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Hainline G, Hainline RD, Handlery R, Fritz S. A Scoping Review of the Predictive Qualities of Walking Speed in Older Adults. J Geriatr Phys Ther 2024; 47:183-191. [PMID: 37820357 PMCID: PMC11006824 DOI: 10.1519/jpt.0000000000000398] [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] [Indexed: 10/13/2023]
Abstract
BACKGROUND AND PURPOSE Walking speed (WS) is an easily assessable and interpretable functional outcome measure with great utility for the physical therapist providing care to older adults. Since WS was proposed as the sixth vital sign, research into its interpretation and use has flourished. The purpose of this scoping review is to identify the current prognostic value of WS for the older adult. METHODS A scoping review was conducted using PubMed, CINAHL, and SPORTDiscus to find relevant articles highlighting the predictive capabilities of WS for older adults. Titles and abstracts were reviewed to identify relevant articles. Articles were excluded based on the following criteria: sample included both younger and older adults without separate analyses, sample was focused on a particular disease, if the study was published before 2017, or if the study did not report relevant cut points for interpretation of WS. The search returned 1064 results. Following removal of articles not meeting inclusion criteria and critical appraisal, relevant cut points were extracted from 47 original research publications. RESULTS AND DISCUSSION A preliminary review of the included articles showed that WS is a valuable prognostic tool across many health domains, including mental health, mortality, disability, pain, bone and joint health, falls, cognition, physical activity, metabolic health, risk for cardiovascular disease, socialization, and metabolic health. The fastest WS of 1.32 meters per second (m/s) served as a cutoff for decreased risk for incident development of type 2 diabetes, while the slowest WS of less than 0.2 m/s was associated with increased duration of hospitalization. Multiple studies reported on the prognostic value of WS slower than 1.0 m/s. CONCLUSION Although the reported range of predictive WS values was broad, multiple studies found WS of approximately 1.0 m/s to be a useful marker for delineating risk or decline across a variety of health domains. Clinicians may find it useful to use a WS slower than 1.0 m/s as a "yellow flag" to guide evaluation and intervention for their older adult clients.
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Lozano-Meca J, Montilla-Herrador J, Gacto-Sánchez M. Gait speed in knee osteoarthritis: A simple 10-meter walk test predicts the distance covered in the 6-minute walk test. Musculoskelet Sci Pract 2024; 72:102983. [PMID: 38851178 DOI: 10.1016/j.msksp.2024.102983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 04/25/2024] [Accepted: 06/01/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND The 6-Minute Walk Test (6MWT) is a common performance-measure in Knee Osteoarthritis (KOA), but the pain and functional impairment characterizing the condition may interfere its adequate performance. OBJECTIVES The shorter 10-m Walk Test (10mWT) could predict the distance performed on the 6MWT, therefore decreasing the burden on patients, enhancing efficiency, and reducing space- and time-constraints in clinical settings. DESIGN A cross sectional study was conducted. METHODS The scores from the 6MWT and the shorter 10mWT of 58 ambulatory subjects with KOA were compared. Correlation, and a univariate regression analysis to explore the predictive ability of the 10mWT, were calculated. RESULTS Correlation was excellent (r = 0.913, p-value<0.001), and the predictive equation based on the 10mWT scores (R2 = 0.834, p-value<0.001) estimates the distance walked in the 6MWT with a relative error of 7.62%. CONCLUSIONS The 10mWT may be an excellent assessment-tool to predict the distance walked in the 6MWT, due to its low strain on patients and as a means of improving efficiency and reducing time-constraints.
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Affiliation(s)
- José Lozano-Meca
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain
| | - Joaquina Montilla-Herrador
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain.
| | - Mariano Gacto-Sánchez
- Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain
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Kocer B, Soke F, Ataoglu NEE, Ersoy N, Gulsen C, Gulsen EO, Yasa ME, Uysal I, Comoglu SS, Bora HAT. The reliability and validity of the 3-m backward walk test in people with Parkinson's disease. Ir J Med Sci 2023; 192:3063-3071. [PMID: 37160569 DOI: 10.1007/s11845-023-03384-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/20/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND People with Parkinson's disease (PwPD) lose the ability in backward walking which is an important part of mobility in daily life. The 3-m backward walk test (3MBWT) evaluates backward walking; however, its reliability and validity have not been examined in PwPD yet. AIMS To examine (1) the test-retest reliability of the 3MBWT in PwPD; (2) the minimum detectable change in the 3MBWT times; (3) the concurrent and known-groups validity of the 3MBWT; and (4) the optimum cutoff time which best discriminates fallers from non-fallers with Parkinson's disease (PD). METHODS This cross-sectional study included 36 PwPD and 33 healthy people. The 3MBWT was conducted with the 10-m walk test, timed up and go test, Berg Balance Scale, four square step test, activity-specific balance confidence scale, Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale, and Hoehn and Yahr Scale. RESULTS The 3MBWT demonstrated excellent test-retest reliability (ICC = 0.965). The MDC of 2.13 s was determined. The 3MBWT had moderate to high correlations with the other outcome measures (correlation coefficient ranged from -0.592 to 0.858). On the 3MBWT times, there were significant differences between PwPD and healthy people, and between fallers and non-fallers with PD (p < 0.001 and p < 0.001, respectively). A 3MBWT time of 10.31 s was found to best discriminate fallers from non-fallers with PD. CONCLUSIONS The 3MBWT is a reliable, valid, and easy to administer outcome measure to assess backward walking performance in PwPD, indicating it to be used in practice and research.
