups as mild PD group and moderate PD group according to the Modified Hoehn & Yahr Scale. 15 age matched healthy adults were recruited as the control group. The Unified Parkinson's Disease Rating Scale (UPDRS), the Purdue Pegboard Test (PPT), the Timed Up and Go Test (TUG), the 10 Meter Walk Test (10MWT), and the Parkinson's Disease Questionnaire (PDQ-8) were used for assessments. RESULTS Single task and dual task scores of all assessments of all groups were significantly different. The DTE on PPT was greater in mild and moderate PD groups than control group and significantly lower in mild PD group than moderate PD group. However, DTE on the TUG and 10MWT was not different in mild PD group than control group and DTE significantly lower in both groups than moderate PD group. Significant correlations between the DTE on PPT, TUG and 10MWT and the PDQ-8 in PwPD were observed. CONCLUSION Dual task has a worsening effect on upper and lower extremity skills in PwPD. This effect can be observed earlier in upper extremity skills than lower extremity skills. Also, the DTE and the QoL in PwPD are related.
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Gender based assessment of gait rhythms during dual-task in Parkinson’s disease and its early detection. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Song Y, Amimoto K, Meidian AC. The effect of a concomitant stroop task during sit-to-stand tasks on postural control. J Phys Ther Sci 2021; 33:917-923. [PMID: 34873374 PMCID: PMC8636917 DOI: 10.1589/jpts.33.917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/20/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to explain the effect of a dual-task technology that utilizes
motor and/or cognitive skills on the performance of major tasks, postural control, and
gait consistency. [Participants and Methods] Eighteen healthy adults were divided into two
groups: the single-word dual-task group and the control group (study 1). We enrolled 32
healthy adults to perform four-word Stroop (study 2) and sit-to-stand tasks simultaneously
to determine the attentional demand for postural control and locomotion. [Results] The
dynamic condition of postural control differed significantly between the single-task and
single-word dual-task groups in Study 1. In Study 2, postural control in the four-word
dual-task condition improved under both static and dynamic conditions. On comparing the
results of studies 1 and 2, we found that during a four-word dual-task, healthy
participants experienced a more significant decrease in postural sway than that
experienced during the single-word dual-task. [Conclusion] Dual task of Stroop task with
sit-to-stand could improve a postural control.
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Affiliation(s)
- Yige Song
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University: 7-2-10 Higashi-Ogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University: 7-2-10 Higashi-Ogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Abdul Chalik Meidian
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University: 7-2-10 Higashi-Ogu, Arakawa-ku, Tokyo 116-8551, Japan
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Delafontaine A, Hansen C, Marolleau I, Kratzenstein S, Gouelle A. Effect of a Concurrent Cognitive Task, with Stabilizing Visual Information and Withdrawal, on Body Sway Adaptation of Parkinsonian's Patients in an Off-Medication State: A Controlled Study. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5059. [PMID: 32899926 PMCID: PMC7571225 DOI: 10.3390/s20185059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 12/23/2022]
Abstract
Background: In persons with Parkinson's disease (pwPD) any additional somatosensory or distractor interference can influence the posture. When deprivation of vision and dual-task are associated, the effect on biomechanical performance is less consistent. The aim of this study was to evaluate the role of the visual deprivation and a cognitive task on the static balance in earlier stage PD subjects. Methods: Fifteen off-medication state pwPD (9 women and 6 men), 67.7 ± 7.3 years old, diagnosed PD since 5.4 ± 3.4 years, only Hoehn and Yahr state 2 and fifteen young control adults (7 women and 8 men) aged 24.9 ± 4.9 years, performed semi-tandem task under four randomized experimental conditions: eyes opened single-task, eyes closed single-task, eyes opened dual-task and eyes closed dual-task. The center of pressure (COP) was measured using a force plate and electromyography signals (EMG) of the ankle/hip muscles were recorded. Traditional parameters, including COP pathway length, ellipse area, mediolateral/anteroposterior root-mean-square and non-linear measurements were computed. The effect of vision privation, cognitive task, and vision X cognitive was investigated by a 2 (eyes opened/eyes closed) × 2 (postural task alone/with cognitive task) repeated-measures ANOVA after application of a Bonferroni pairwise correction for multiple comparisons. Significant interactions were further analyzed using post-hoc tests. Results: In pwPD, both COP pathway length (p < 0.01), ellipse area (p < 0.01) and mediolateral/anteroposterior root-mean-square (p < 0.01) were increased with the eyes closed, while the dual-task had no significant effect when compared to the single-task condition. Comparable results were observed in the control group for who COP pathway was longer in all conditions compared to eyes opened single-task (p < 0.01) and longer in conditions with eyes closed compared to eyes opened dual-task (p < 0.01). Similarly, all differences in EMG activity of pwPD were exclusively observed between eyes opened vs. eyes closed conditions, and especially for the forward leg's soleus (p < 0.01) and backward tibialis anterior (p < 0.01). Conclusions: These results in pwPD without noticeable impairment of static balance encourage the assessment of both visual occlusion and dual-task conditions when the appearance of significant alteration during the dual-task could reveal the subtle worsening onset of the balance control.