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Affiliation(s)
- Bilge Kocer
- Ankara Etlik City Hospital, Department of Neurology, University of Health Sciences, Varlik Neighborhood, Halil Sezai Erkut Street, Yenimahalle, Ankara, Turkey.
| | - Fatih Soke
- Gulhane Faculty of Physiotherapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | | | - Nursena Ersoy
- Faculty of Health Sciences, Department of Nutrition and Dietetic, Ankara University, Ankara, Turkey
| | - Cagri Gulsen
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Elvan Ozcan Gulsen
- Vocational School of Health Services, Elderly Care Program, Anadolu University, Eskisehir, Turkey
| | - Mustafa Ertugrul Yasa
- Gulhane Faculty of Physiotherapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Ismail Uysal
- Fethiye Vocational School of Health Services, Department of Health Care Services, Mugla Sitki Kocman University, Ankara, Turkey
| | - Selim Selcuk Comoglu
- Ankara Etlik City Hospital, Department of Neurology, University of Health Sciences, Varlik Neighborhood, Halil Sezai Erkut Street, Yenimahalle, Ankara, Turkey
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Demircan EN, Köse N, Çakmaklı GY, Aksoy S, Göçmen R, Zengin HY, Elibol B. Do cervical stabilization exercises change the effects of conventional exercises in patients with Parkinson's disease? Neurol Res 2023; 45:936-946. [PMID: 37608568 DOI: 10.1080/01616412.2023.2249699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 08/15/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES The aim of this study was to examine whether cervical stabilization exercises (CSEs) change the effects of conventional exercises (CEs) in patients with PD. METHODS Twenty-five patients with PD were randomized into two groups. While the experimental group (EG) received CSEs in addition to CEs, the control group (CG) received only CEs. Both programs lasted 8 weeks. Eighteen participants were able to complete the study. The outcomes were the changes in posture, cervical joint position sense (JPS), balance assessment, 10-m walking tests (10MWT), and the Timed Up & Go (TUG) test. RESULTS At the end of the study, significant improvement was observed in both groups in terms of trunk rotation angle and pelvic asymmetry, the time parameter of TUG, and the 10MWT (p < 0.05). In the EG, greater improvement was detected in the Berg Balance Scale, static posturography, postural alignment, JPS, and the cadence parameter of TUG (p < 0.05). DISCUSSION CEs and CSEs could improve walking speed and posture in patients with PD, but if CSEs are added to CEs, greater improvements could be achieved in JPS and postural control.(Clinical Trials ID: NCT03854747).
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Affiliation(s)
- Emine Nur Demircan
- Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Nezire Köse
- Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gül Yalçın Çakmaklı
- Faculty of Medicine, Department of Neurology, Hacettepe University, Ankara, Turkey
| | - Songül Aksoy
- Faculty of Health Sciences, Department of Audiology, Lokman Hekim University, Ankara, Turkey
| | - Rahşan Göçmen
- Faculty of Medicine, Department of Radiology, Hacettepe University, Ankara, Turkey
| | - Hatice Yağmur Zengin
- Faculty of Medicine, Department of Biostatistics, Hacettepe University, Ankara, Turkey
| | - Bülent Elibol
- Faculty of Medicine, Department of Neurology, Hacettepe University, Ankara, Turkey
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Smitheman HP, Lundberg M, Härnesand M, Gelfgren S, Grävare Silbernagel K. Putting the fear-avoidance model into practice - what can patients with chronic low back pain learn from patients with Achilles tendinopathy and vice versa? Braz J Phys Ther 2023; 27:100557. [PMID: 37952338 PMCID: PMC10682544 DOI: 10.1016/j.bjpt.2023.100557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 02/02/2023] [Accepted: 10/25/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Fear-avoidance variables are present in patients with musculoskeletal pain conditions, such as chronic low back pain (CLBP) and Achilles tendinopathy (AT) and can lead to reduced function and recovery. It is unknown how these variables relate in populations with different etiologies but similar pain provocation mechanisms. OBJECTIVE To compare kinesiophobia, pain catastrophizing, and disability between these two groups. METHODS Patients with CLBP and those with AT were included. Tampa Scale of Kinesiophobia (TSK-17) and Pain Catastrophizing Scale (PCS-13) were evaluated in both groups. The CLBP group completed the Oswestry Disability Index (ODI) and the AT group completed the PROMIS-29 questionnaire. Gait speed was calculated for each group. Disability outcomes were normalized between groups. RESULTS 119 patients in the CLBP group (64 female, 46 ± 8 years) and 83 patients in the AT group (42 female, 48 ± 12 years) were included. Both groups (CLBP, AT) presented with high prevalence of kinesiophobia (67%, 55%) but the CLBP group presented with higher prevalence of pain catastrophizing (22%, 2%). The CLBP group demonstrated higher levels of disability via normalized ODI (MD= 12.4, 95% CI: 9.2, 15.5) but the AT group demonstrated slower gait speed (MD= 0.1 m/s, 95% CI: 0.0, 0.2). CONCLUSION Similarly high prevalence of kinesiophobia was found in patients with CLBP and patients with AT. While the CLBP group reported greater prevalence of catastrophizing thoughts and greater disability, the AT group had slower gait speed. Overall, these findings demonstrate that CLBP and AT have similarities that may allow clinicians to learn from one to inform treatment of the other. CLINICAL TRIAL REGISTRATION NUMBERS NCT03523325, ISRCTN17115599.
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Affiliation(s)
| | - Mari Lundberg
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Malin Härnesand
- Department of Health and Rehabilitation, University of Gothenburg, Göteborg, Sweden
| | - Sara Gelfgren
- Department of Health and Rehabilitation, University of Gothenburg, Göteborg, Sweden
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Capecci M, Cima R, Barbini FA, Mantoan A, Sernissi F, Lai S, Fava R, Tagliapietra L, Ascari L, Izzo RN, Leombruni ME, Casoli P, Hibel M, Ceravolo MG. Telerehabilitation with ARC Intellicare to Cope with Motor and Respiratory Disabilities: Results about the Process, Usability, and Clinical Effect of the "Ricominciare" Pilot Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:7238. [PMID: 37631774 PMCID: PMC10459854 DOI: 10.3390/s23167238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/04/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND "Ricominciare" is a single-center, prospective, pre-/post-intervention pilot study aimed at verifying the feasibility and safety of the ARC Intellicare (ARC) system (an artificial intelligence-powered and inertial motion unit-based mobile platform) in the home rehabilitation of people with disabilities due to respiratory or neurological diseases. METHODS People with Parkinson's disease (pwPD) or post-COVID-19 condition (COV19) and an indication for exercise or home rehabilitation to optimize motor and respiratory function were enrolled. They underwent training for ARC usage and received an ARC unit to be used independently at home for 4 weeks, for 45 min 5 days/week sessions of respiratory and motor patient-tailored rehabilitation. ARC allows for exercise monitoring thanks to data from five IMU sensors, processed by an AI proprietary library to provide (i) patients with real-time feedback and (ii) therapists with information on patient adherence to the prescribed therapy. Usability (System Usability Scale, SUS), adherence, and adverse events were primary study outcomes. Modified Barthel Index (mBI), Barthel Dyspnea Index (BaDI), 2-Minute Walking Test (2MWT), Brief Fatigue Inventory (BFI), Beck Depression or Anxiety Inventory (BDI, BAI), and quality of life (EQ-5D) were also monitored pre- and post-treatment. RESULTS A total of 21 out of 23 eligible patients were enrolled and completed the study: 11 COV19 and 10 pwPD. The mean total SUS score was 77/100. The median patients' adherence to exercise prescriptions was 80%. Clinical outcome measures (BaDI, 2MWT distance, BFI; BAI, BDI, and EQ-5D) improved significantly; no side effects were reported. CONCLUSION ARC is usable and safe for home rehabilitation. Preliminary data suggest promising results on the effectiveness in subjects with post-COVID condition or Parkinson's disease.
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Affiliation(s)
- Marianna Capecci
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy; (R.C.); (F.A.B.); (R.N.I.); (M.E.L.); (P.C.); (M.H.); (M.G.C.)
| | - Rossella Cima
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy; (R.C.); (F.A.B.); (R.N.I.); (M.E.L.); (P.C.); (M.H.); (M.G.C.)
| | - Filippo A. Barbini
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy; (R.C.); (F.A.B.); (R.N.I.); (M.E.L.); (P.C.); (M.H.); (M.G.C.)
| | - Alice Mantoan
- Henesis Division, Camlin Italy Srl, 43123 Parma, Italy; (A.M.); (F.S.); (S.L.); (R.F.); (L.T.); (L.A.)
| | - Francesca Sernissi
- Henesis Division, Camlin Italy Srl, 43123 Parma, Italy; (A.M.); (F.S.); (S.L.); (R.F.); (L.T.); (L.A.)
| | - Stefano Lai
- Henesis Division, Camlin Italy Srl, 43123 Parma, Italy; (A.M.); (F.S.); (S.L.); (R.F.); (L.T.); (L.A.)
| | - Riccardo Fava
- Henesis Division, Camlin Italy Srl, 43123 Parma, Italy; (A.M.); (F.S.); (S.L.); (R.F.); (L.T.); (L.A.)
| | - Luca Tagliapietra
- Henesis Division, Camlin Italy Srl, 43123 Parma, Italy; (A.M.); (F.S.); (S.L.); (R.F.); (L.T.); (L.A.)
| | - Luca Ascari
- Henesis Division, Camlin Italy Srl, 43123 Parma, Italy; (A.M.); (F.S.); (S.L.); (R.F.); (L.T.); (L.A.)
| | - Roberto N. Izzo
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy; (R.C.); (F.A.B.); (R.N.I.); (M.E.L.); (P.C.); (M.H.); (M.G.C.)
| | - Maria Eleonora Leombruni
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy; (R.C.); (F.A.B.); (R.N.I.); (M.E.L.); (P.C.); (M.H.); (M.G.C.)
| | - Paola Casoli
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy; (R.C.); (F.A.B.); (R.N.I.); (M.E.L.); (P.C.); (M.H.); (M.G.C.)
| | - Margherita Hibel
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy; (R.C.); (F.A.B.); (R.N.I.); (M.E.L.); (P.C.); (M.H.); (M.G.C.)
| | - Maria Gabriella Ceravolo
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy; (R.C.); (F.A.B.); (R.N.I.); (M.E.L.); (P.C.); (M.H.); (M.G.C.)
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Ge L, Huang H, Yu Q, Li Y, Li X, Li Z, Chen X, Li L, Wang C. Effects of core stability training on older women with low back pain: a randomized controlled trial. Eur Rev Aging Phys Act 2022; 19:10. [PMID: 35428169 PMCID: PMC9011968 DOI: 10.1186/s11556-022-00289-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/01/2022] [Indexed: 11/28/2022] Open
Abstract
Background Studies have demonstrated that elderly people with low back pain (LBP) may have poor postural control compared to healthy older adults. Poor postural control is associated with poor balance performance and a high risk of serious falls. A variety of training strategies are proposed for LBP therapy, particularly core stabilization training. But this treatment for older people with LBP remains unclear. Methods 31 participants were randomly placed in a core stability training group (TG, n = 15) and a control group (CG, n = 16). The participants in the training group were required to complete 4 sets of core stability training and conventional physiotherapy 4 times per week for 4 weeks, whereas the participants in the control group only completed physiotherapy 4 times per week for 4 weeks. Ultrasound imaging was used to measure transverse abdominal muscle (TrA) thickness before and after the intervention. A 10-cm visual analog scale (VAS), the Oswestry Disability Index (ODI), and mobility functions were applied before and after the intervention. Data are reported as the median and range and were compared using two-way repeated-measures ANOVA,t-tests and chi-squared tests. P < 0.05 was considered significant in all statistical tests. Results After intervention, there was a statistically significant difference in scores in the intervention group, especially for VAS, ODI, timed up-and-go,10-m walking and the four-square step test. TrA thickness was increased after core stability training, which was not observed in the control group. Conclusion Core stability training is an effective intervention for older women with LBP. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-022-00289-x.
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Adams JL, Dinesh K, Snyder CW, Xiong M, Tarolli CG, Sharma S, Dorsey ER, Sharma G. A real-world study of wearable sensors in Parkinson's disease. NPJ Parkinsons Dis 2021; 7:106. [PMID: 34845224 PMCID: PMC8629990 DOI: 10.1038/s41531-021-00248-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 10/27/2021] [Indexed: 12/17/2022] Open
Abstract
Most wearable sensor studies in Parkinson's disease have been conducted in the clinic and thus may not be a true representation of everyday symptoms and symptom variation. Our goal was to measure activity, gait, and tremor using wearable sensors inside and outside the clinic. In this observational study, we assessed motor features using wearable sensors developed by MC10, Inc. Participants wore five sensors, one on each limb and on the trunk, during an in-person clinic visit and for two days thereafter. Using the accelerometer data from the sensors, activity states (lying, sitting, standing, walking) were determined and steps per day were also computed by aggregating over 2 s walking intervals. For non-walking periods, tremor durations were identified that had a characteristic frequency between 3 and 10 Hz. We analyzed data from 17 individuals with Parkinson's disease and 17 age-matched controls over an average 45.4 h of sensor wear. Individuals with Parkinson's walked significantly less (median [inter-quartile range]: 4980 [2835-7163] steps/day) than controls (7367 [5106-8928] steps/day; P = 0.04). Tremor was present for 1.6 [0.4-5.9] hours (median [range]) per day in most-affected hands (MDS-UPDRS 3.17a or 3.17b = 1-4) of individuals with Parkinson's, which was significantly higher than the 0.5 [0.3-2.3] hours per day in less-affected hands (MDS-UPDRS 3.17a or 3.17b = 0). These results, which require replication in larger cohorts, advance our understanding of the manifestations of Parkinson's in real-world settings.