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Affiliation(s)
- Arnaud Delafontaine
- CIAMS, University Paris-Sud, Université Paris-Saclay, 91405 Orsay, France;
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Clint Hansen
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, 24098 Kiel, Germany;
| | - Iris Marolleau
- CIAMS, University Paris-Sud, Université Paris-Saclay, 91405 Orsay, France;
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Stefan Kratzenstein
- CAU Motion Lab, Kiel University, Olshausenstraße 74, 24098 Kiel, Germany;
- Institute of Sport Science, Kiel University, Olshausenstraße 74, 24098 Kiel, Germany
| | - Arnaud Gouelle
- ProtoKinetics, Havertown, PA 19083, USA;
- Laboratory Performance, Santé, Métrologie, Société (PSMS), UFR STAPS, 51100 Reims, France
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Morenilla L, Márquez G, Sánchez JA, Bello O, López-Alonso V, Fernández-Lago H, Fernández-Del-Olmo MÁ. Postural Stability and Cognitive Performance of Subjects With Parkinson's Disease During a Dual-Task in an Upright Stance. Front Psychol 2020; 11:1256. [PMID: 32903649 PMCID: PMC7438725 DOI: 10.3389/fpsyg.2020.01256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 05/14/2020] [Indexed: 11/16/2022] Open
Abstract
Background The reviewed studies on center of pressure (COP) displacement in Parkinson’s disease (PD) subjects show important methodological differences and contradictory results with regard to healthy subjects. The dual-task paradigm method has been used to examine cognitive prioritization strategies to control concurrent postural and cognitive tasks. The motor requirements, such as pronouncing words, involved in the cognitive tasks used in double-task conditions could be related to the heterogeneity of the results. Research Objective To compare postural sway and cognitive performance in subjects with PD and controls using a dual-task paradigm with a cognitive task free of motor demands. We tried to examine the prioritization strategy of PD patients regarding healthy adults to control for concurrent postural and cognitive tasks. Materials and Methods 25 subjects with PD and 20 healthy controls carried out a postural task under both single-task and dual-task conditions. The postural task was to stand as still as possible, with eyes first open and then closed. The dual-task condition added a concurrent cognitive task based on phoneme monitoring. COP displacement variables and cognitive performance were compared between the groups and within-subject factors were also examined. Results PD participants showed higher COP displacement results than the controls. All participants shortened the mean sway radius in dual-task conditions compared with single-task conditions; only healthy subjects presented less transversal COP sway in dual-task conditions than in single-task conditions. The cognitive performance of PD patients on a phoneme monitoring task worsened when they carried it out while maintaining balance in a standing position compared to sitting. The opposite effect occurred in control subjects. Conclusion This study confirms the negative influence of Parkinson’s disease on the control of standing stability, increasing the COP sway amplitude. The attentional demands of a postural task, such as standing balance, may be greater in PD patients than in healthy subjects. This would affect the performance of patients during dual-task conditions to be able to control a postural task while performing other cognitive tasks. In these conditions, cognitive performance would be negatively affected. These results suggest that subjects with PD, at least during initial disease stages, prioritize postural control over other concurrent tasks, as is also seen in healthy subjects.