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Affiliation(s)
- Jamie L Adams
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA.
| | - Karthik Dinesh
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, USA
| | | | - Mulin Xiong
- Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Christopher G Tarolli
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Saloni Sharma
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - E Ray Dorsey
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Gaurav Sharma
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, USA
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Lavoie V, Bouchard M, Turcotte S, Tousignant M. Telerehabilitation for Individuals with Parkinson's Disease and a History of Falls: A Pilot Study. Physiother Can 2021; 73:343-350. [PMID: 34880539 DOI: 10.3138/ptc-2019-0108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Falls among persons with Parkinson's disease (PD) decrease health-related quality of life (HRQOL) and are a risk factor for hospitalization. Although physiotherapy can decrease falls and improve functional capacity, people living in remote areas have limited access to such services. This pilot study aimed to document the feasibility of a physiotherapy telerehabilitation intervention for patients with PD and to estimate the change over time in functional capacity, HRQOL, and the rate of falls. Methods: Eleven persons with PD participated in an 8-week physiotherapy telerehabilitation intervention. We assessed feasibility by computing retention rate and assiduity, number of undesirable health events, and technical problems. We assessed functional capacity, HRQOL, and falls at baseline, after the intervention, and at the 3-month follow-up. Results: Retention rate and assiduity were 91% and 100%. We resolved all technical problems (21.9% of sessions). No undesirable health events occurred. Point estimates suggest an improvement in functional capacity (Mini-BESTest) and HRQOL. Forty percent of participants fell during the intervention phase. Conclusion: Physiotherapy telerehabilitation is feasible and safe for persons with PD. Improvements in functional capacity and HRQOL must be confirmed with an appropriate design.
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Affiliation(s)
- Violaine Lavoie
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Quebec, Canada.,Centre de recherche CISSS-CA, Lévis, Quebec, Canada
| | - Manon Bouchard
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Quebec, Canada.,Clinique Neuro-Lévis, Lévis, Quebec, Canada
| | - Stéphane Turcotte
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Quebec, Canada
| | - Michel Tousignant
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Quebec, Canada.,Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
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10
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Waddell EM, Dinesh K, Spear KL, Elson MJ, Wagner E, Curtis MJ, Mitten DJ, Tarolli CG, Sharma G, Dorsey ER, Adams JL. GEORGE®: A Pilot Study of a Smartphone Application for Huntington's Disease. J Huntingtons Dis 2021; 10:293-301. [PMID: 33814455 DOI: 10.3233/jhd-200452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Current Huntington's disease (HD) measures are limited to subjective, episodic assessments conducted in clinic. Smartphones can enable the collection of objective, real-world data but their use has not been extensively evaluated in HD. OBJECTIVE Develop and evaluate a smartphone application to assess feasibility of use and key features of HD in clinic and at home. METHODS We developed GEORGE®, an Android smartphone application for HD which assesses voice, chorea, balance, gait, and finger tapping speed. We then conducted an observational pilot study of individuals with manifest HD, prodromal HD, and without a movement disorder. In clinic, participants performed standard clinical assessments and a battery of active tasks in GEORGE. At home, participants were instructed to complete the activities thrice daily for one month. Sensor data were used to measure chorea, tap rate, and step count. Audio data was not analyzed. RESULTS Twenty-three participants (8 manifest HD, 5 prodromal HD, 10 controls) enrolled, and all but one completed the study. On average, participants used the application 2.1 times daily. We observed a significant difference in chorea score (HD: 19.5; prodromal HD: 4.5, p = 0.007; controls: 4.3, p = 0.001) and tap rate (HD: 2.5 taps/s; prodromal HD: 8.9 taps/s, p = 0.001; controls: 8.1 taps/s, p = 0.001) between individuals with and without manifest HD. Tap rate correlated strongly with the traditional UHDRS finger tapping score (left hand: r = -0.82, p = 0.022; right hand: r = -0.79, p = 0.03). CONCLUSION GEORGE is an acceptable and effective tool to differentiate individuals with and without manifest HD and measure key disease features. Refinement of the application's interface and activities will improve its usability and sensitivity and, ideally, make it useful for clinical care and research.
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Affiliation(s)
- Emma M Waddell
- Center for Health+Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Karthik Dinesh
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, USA
| | - Kelsey L Spear
- Center for Health+Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Molly J Elson
- Emory University School of Medicine, Emory University, Atlanta, GA, USA
| | - Ellen Wagner
- Center for Health+Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael J Curtis
- UR Health Lab, University of Rochester Medical Center, Rochester, NY, USA
| | - David J Mitten
- UR Health Lab, University of Rochester Medical Center, Rochester, NY, USA
| | - Christopher G Tarolli
- Center for Health+Technology, University of Rochester Medical Center, Rochester, NY, USA.,Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Gaurav Sharma
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, USA
| | - E Ray Dorsey
- Center for Health+Technology, University of Rochester Medical Center, Rochester, NY, USA.,Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Jamie L Adams
- Center for Health+Technology, University of Rochester Medical Center, Rochester, NY, USA.,Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
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11
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Shearin S, Medley A, Trudelle-Jackson E, Swank C, Querry R. Differences in predictors for gait speed and gait endurance in Parkinson's disease. Gait Posture 2021; 87:49-53. [PMID: 33892391 DOI: 10.1016/j.gaitpost.2021.04.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Both gait speed and gait endurance directly impact independence and community engagement for individuals with Parkinson's disease (PD). However, factors accounting for variability in gait speed and gait endurance performance are unclear. The purpose of this study was to investigate whether key factors associated with gait speed in individuals with PD also predicted gait endurance. METHODS Community dwelling ambulatory individuals with PD were recruited for a single session. Key measures included 10 Meter Walk Test (10MWT) and 6 Minute Walk Test (6MWT) and key factors: age, disease severity [Movement Disorders Society United Parkinson's Disease Rating Scale (motor scale only) (MDS-UPDRS motor)], plantar flexor strength [Calf Raise Senior (CRS)], fatigue [Fatigue Severity Scale (FSS)], cognition [Montreal Cognitive Assessment (MoCA)], and balance [Four Square Step Test (FSST)]. Multiple linear regression analyses were conducted to determine clinical relationships. RESULTS Seventy-two individuals with PD (mean (standard deviation) (age = 70.83 (7.91) years; 50 males; MDS-UPDRS motor = 30.67 (13.50)) completed all assessments. The model predicting gait speed was significant, F(6, 65) = 15.143, p <.001, accounting for 54 % of the variance. Of the predictor variables age, MDS-UPDRS motor, CRS, MoCA and FSST scores were significant predictors. The model predicting gait endurance was significant, F(6, 65) = 15.608, p <.001, accounting for 55 % of the variance. Of the predictor variables, age, MDS-UPDRS motor scale, and CRS scores were significant predictors. DISCUSSION Gait speed and gait endurance are similarly influenced by age, motor impairment, and plantarflexion strength. However, cognition and balance were predictors only of gait speed, which may suggest unique task differences exist between gait speed and gait endurance.
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Affiliation(s)
- Staci Shearin
- The University of Texas Southwestern Medical Center, 6011 Harry Hines Blvd, Dallas, TX, 75235, United States.
| | - Ann Medley
- Texas Woman's University, School of Physical Therapy, 5500 Southwestern Medical Avenue, Dallas, TX, 75235, United States.
| | - Elaine Trudelle-Jackson
- Texas Woman's University, School of Physical Therapy, 5500 Southwestern Medical Avenue, Dallas, TX, 75235, United States.
| | - Chad Swank
- Baylor Scott and White Institute for Rehabilitation, 909 N. Washington Ave, Dallas, TX, 75246, United States.
| | - Ross Querry
- The University of Texas Southwestern Medical Center, 6011 Harry Hines Blvd, Dallas, TX, 75235, United States.
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12
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Pina I, Mendham AE, Tomaz SA, Goedecke JH, Micklesfield LK, Brooks NE, Gallagher IJ, Crockett R, Dudchenko P, Hunter AM. Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4310. [PMID: 33921644 PMCID: PMC8072994 DOI: 10.3390/ijerph18084310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/15/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate differences in physical activity (PA) patterns and the associations between objectively measured 24-h movement behaviors and musculoskeletal measures (muscle strength, muscle mass, physical performance, and bone mineral density) in a high-income and a low-income community. This cross-sectional study recruited independent living older adults aged 60-85 years from high-income Scottish (n = 150) and low-income South African (n = 138) settings. Participants completed demographic and health questionnaires, and testing included body composition and bone mineral density (dual energy X-ray absorptiometry), physical performance (grip strength, gait speed), and PA (accelerometry). Participants accumulated similar amounts of weekly total PA, however, the Scottish cohort engaged in more moderate-to-vigorous intensity PA (MVPA) and sedentary behavior (SB), while the South African cohort spent more time sleeping and in light intensity PA (LPA). From compositional data analysis, more time spent in MVPA relative to the other movement behaviors was positively associated with higher muscle mass (p < 0.001) and strength (p = 0.001) in the Scottish cohort. Conversely, more time spent in MVPA was associated with faster gait speed (p < 0.001) and greater hip bone mineral density (p = 0.011) in the South African cohort. Our findings confirm the beneficial role of MVPA in both high- and low-income cohorts, however, the relationship MVPA had with components of musculoskeletal health in older adults differed between settings.
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Affiliation(s)
- Ilaria Pina
- Department of Psychology, University of Stirling, Stirling FK9 4LA, UK; (R.C.); (P.D.)
| | - Amy E. Mendham
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa; (A.E.M.); (J.H.G.); (L.K.M.)
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa
| | - Simone A. Tomaz
- Faculty of Health Science and Sport, University of Stirling, Stirling FK9 4LA, UK; (S.A.T.); (N.E.B.); (I.J.G.); (A.M.H.)
| | - Julia H. Goedecke
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa; (A.E.M.); (J.H.G.); (L.K.M.)
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa
| | - Lisa K. Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa; (A.E.M.); (J.H.G.); (L.K.M.)
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa
| | - Naomi E. Brooks
- Faculty of Health Science and Sport, University of Stirling, Stirling FK9 4LA, UK; (S.A.T.); (N.E.B.); (I.J.G.); (A.M.H.)
| | - Iain J. Gallagher
- Faculty of Health Science and Sport, University of Stirling, Stirling FK9 4LA, UK; (S.A.T.); (N.E.B.); (I.J.G.); (A.M.H.)
| | - Rachel Crockett
- Department of Psychology, University of Stirling, Stirling FK9 4LA, UK; (R.C.); (P.D.)
| | - Paul Dudchenko
- Department of Psychology, University of Stirling, Stirling FK9 4LA, UK; (R.C.); (P.D.)
| | - Angus M. Hunter
- Faculty of Health Science and Sport, University of Stirling, Stirling FK9 4LA, UK; (S.A.T.); (N.E.B.); (I.J.G.); (A.M.H.)