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Affiliation(s)
- Luis Morenilla
- Department of Physical Education, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Gonzalo Márquez
- Department of Physical Education, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - José Andrés Sánchez
- Department of Physical Education, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Olalla Bello
- Department of Biomedical Sciences, Medicine and Physical Therapy, Faculty of Physical Therapy, University of A Coruña, A Coruña, Spain
| | - Virginia López-Alonso
- Department of Physical Education, Center of Higher Education Alberta Giménez, Palma, Spain
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Lazarotto L, Bobbo GZG, Siega J, da Silva AZ, Iucksch DD, Israel VL, Bento PCB. Static and dynamic postural control: Comparison between community old adults and people with Parkinson's disease. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 25:e1844. [PMID: 32363670 DOI: 10.1002/pri.1844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 01/16/2020] [Accepted: 03/23/2020] [Indexed: 11/12/2022]
Abstract
AIMS To compare the static and dynamic postural control of people with Parkinson's disease and community old adults. METHODS Thirty-five people were in the Parkinson's disease group (PDG; 12 women, 62.4 ± 11.0 years, 77.9 ± 15.6 kg, 166.5 ± 11.0 cm, 27.9 ± 3.8 kg/m2 , 1.9 ± 0.5 Hoehn & Yahr) and 32 were in the old adults group (OAG; 13 women, 69.5 ± 6.0 years, 74.2 ± 12.3 kg, 165.0 ± 8.3 cm, 27.2 ± 4.0 kg/m2 ). The static balance was measured on a force platform, three 30-s trials in four conditions: feet side-by-side (FSBS) and semi-tandem stance (ST) positioning, eyes open (EO) and eyes closed (EC). The total sway path length (SPL), sway area (SA), anterior-posterior (APSR) and medial-lateral (MLSR) sway range of the centre of pressure were obtained. Dynamic balance was assessed using the timed-up-and-go test (TUG). For comparison between groups and repeated-measures, a mixed-design ANOVA was carried out and the Mann-Whitney U test to compare TUG between groups. The significance level was set at p ≤ .05. RESULTS Between groups, PDG presented higher mean values for SPL, APSR and SA in feet side-by-side eyes open compared to the OAG, for SPL in feet side-by-side eyes closed, for SPL and SA in STEO. For repeated-measures, both groups had higher mean values in the EC condition compared to EO and MLSR compared to APSR. No significant difference was found between groups for TUG. CONCLUSION Balance disorders are found early in people with Parkinson's disease compared to healthy older adults. Thus, Parkinson's disease seems to advance the process of alterations in the postural control system.
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Affiliation(s)
- Leilane Lazarotto
- Center for Motor Behavior Studies Center (CECOM), Ph.D. Program in Physical Education, Federal University of Paraná, Curitiba, Brazil.,Department of Physical Education, Universidade Federal do Parná, Curitiba, Brazil
| | - Giovana Z G Bobbo
- Center for Motor Behavior Studies Center (CECOM), Ph.D. Program in Physical Education, Federal University of Paraná, Curitiba, Brazil.,Department of Physical Education, Universidade Federal do Parná, Curitiba, Brazil
| | - Juliana Siega
- Center for Motor Behavior Studies Center (CECOM), Ph.D. Program in Physical Education, Federal University of Paraná, Curitiba, Brazil
| | - Adriano Z da Silva
- Center for Motor Behavior Studies Center (CECOM), Ph.D. Program in Physical Education, Federal University of Paraná, Curitiba, Brazil
| | - Dielise D Iucksch
- Center for Motor Behavior Studies Center (CECOM), Ph.D. Program in Physical Education, Federal University of Paraná, Curitiba, Brazil
| | - Vera L Israel
- Center for Motor Behavior Studies Center (CECOM), Ph.D. Program in Physical Education, Federal University of Paraná, Curitiba, Brazil
| | - Paulo C B Bento
- Center for Motor Behavior Studies Center (CECOM), Ph.D. Program in Physical Education, Federal University of Paraná, Curitiba, Brazil.,Department of Physical Education, Universidade Federal do Parná, Curitiba, Brazil
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Freitag F, Brucki SMD, Barbosa AF, Chen J, Souza CDO, Valente DF, Chien HF, Bedeschi C, Voos MC. Is virtual reality beneficial for dual-task gait training in patients with Parkinson's disease? A systematic review. Dement Neuropsychol 2019; 13:259-267. [PMID: 31555398 PMCID: PMC6753902 DOI: 10.1590/1980-57642018dn13-030002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
This systematic review examined the evidence about the effects of virtual reality (VR) on dual-task gait training in Parkinson's disease (PD).