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13
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Mendham AE, Goedecke JH, Micklesfield LK, Brooks NE, Faber M, Christensen DL, Gallagher IJ, Lundin-Olsson L, Myburgh KH, Odunitan-Wayas FA, Lambert EV, Kalula S, Hunter AM. Understanding factors associated with sarcopenic obesity in older African women from a low-income setting: a cross-sectional analysis. BMC Geriatr 2021; 21:247. [PMID: 33853546 PMCID: PMC8048063 DOI: 10.1186/s12877-021-02132-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/03/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND High rates of food insecurity, obesity and obesity-related comorbidities in ageing South African (SA) women may amplify the risk of developing sarcopenic obesity. This study aimed to investigate the prevalence and correlates of sarcopenic obesity and its diagnostic components [grip strength, appendicular skeletal muscle mass (ASM) and body mass index (BMI)] in older SA women from a low-income setting. METHODS This cross-sectional study recruited black SA women between the ages of 60-85 years (n = 122) from a low-income community. Testing included a fasting blood sample (markers of cardiometabolic risk, HIV), whole body and regional muscle and fat mass (dual-energy absorptiometry x-ray), anthropometry, blood pressure, functional movement tests, current medication use, demographic and health questionnaires, physical activity (PA; accelerometery), household food insecurity access scale, and a one-week quantified food frequency questionnaire. Foundation for the National Institutes of Health (FNIH) criteria (grip strength and ASM, adjusted for BMI) were used to classify sarcopenia. Participants with sarcopenia alongside a BMI of > 30.0 kg/m2 were classified as having sarcopenic obesity. Prevalence using other criteria (European Working Group on Sarcopenia in Older People, Asian Working Group for Sarcopenia and the International Working Group for Sarcopenia) were also explored. RESULTS The prevalence of sarcopenia was 27.9%, which comprised of sarcopenia without obesity (3.3%) and sarcopenic obesity (24.6%). Other classification criteria showed that sarcopenia ranged from 0.8-14.7%, including 0.8-9.8% without obesity and 0-4.9% with sarcopenic obesity. Using multivariate-discriminant analysis (OPLS-DA) those with sarcopenic obesity presented with a descriptive profile of higher C-reactive protein, waist circumference, food security and sedentary time than women without sarcopenic obesity (p = 0.046). A similar profile described women with low BMI-adjusted grip strength (p < 0.001). CONCLUSIONS The majority of women with sarcopenia were also obese (88%). We show a large discrepancy in the diagnostic criteria and the potential for significantly underestimating the prevalence of sarcopenia if BMI is not adjusted for. The main variables common to women with sarcopenic obesity were higher food security, lower PA and chronic inflammation. Our data highlights the importance of addressing obesity within these low-income communities to ensure the prevention of sarcopenic obesity and that quality of life is maintained with ageing.
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Affiliation(s)
- Amy E Mendham
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa. .,Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Julia H Goedecke
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Non-communicable Diseases Research Unit, South African Medical Research Council Tygerberg, Cape Town, South Africa
| | - Lisa K Micklesfield
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.,Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Naomi E Brooks
- Health Sciences and Sport, University of Stirling, Stirling, Scotland
| | - Mieke Faber
- Non-communicable Diseases Research Unit, South African Medical Research Council Tygerberg, Cape Town, South Africa
| | - Dirk L Christensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Iain J Gallagher
- Health Sciences and Sport, University of Stirling, Stirling, Scotland
| | | | - Kathryn H Myburgh
- Department of Physiological Sciences, University of Stellenbosch, Stellenbosch, South Africa
| | - Feyisayo A Odunitan-Wayas
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Estelle V Lambert
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Sebastiana Kalula
- Division of Geriatric Medicine, University of Cape Town, Cape Town, South Africa
| | - Angus M Hunter
- Health Sciences and Sport, University of Stirling, Stirling, Scotland
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Yun SJ, Lee HH, Lee WH, Lee SH, Oh BM, Seo HG. Effect of robot-assisted gait training on gait automaticity in Parkinson disease: A prospective, open-label, single-arm, pilot study. Medicine (Baltimore) 2021; 100:e24348. [PMID: 33592882 PMCID: PMC7870221 DOI: 10.1097/md.0000000000024348] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/17/2020] [Accepted: 12/27/2020] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Gait automaticity is reduced in patients with Parkinson disease (PD) due to impaired habitual control. The aim of this study was to investigate the effect of robot-assisted gait training (RAGT) on gait automaticity as well as gait speed and balance in patients with PD.This study was a prospective, open-label, single-arm, pilot study. We planned to recruit 12 patients with idiopathic PD. Participants received 12 sessions of RAGT using exoskeleton-type robotic device. Sessions were 45-minute each, 3 days a week, for 4 consecutive weeks using an exoskeleton-type gait robot. The primary outcome was the percentage of dual-task interference measured by the 10-Meter Walk Test (10MWT) under single and dual-task (cognitive and physical) conditions. Secondary outcomes were the Berg Balance Scale and Korean version of the Falls Efficacy Scale-International. All measures were evaluated before treatment (T0), after treatment (T1), and 1-month post-treatment (T2).Twelve patients were enrolled and 1 dropped out. Finally, 11 patients with idiopathic PD were analyzed. The mean age of 11 patients (5 males) was 66.46 ± 5.66 years, and disease duration was 112.91 ± 50.19 months. The Hoehn and Yahr stages were 2.5 in 8 patients and 3 in 3 patients. Linear mixed-effect model analysis showed a significant change over time only in single-task gait speed of the 10MWT (P = .007), but not in dual-task gait speed, dual-task interferences, and Korean version of the Falls Efficacy Scale-International. Cognitive dual-task interference significantly increased (P = .026) at T1, but not at T2 (P = .203). No significant changes were observed for physical dual-task interference at T1 and T2. Single-task gait speed of the 10MWT was significantly increased at T1 (P = .041), but not at T2 (P = .445). There were no significant changes in the dual-task gait speed of 10MWT. A significant improvement was observed in Berg Balance Scale score at T1 and T2 (P = .004 and P = .024, respectively).In this pilot study, despite improvement in walking speed and balance, gait automaticity in patients with PD was not improved by RAGT using an exoskeleton-type robot. Additional therapeutic components may be needed to improve gait automaticity using RAGT in patients with PD.
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Affiliation(s)
- Seo Jung Yun
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital
| | - Hyun Haeng Lee
- Department of Rehabilitation Medicine, Konkuk University Medical Center
| | - Woo Hyung Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital
| | - Seung Hak Lee
- Department of Rehabilitation Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital
| | - Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital
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15
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Wang Y, Witchalls J, Preston E, Wang Z, Zhuang J, Waddington G, Adams R, Han J. The Relationship Between Ankle Proprioception and Functional Mobility in People With Parkinson's Disease: A Cross-Sectional Study. Front Neurol 2021; 11:603814. [PMID: 33519682 PMCID: PMC7844086 DOI: 10.3389/fneur.2020.603814] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 12/14/2020] [Indexed: 12/20/2022] Open
Abstract
Previous research has found ankle proprioception to be impaired in people with Parkinson's disease (PD). However, the relationship between ankle proprioception and functional mobility in people with PD has not been fully investigated. The purpose of this study was to examine whether ankle proprioception is related to the functional mobility of people with PD. Forty-two participants with mild to moderate PD volunteered. Ankle proprioceptive acuity was measured in standing, by using active movement extent discrimination assessment (AMEDA). Functional mobility measures included the timed-up-and-go test (TUG), 30 s sit-to-stand test (30s-STS) and 10-meter walking test (10MWT). Step length and step cadence were recorded during the 10MWT. No significant correlation was found between ankle proprioceptive discrimination scores and any mobility performance measure in people with PD (−0.20<r<0.04, all p > 0.05). However, ankle proprioception scores were significantly correlated with step length (r = 0.38, p < 0.05) and step cadence (r = −0.30, p < 0.05), and were significantly and negatively correlated with the stage of modified Hoehn and Yahr (rho = −0.53, p < 0.01). The lack of relationship between ankle proprioceptive acuity and functional mobility in PD suggests that people with PD may be more limited by reduced sensorimotor integration or may rely more on other sensory input, rather than ankle proprioception, to achieve functional mobility, a finding consistent with sensory reweighting theory. In addition, poorer ankle proprioceptive acuity was associated with decreased step length and increased step cadence, suggesting that the shuffling gait observed in PD may be related to impaired ankle proprioception, which has important clinical implications for gait retraining in people with PD. Given that ankle proprioception was significantly and negatively correlated with the stage of modified Hoehn and Yahr, it may warrant being used as an objective biomarker to monitor the progression of PD.
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Affiliation(s)
- Yejun Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | | | - Zhen Wang
- College of Chinese Wushu, Shanghai University of Sport, Shanghai, China
| | - Jie Zhuang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Jia Han
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.,Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.,Faculty of Health, University of Canberra, Canberra, ACT, Australia
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16
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Álvarez I, Latorre J, Aguilar M, Pastor P, Llorens R. Validity and sensitivity of instrumented postural and gait assessment using low-cost devices in Parkinson's disease. J Neuroeng Rehabil 2020; 17:149. [PMID: 33176833 PMCID: PMC7656721 DOI: 10.1186/s12984-020-00770-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accurate assessment of balance and gait is necessary to monitor the clinical progress of Parkinson's disease (PD). Conventional clinical scales can be biased and have limited accuracy. Novel interactive devices are potentially useful to detect subtle posture or gait-related impairments. METHODS Posturographic and single and dual-task gait assessments were performed to 54 individuals with PD and 43 healthy controls with the Wii Balance Board and the Kinect v2 and the, respectively. Individuals with PD were also assessed with the Tinetti Performance Oriented Mobility Assessment, the Functional Gait Assessment and the 10-m Walking Test. The influence of demographic and clinical variables on the performance in the instrumented posturographic and gait tests, the sensitivity of these tests to the clinical condition and phenotypes, and their convergent validity with clinical scales were investigated. RESULTS Individuals with PD in H&Y I and I.5 stages showed similar performance to controls. The greatest differences in posture and gait were found between subjects in H&Y II.5 and H&Y I-I.5 stage, as well as controls. Dual-tasking enhanced the differences among all groups in gait parameters. Akinetic/rigid phenotype showed worse postural control and gait than other phenotypes. High significant correlations were found between the limits of stability and most of gait parameters with the clinical scales. CONCLUSIONS Low-cost devices showed potential to objectively quantify posture and gait in established PD (H&Y ≥ II). Dual-tasking gait evaluation was more sensitive to detect differences among PD stages and compared to controls than free gait. Gait and posture were more impaired in akinetic/rigid PD.
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Affiliation(s)
- Ignacio Álvarez
- Fundació Docència i Recerca Mútua de Terrassa, Terrassa, Barcelona, Spain
- Movement disorders Unit, Department of Neurology, Memory Disorders Unit, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Jorge Latorre
- Neurorehabilitation and Brain Research Group, Instituto Interuniversitario de Investigación en Bioingeniería, Universitat Politècnica de València, Ciudad Politécnica de la Innovación-Building 8B-Access M-Floor 0, Camino de Vera s/n, 46022, Valencia, Spain
- NEURORHB. Servicio de Neurorrehabilitación de Hospitales Vithas, Río Tajo 1, 46011, Valencia, Spain
| | - Miquel Aguilar
- Fundació Docència i Recerca Mútua de Terrassa, Terrassa, Barcelona, Spain
- Movement disorders Unit, Department of Neurology, Memory Disorders Unit, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Pau Pastor
- Fundació Docència i Recerca Mútua de Terrassa, Terrassa, Barcelona, Spain
- Movement disorders Unit, Department of Neurology, Memory Disorders Unit, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Roberto Llorens
- Neurorehabilitation and Brain Research Group, Instituto Interuniversitario de Investigación en Bioingeniería, Universitat Politècnica de València, Ciudad Politécnica de la Innovación-Building 8B-Access M-Floor 0, Camino de Vera s/n, 46022, Valencia, Spain.
- NEURORHB. Servicio de Neurorrehabilitación de Hospitales Vithas, Río Tajo 1, 46011, Valencia, Spain.
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Pehlivan E, Balcı A, Kılıç L, Yazar E. Is it Possible to Use the Timed Performance Tests in Lung Transplantation Candidates to Determine the Exercise Capacity? Turk Thorac J 2020; 21:329-333. [PMID: 33031724 DOI: 10.5152/turkthoracj.2019.19046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 10/10/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Lung transplantation (LTx) candidates have severe exercise intolerance. This makes it difficult for them to complete the field tests used to determine the exercise capacity of patients. Therefore, there is a need for alternative tests that require less effort. We aimed to investigate the use of short-timed performance tests instead of 6-minute walk test (6MWT) in the determination of exercise capacity in LTx. MATERIALS AND METHODS A total of 63 LTx candidates were included in the study. Ten-meter walking speed test (10MWT), 5-times sit-to-stand test (5XSST), 6MWT were performed at one-hour intervals within the same day, and by the same physiotherapist in all patients. Maximal inspiratory (MIP) and expiratory pressure (MEP), peripheral muscle strengths, pulmonary function tests, and body mass index (BMI) were recorded for each patient. RESULTS The subjects' baseline mean 6-minute walking distance (6MWD) was 336m, 5XSST time was 11.59 sec, and 10MWT time was 8.45sec. There was a negative and moderate correlation between 6MWD and 10MWT (p<0.001, r=0.449). Similarly there was a negative but weak correlation between 6MWD and 5XSST (p=0.001, r=0.397). In addition, there was a strong relationship between 5XSST and 10MWT (p<0.001, r=0.767). CONCLUSION This study showed that 6MWT and short-timed performance tests were correlated in terms of exercise capacity assessment. In contrast, there was a strong relationship between 6MWT and 10MWT according to 6MWT and 5XSST. The timed performance tests may be alternative tests to determine exercise capacity in LTx candidates.