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Affiliation(s)
- Fernanda Freitag
- FMUSP Department of Neurology Postgraduate Program in Neurology São PauloSP Brazil Postgraduate Program in Neurology, Department of Neurology, FMUSP, São Paulo, SP, Brazil.,Rehabilitation in Movement Disorders (REMOVE) Research Group São PauloSP Brazil Rehabilitation in Movement Disorders (REMOVE) Research Group,São Paulo, SP, Brazil
| | - Sonia Maria Dozzi Brucki
- FMUSP Department of Neurology Postgraduate Program in Neurology São PauloSP Brazil Postgraduate Program in Neurology, Department of Neurology, FMUSP, São Paulo, SP, Brazil
| | - Alessandra Ferreira Barbosa
- Rehabilitation in Movement Disorders (REMOVE) Research Group São PauloSP Brazil Rehabilitation in Movement Disorders (REMOVE) Research Group,São Paulo, SP, Brazil.,FMUSP Physiotherapy, Speech Therapy and Occupational Therapy Postgraduate Program in Rehabilitation Sciences São PauloSP Brazil Postgraduate Program in Rehabilitation Sciences. Physiotherapy, Speech Therapy and Occupational Therapy, FMUSP, São Paulo, SP, Brazil
| | - Janini Chen
- FMUSP Department of Neurology Postgraduate Program in Neurology São PauloSP Brazil Postgraduate Program in Neurology, Department of Neurology, FMUSP, São Paulo, SP, Brazil.,Rehabilitation in Movement Disorders (REMOVE) Research Group São PauloSP Brazil Rehabilitation in Movement Disorders (REMOVE) Research Group,São Paulo, SP, Brazil
| | - Carolina de Oliveira Souza
- FMUSP Department of Neurology Postgraduate Program in Neurology São PauloSP Brazil Postgraduate Program in Neurology, Department of Neurology, FMUSP, São Paulo, SP, Brazil.,Rehabilitation in Movement Disorders (REMOVE) Research Group São PauloSP Brazil Rehabilitation in Movement Disorders (REMOVE) Research Group,São Paulo, SP, Brazil
| | - Débora Francato Valente
- Rehabilitation in Movement Disorders (REMOVE) Research Group São PauloSP Brazil Rehabilitation in Movement Disorders (REMOVE) Research Group,São Paulo, SP, Brazil
| | - Hsin Fen Chien
- FMUSP Department of Neurology Postgraduate Program in Neurology São PauloSP Brazil Postgraduate Program in Neurology, Department of Neurology, FMUSP, São Paulo, SP, Brazil.,Rehabilitation in Movement Disorders (REMOVE) Research Group São PauloSP Brazil Rehabilitation in Movement Disorders (REMOVE) Research Group,São Paulo, SP, Brazil
| | - Cynthia Bedeschi
- USP Institute of Psychology Postgraduate program in Neuroscience and Behavior São PauloSP Brazil Postgraduate program in Neuroscience and Behavior, Institute of Psychology, USP, São Paulo, SP, Brazil
| | - Mariana Callil Voos
- FMUSP Department of Neurology Postgraduate Program in Neurology São PauloSP Brazil Postgraduate Program in Neurology, Department of Neurology, FMUSP, São Paulo, SP, Brazil.,Rehabilitation in Movement Disorders (REMOVE) Research Group São PauloSP Brazil Rehabilitation in Movement Disorders (REMOVE) Research Group,São Paulo, SP, Brazil.,FMUSP Physiotherapy, Speech Therapy and Occupational Therapy Postgraduate Program in Rehabilitation Sciences São PauloSP Brazil Postgraduate Program in Rehabilitation Sciences. Physiotherapy, Speech Therapy and Occupational Therapy, FMUSP, São Paulo, SP, Brazil
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13
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Workman CD, Thrasher TA. The influence of dopaminergic medication on balance automaticity in Parkinson's disease. Gait Posture 2019; 70:98-103. [PMID: 30836253 DOI: 10.1016/j.gaitpost.2019.02.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/05/2019] [Accepted: 02/20/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Studies have shown that dual-task standing balance in Parkinson's disease (PD) is significantly diminished. Additionally, it is well accepted that dopaminergic medication improves dynamic balance (Berg Balance Scale, mini-BESTest), but standing balance (force platform posturography) may suffer. What remains unknown is how dopaminergic medication influences standing balance automaticity in PD. RESEARCH QUESTION Does dopaminergic medication improve standing balance automaticity during a phoneme monitoring dual-task in PD? METHODS This was a cross-sectional study. Sixteen subjects with PD completed single- and dual-task standing with eyes open and eyes closed for 3 min each in off and on medication states. 95% confidence ellipse area, anterior-posterior sway velocity, medial-lateral sway velocity, and integrated time to boundary were calculated. Data were analyzed with a repeated measures ANOVA. RESULTS Dopaminergic medication significantly increased ellipse area (p = 0.002) and decreased the performance on the secondary task (p = 0.004). Different eyes conditions (open vs. closed) significantly increased both sway velocities (anterior-posterior = p < 0.001, medial-lateral = p < 0.001), and increased integrated time to boundary (p < 0.001). There were also task by eyes condition interaction effects for anterior-posterior velocity and integrated time to boundary (p = 0.015 and p = 0.009, respectively). Increases in sway velocity and integrated time to boundary seen in the eyes condition and interaction effects are traditionally interpreted as poorer balance performance. However, in the context of stability/maneuverability tradeoff, the changes may indicate an increase in freedom of movement instead of a decrease in stability. SIGNIFICANCE The data did not support a medication-induced improvement in automaticity, as measured by significant medication by task interactions. An alternate interpretation for medication-induced balance changes in PD includes an increase in maneuverability without sacrificing stability after taking dopaminergic medication.
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Affiliation(s)
- Craig D Workman
- Department of Health and Human Performance, University of Houston, 3855 Holman Street, 104 Garrison Gym, Houston, TX, 77204, USA; Center for Neuromotor and Biomechanics Research, 4733 Wheeler Ave, Houston, TX, 77204 USA.
| | - T Adam Thrasher
- Department of Health and Human Performance, University of Houston, 3855 Holman Street, 104 Garrison Gym, Houston, TX, 77204, USA; Center for Neuromotor and Biomechanics Research, 4733 Wheeler Ave, Houston, TX, 77204 USA.
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14
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Effects of dual-task aquatic exercises on functional mobility, balance and gait of individuals with Parkinson's disease: A randomized clinical trial with a 3-month follow-up. Complement Ther Med 2019; 42:119-124. [DOI: 10.1016/j.ctim.2018.10.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 09/19/2018] [Accepted: 10/29/2018] [Indexed: 11/18/2022] Open
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15
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Freitas TBD, Silva KGD, Nuvolini RA, Doná F, Pompeu JE, Swarowsky A, Torriani-Pasin C. Dual-task demands in various motor skills through Parkinson’s disease progression. MOTRIZ: REVISTA DE EDUCACAO FISICA 2019. [DOI: 10.1590/s1980-6574201900010011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | - Flávia Doná
- Universidade Anhanguera de São Paulo, Brazil
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16
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De Freitas TB, Leite PHW, Doná F, Pompeu JE, Swarowsky A, Torriani-Pasin C. The effects of dual task gait and balance training in Parkinson’s disease: a systematic review. Physiother Theory Pract 2018; 36:1088-1096. [DOI: 10.1080/09593985.2018.1551455] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Tatiana Beline De Freitas
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Paulo Henrique Wong Leite
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | - José Eduardo Pompeu
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Alessandra Swarowsky
- Physical Therapy Postgraduate Program, Physical Therapy Department, Santa Catarina State University (UDESC), Florianópolis, Brazil
- Brazilian Parkinson’s Disease Rehabilitation Initiative, Santa Catarina State University (UDESC), Florianópolis, Brazil
| | - Camila Torriani-Pasin
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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17
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Kamieniarz A, Michalska J, Brachman A, Pawłowski M, Słomka KJ, Juras G. A posturographic procedure assessing balance disorders in Parkinson's disease: a systematic review. Clin Interv Aging 2018; 13:2301-2316. [PMID: 30519012 PMCID: PMC6237244 DOI: 10.2147/cia.s180894] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Postural instability is common in Parkinson's disease (PD), often contributing to falls, injuries, and reduced mobility. In the clinical setting, balance disorder is commonly diagnosed using clinical tests and balance scales, but it is suggested that the most sensitive measurement is the force platform. The aim of this systematic review was to summarize the methods and various posturographic procedures used to assess the body balance and gait in PD. A systematic review was conducted of papers published from 2000 to 2017. Databases searched were PubMed and EBSCO. Studies must have involved patients with PD, used force platform or motion analysis system as a measurement tool, and described posturographic procedure. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. A total of 32 studies met the inclusion criteria. The PEDro scores ranged from 5 to 7 points. The analysis of the objective methods assessing balance disorders revealed a large discrepancy in the duration and procedures of measurements. The number of repetitions of each trial fluctuated between 1 and 8, and the duration of a single trial ranged from 10 to 60 seconds. Overall, there are many scales and tests used to assess the balance disorders and disabilities of people with PD. Although in many included studies the authors have used posturography as a method to evaluate the postural instability of PD patients, the results are contradictory. To solve this issue, it is indicated to establish a "gold standard" of procedures of measures of balance.
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Affiliation(s)
- Anna Kamieniarz
- Department of Human Motor Behavior, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland,
| | - Justyna Michalska
- Department of Human Motor Behavior, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland,
| | - Anna Brachman
- Department of Human Motor Behavior, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland,
| | - Michał Pawłowski
- Department of Human Motor Behavior, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland,
| | - Kajetan J Słomka
- Department of Human Motor Behavior, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland,
| | - Grzegorz Juras
- Department of Human Motor Behavior, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland,
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18
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Age-related changes in the range and velocity of postural sway. Arch Gerontol Geriatr 2018; 77:68-80. [PMID: 29684741 DOI: 10.1016/j.archger.2018.04.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 03/27/2018] [Accepted: 04/07/2018] [Indexed: 11/23/2022]
Abstract
The aim of this analysis was to compare values of centre of pressure (CoP) measures, which describe the ability to maintain static body balance (range of body sway and velocity in antero-posterior and medio-lateral directions), in two age groups on the basis of a systematic review and meta-analysis of available data published worldwide. After a systematic review of publications presenting values of selected CoP measures, a numerical database with means and standard deviations was created. Data were classified by eye condition (open or closed) and by age group (18-35 or ≥56). Allocation to each group was based on the mean value of age of each sub-group in the numerical database. The Mann-Whitney U test was used to test the statistical significance of differences between age groups and eyes-open and eyes-closed conditions. This article shows mathematical equations, which quantitatively express increases in body sway and its velocity with age. On the basis of those equations, higher values have been shown for both displacement and velocity measures for the EC vs. the EO conditions and for the elderly vs. the young. The differences between age groups are greater for the velocity measures.