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Affiliation(s)
- Esra Pehlivan
- Department of Physical Therapy and Rehabilitation, University of Health Sciences Turkey, School of Health Sciences, İstanbul, Turkey
| | - Arif Balcı
- Department of Pulmonary Rehabilitation, University of Health Sciences Turkey, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Lütfiye Kılıç
- Department of Pulmonary Rehabilitation, University of Health Sciences Turkey, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Esra Yazar
- Department of Pulmonary Rehabilitation, University of Health Sciences Turkey, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
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Methods of 10-Meter Walk Test and Repercussions for Reliability Obtained in Typically Developing Children. Rehabil Res Pract 2020; 2020:4209812. [PMID: 32884845 PMCID: PMC7455832 DOI: 10.1155/2020/4209812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 01/01/2023] Open
Abstract
Introduction Research and clinical settings use the 10-meter walk test (10MWT) to measure locomotor capacity with considerable methodological diversity. Comparison between healthy and disabled children is frequent; however, the reproducibility of 10MWT using different methods is unknown. Objectives This study analysed intrasubject, test-retest reliability, and agreement of four methods of 10MWT, exploring the influence of pace, acceleration-deceleration phases, and anthropometric measurements when calculating mean velocity. Methods This cross-sectional study evaluated 120 typical children, both sexes, aged 6, 8, 10, and 12 (n = 30 for each age). The mean times and velocities of the path (10 m) and middle path (6 m) obtained at a self-selected and fast pace were analysed. Initial assessment and another after seven days recorded three measurements per method (sV6 = self-selected pace and 6 m; sV10 = self-selected pace and 10 m; fV6 = fast pace and 6 m; fV10 = fast pace and 10 m). Interclass correlation coefficient (ICC), multiple regression, and Snedecor-F test (5% significance level) were used. Results The fV10 method had high intrasubject reliability for all tested ages (0.70 < ICC > 0.89); sV10 exhibited high intrasubject reliability for ages 6, 8, and 12 (0.70 < ICC > 0.89) and moderate for age 10 (0.50 < ICC < 0.69).Test-retest reliability at sV6 and fV6 did not reach high ICC in any tested ages. The test-retest reliability at sV10 and fV10 was moderate for ages 6, 8, and 12 (0.50 < ICC > 0.69) and poor for age 10 (0.25 < ICC > 0.49). There was no agreement between methods: sV6 versus sV10 (mean difference = 0.91 m/s; SEM = 0.036); fV6 versus fV10 (mean difference = 1.70; SEM = 0.046). The fV6 method versus fV10 overestimated the velocity (bias = 1.70 m/s). Conclusions For typical children, the method that ensured the highest intrasubject reliability used fast pace and 10 m. Moreover, test-retest reliability increased when adopting 10 m at both self-selected and fast pace. The methods were not equivalent but were related, and those that did not compute the entire pathway overestimated the results.
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Dinesh K, Snyder CW, Xiong M, Tarolli CG, Sharma S, Dorsey ER, Sharma G, Adams JL. A Longitudinal Wearable Sensor Study in Huntington’s Disease. J Huntingtons Dis 2020; 9:69-81. [DOI: 10.3233/jhd-190375] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Karthik Dinesh
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, USA
| | - Christopher W. Snyder
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Mulin Xiong
- Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Christopher G. Tarolli
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Saloni Sharma
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - E. Ray Dorsey
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Gaurav Sharma
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, USA
| | - Jamie L. Adams
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
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Quigley A, MacKay-Lyons M. Physical deficits among people living with HIV: a review of the literature and implications for rehabilitation. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1701763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Adria Quigley
- Department of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marilyn MacKay-Lyons
- Department of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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Adams JL, Dinesh K, Xiong M, Tarolli CG, Sharma S, Sheth N, Aranyosi AJ, Zhu W, Goldenthal S, Biglan KM, Dorsey ER, Sharma G. Multiple Wearable Sensors in Parkinson and Huntington Disease Individuals: A Pilot Study in Clinic and at Home. Digit Biomark 2017; 1:52-63. [PMID: 32095745 DOI: 10.1159/000479018] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/26/2017] [Indexed: 12/24/2022] Open
Abstract
Background Clinician rating scales and patient-reported outcomes are the principal means of assessing motor symptoms in Parkinson disease and Huntington disease. However, these assessments are subjective and generally limited to episodic in-person visits. Wearable sensors can objectively and continuously measure motor features and could be valuable in clinical research and care. Methods We recruited participants with Parkinson disease, Huntington disease, and prodromal Huntington disease (individuals who carry the genetic marker but do not yet exhibit symptoms of the disease), and controls to wear 5 accelerometer-based sensors on their chest and limbs for standardized in-clinic assessments and for 2 days at home. The study's aims were to assess the feasibility of use of wearable sensors, to determine the activity (lying, sitting, standing, walking) of participants, and to survey participants on their experience. Results Fifty-six individuals (16 with Parkinson disease, 15 with Huntington disease, 5 with prodromal Huntington disease, and 20 controls) were enrolled in the study. Data were successfully obtained from 99.3% (278/280) of sensors dispatched. On average, individuals with Huntington disease spent over 50% of the total time lying down, substantially more than individuals with prodromal Huntington disease (33%, p = 0.003), Parkinson disease (38%, p = 0.01), and controls (34%; p < 0.001). Most (86%) participants were "willing" or "very willing" to wear the sensors again. Conclusions Among individuals with movement disorders, the use of wearable sensors in clinic and at home was feasible and well-received. These sensors can identify statistically significant differences in activity profiles between individuals with movement disorders and those without. In addition, continuous, objective monitoring can reveal disease characteristics not observed in clinic.
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Affiliation(s)
- Jamie L Adams
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.,Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Karthik Dinesh
- Department of Electrical and Computer Engineering, University of Rochester Medical Center, Rochester, New York, USA
| | - Mulin Xiong
- Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Christopher G Tarolli
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.,Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Saloni Sharma
- Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | | | | | - William Zhu
- Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Steven Goldenthal
- Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Kevin M Biglan
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.,Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - E Ray Dorsey
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.,Center for Health and Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Gaurav Sharma
- Department of Electrical and Computer Engineering, University of Rochester Medical Center, Rochester, New York, USA.,Department of Computer Science, University of Rochester, Rochester, New York, USA
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