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19
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Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease. Arch Phys Med Rehabil 2018; 99:1540-1546.e2. [PMID: 29608901 DOI: 10.1016/j.apmr.2018.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/12/2018] [Accepted: 02/19/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine the task prioritization effects on postural-suprapostural dual-task performance in patients with early-stage Parkinson disease (PD) without clinically observed postural symptoms. DESIGN Cross-sectional study. Participants performed a force-matching task while standing on a mobile platform, and were instructed to focus their attention on either the postural task (posture-first strategy) or the force-matching task (posture-second strategy). SETTING University research laboratory. PARTICIPANTS Individuals (N=16) with early-stage PD who had no clinically observed postural symptoms. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Dual-task change (DTC; percent change between single-task and dual-task performance) of posture error, posture approximate entropy (ApEn), force error, and reaction time (RT). Positive DTC values indicate higher postural error, posture ApEn, force error, and force RT during dual-task conditions compared with single-task conditions. RESULTS Compared with the posture-first strategy, the posture-second strategy was associated with smaller DTC of posture error and force error, and greater DTC of posture ApEn. In contrast, greater DTC of force RT was observed under the posture-second strategy. CONCLUSIONS Contrary to typical recommendations, our results suggest that the posture-second strategy may be an effective dual-task strategy in patients with early-stage PD who have no clinically observed postural symptoms in order to reduce the negative effect of dual tasking on performance and facilitate postural automaticity.
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20
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Phenotype of postural instability/gait difficulty in Parkinson disease: relevance to cognitive impairment and mechanism relating pathological proteins and neurotransmitters. Sci Rep 2017; 7:44872. [PMID: 28332604 PMCID: PMC5362957 DOI: 10.1038/srep44872] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 02/15/2017] [Indexed: 12/25/2022] Open
Abstract
Parkinson disease (PD) is identified as tremor-dominant (TD) and postural instability and gait difficulty (PIGD) phenotypes. The relationships between motor phenotypes and cognitive impairment and the underlying mechanisms relating pathological proteins and neurotransmitters in cerebrospinal fluid (CSF) are unknown. We evaluated the motor symptoms and cognitive function by scales, and detected the levels of pathological proteins and neurotransmitters in CSF. TD group and PIGD group had significantly higher levels of total tau, tau phosphorylated at the position of threonine 181(P-tau181t), threonine 231, serine 396, serine 199 and lower β amyloid (Aβ)1–42 level in CSF than those in control group; PIGD group had significantly higher P-tau181t level and lower Aβ1–42 level than those in TD group. In PD group, PIGD severity was negatively correlated with MoCA score and Aβ1–42 level in CSF, and positively correlated with Hoehn-Yahr stage and P-tau181t level in CSF. In PIGD group, PIGD severity was negatively correlated with homovanillic acid (HVA) level in CSF, and HVA level was positively correlated with Aβ1–42 level in CSF. PIGD was significantly correlated with cognitive impairment, which underlying mechanism might be involved in Aβ1–42 aggregation in brain and relevant neurochemical disturbance featured by the depletion of HVA in CSF.
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21
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Nadeau A, Lungu O, Duchesne C, Robillard MÈ, Bore A, Bobeuf F, Plamondon R, Lafontaine AL, Gheysen F, Bherer L, Doyon J. A 12-Week Cycling Training Regimen Improves Gait and Executive Functions Concomitantly in People with Parkinson's Disease. Front Hum Neurosci 2017; 10:690. [PMID: 28127282 PMCID: PMC5226941 DOI: 10.3389/fnhum.2016.00690] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/26/2016] [Indexed: 12/13/2022] Open
Abstract
Background: There is increasing evidence that executive functions and attention are associated with gait and balance, and that this link is especially prominent in older individuals or those who are afflicted by neurodegenerative diseases that affect cognition and/or motor functions. People with Parkinson’s disease (PD) often present gait disturbances, which can be reduced when PD patients engage in different types of physical exercise (PE), such as walking on a treadmill. Similarly, PE has also been found to improve executive functions in this population. Yet, no exercise intervention investigated simultaneously gait and non-motor symptoms (executive functions, motor learning) in PD patients. Objective: To assess the impact of aerobic exercise training (AET) using a stationary bicycle on a set of gait parameters (walking speed, cadence, step length, step width, single and double support time, as well as variability of step length, step width and double support time) and executive functions (cognitive inhibition and flexibility) in sedentary PD patients and healthy controls. Methods: Two groups, 19 PD patients (Hoehn and Yahr ≤2) and 20 healthy adults, matched on age and sedentary level, followed a 3-month stationary bicycle AET regimen. Results: Aerobic capacity, as well as performance of motor learning and on cognitive inhibition, increased significantly in both groups after the training regimen, but only PD patients improved their walking speed and cadence (all p < 0.05; with no change in the step length). Moreover, in PD patients, training-related improvements in aerobic capacity correlated positively with improvements in walking speed (r = 0.461, p < 0.05). Conclusion: AET using stationary bicycle can independently improve gait and cognitive inhibition in sedentary PD patients. Given that increases in walking speed were obtained through increases in cadence, with no change in step length, our findings suggest that gait improvements are specific to the type of motor activity practiced during exercise (i.e., pedaling). In contrast, the improvements seen in cognitive inhibition were, most likely, not specific to the type of training and they could be due to indirect action mechanisms (i.e., improvement of cardiovascular capacity). These results are also relevant for the development of targeted AET interventions to improve functional autonomy in PD patients.
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Affiliation(s)
- Alexandra Nadeau
- Research Center of the University Institute of Geriatrics of MontrealMontreal, QC, Canada; Functional Neuroimaging UnitMontreal, QC, Canada; Department of Psychology, University of MontrealMontreal, QC, Canada
| | - Ovidiu Lungu
- Research Center of the University Institute of Geriatrics of MontrealMontreal, QC, Canada; Functional Neuroimaging UnitMontreal, QC, Canada; Department of Psychiatry, University of MontrealMontreal, QC, Canada; Centre for Research in Aging, Donald Berman Maimonides Geriatric CentreMontreal, QC, Canada
| | - Catherine Duchesne
- Research Center of the University Institute of Geriatrics of MontrealMontreal, QC, Canada; Functional Neuroimaging UnitMontreal, QC, Canada; Department of Psychology, University of MontrealMontreal, QC, Canada
| | - Marie-Ève Robillard
- Research Center of the University Institute of Geriatrics of MontrealMontreal, QC, Canada; Functional Neuroimaging UnitMontreal, QC, Canada
| | - Arnaud Bore
- Research Center of the University Institute of Geriatrics of MontrealMontreal, QC, Canada; Functional Neuroimaging UnitMontreal, QC, Canada
| | - Florian Bobeuf
- Research Center of the University Institute of Geriatrics of MontrealMontreal, QC, Canada; PERFORM Centre, Concordia UniversityMontreal, QC, Canada
| | - Réjean Plamondon
- Department of Electrical Engineering, Polytechnique Montreal Montreal, QC, Canada
| | - Anne-Louise Lafontaine
- Research Center of the University Institute of Geriatrics of MontrealMontreal, QC, Canada; Functional Neuroimaging UnitMontreal, QC, Canada; McGill Movement Disorder Clinic, McGill UniversityMontreal, QC, Canada
| | - Freja Gheysen
- Department of Movement and Sport Sciences, Ghent University Ghent, Belgium
| | - Louis Bherer
- Research Center of the University Institute of Geriatrics of MontrealMontreal, QC, Canada; PERFORM Centre, Concordia UniversityMontreal, QC, Canada; Department of Medicine, University of MontrealMontreal, QC, Canada; Montreal Heart InstituteMontreal, QC, Canada
| | - Julien Doyon
- Research Center of the University Institute of Geriatrics of MontrealMontreal, QC, Canada; Functional Neuroimaging UnitMontreal, QC, Canada; Department of Psychology, University of MontrealMontreal, QC, Canada
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Barbosa AF, Chen J, Freitag F, Valente D, Souza CDO, Voos MC, Chien HF. Gait, posture and cognition in Parkinson's disease. Dement Neuropsychol 2016; 10:280-286. [PMID: 29213470 PMCID: PMC5619266 DOI: 10.1590/s1980-5764-2016dn1004005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Gait disorders and postural instability are the leading causes of falls and
disability in Parkinson's disease (PD). Cognition plays an important role in
postural control and may interfere with gait and posture assessment and
treatment. It is important to recognize gait, posture and balance dysfunctions
by choosing proper assessment tools for PD. Patients at higher risk of falling
must be referred for rehabilitation as early as possible, because
antiparkinsonian drugs and surgery do not improve gait and posture in PD.
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Affiliation(s)
- Alessandra Ferreira Barbosa
- Physical Therapy, Occupational Therapy and Speech Therapy Department, University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group
| | - Janini Chen
- Movement Disorders Clinic of Hospital das Clinicas of the Department of Neurology. University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group
| | - Fernanda Freitag
- Movement Disorders Clinic of Hospital das Clinicas of the Department of Neurology. University of São Paulo School of Medicine, São Paulo, SP, Brazil
| | - Debora Valente
- Movement Disorders Clinic of Hospital das Clinicas of the Department of Neurology. University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group
| | - Carolina de Oliveira Souza
- Movement Disorders Clinic of Hospital das Clinicas of the Department of Neurology. University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group
| | - Mariana Callil Voos
- Physical Therapy, Occupational Therapy and Speech Therapy Department, University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group
| | - Hsin Fen Chien
- Movement Disorders Clinic of Hospital das Clinicas of the Department of Neurology. University of São Paulo School of Medicine, São Paulo, SP, Brazil.,ReMove. Rehabilitation of Movement Disorders Research Group.,Institute of Orthopedics and Traumatology of Hospital das Clínicas of University of São Paulo School of Medicine, São Paulo, SP, Brazil
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Terra MB, Rosa PC, Torrecilha LA, Costa BT, Ferraz HB, Santos SMS. Impacto da doença de Parkinson na performance do equilíbrio em diferentes demandas atencionais. FISIOTERAPIA E PESQUISA 2016. [DOI: 10.1590/1809-2950/16659423042016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo foi avaliar o equilíbrio de pacientes com doença de Parkinson (DP) na posição de tandem com os olhos abertos (OA), olhos fechados (OF) e em condição de dupla tarefa (DT). Trata-se de um estudo transversal composto por 19 indivíduos com DP nos estágios leve a moderado. Os pacientes foram avaliados em uma plataforma de força Biomec400. Os parâmetros analisados foram a área do centro de pressão dos pés (COP) e a amplitude e velocidade do COP nas direções anteroposterior (AP) e mediolateral (ML). Foram encontrados resultados estatisticamente significantes para amplitude AP e ML do COP e da área do COP, com valores maiores para as posições em tandem de OF e tandem com DT, quando comparados com a posição em tandem de OA. Os valores de velocidade média AP e ML foram maiores na posição em tandem de OF em comparação ao tandem de OA (p=0,009 e p=0), respectivamente. Concluiu-se que indivíduos com DP, quando submetidos a desafios cognitivos, comportam-se de forma semelhante à retirada do recurso visual no que diz respeito às alterações de equilíbrio. Isso reforça a necessidade de introduzir no plano terapêutico desses indivíduos atividades que requeiram o treino dessas habilidades.
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24
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Coelho T, Fernandes Â, Santos R, Paúl C, Fernandes L. Quality of standing balance in community-dwelling elderly: Age-related differences in single and dual task conditions. Arch Gerontol Geriatr 2016; 67:34-9. [PMID: 27400450 DOI: 10.1016/j.archger.2016.06.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/26/2016] [Accepted: 06/12/2016] [Indexed: 10/21/2022]
Abstract
AIM To examine the relationship between age and quality of standing balance in single and dual task conditions. METHODS A cross-sectional study was conducted using a sample of 243 community-dwellers aged ≥65 years. Quality of standing balance was assessed by measuring the center of pressure (COP) sway with a pressure platform. Measurements were performed under single task (orthostatic position) and dual task (orthostatic position while performing a verbal fluency task) conditions. RESULTS The mean age of the participants was 79.1(±7.3)years and 76.1% were women. Older age was associated with an increased COP sway, mainly in the medial/lateral (ML) direction. Most COP sway parameters were higher under dual task conditions than under single task. After controlling for the effect of the number of words enunciated in dual task conditions, only the differences in COP sway parameters in the ML direction remained significant. There was no significant interaction between age group (65-79; ≥80 years) and condition, which indicates that differences in COP sway caused by performing a secondary task were similar for younger and for older participants. CONCLUSION Age did not seem to influence significantly the decline in the quality of standing balance triggered by performing a concurrent cognitive task. However, older age was consistently associated with poorer standing balance, both in single and in dual task conditions. Therefore, performing a secondary task may lead older individuals to reach their postural stability limits and, consequently, to fall.
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Affiliation(s)
- Tiago Coelho
- School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal.
| | - Ângela Fernandes
- School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal; Activity and Human Movement Study Center, School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal
| | - Rubim Santos
- School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal; Activity and Human Movement Study Center, School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal
| | - Constança Paúl
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Portugal; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal
| | - Lia Fernandes
- Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal; Faculty of Medicine, University of Porto, Portugal
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