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Zhang X, Wang M, Lee SY, Yue Y, Chen Z, Zhang Y, Wang L, Guan Q, Fan W, Shen T. Cholinergic nucleus degeneration and its association with gait impairment in Parkinson's disease. J Neuroeng Rehabil 2024; 21:120. [PMID: 39026279 PMCID: PMC11256459 DOI: 10.1186/s12984-024-01417-7] [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: 11/23/2023] [Accepted: 07/04/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND The contribution of cholinergic degeneration to gait disturbance in Parkinson's disease (PD) is increasingly recognized, yet its relationship with dopaminergic-resistant gait parameters has been poorly investigated. We investigated the association between comprehensive gait parameters and cholinergic nucleus degeneration in PD. METHODS This cross-sectional study enrolled 84 PD patients and 69 controls. All subjects underwent brain structural magnetic resonance imaging to assess the gray matter density (GMD) and volume (GMV) of the cholinergic nuclei (Ch123/Ch4). Gait parameters under single-task (ST) and dual-task (DT) walking tests were acquired using sensor wearables in PD group. We compared cholinergic nucleus morphology and gait performance between groups and examined their association. RESULTS PD patients exhibited significantly decreased GMD and GMV of the left Ch4 compared to controls after reaching HY stage > 2. Significant correlations were observed between multiple gait parameters and bilateral Ch123/Ch4. After multiple testing correction, the Ch123/Ch4 degeneration was significantly associated with shorter stride length, lower gait velocity, longer stance phase, smaller ankle toe-off and heel-strike angles under both ST and DT condition. For PD patients with HY stage 1-2, there were no significant degeneration of Ch123/4, and only right side Ch123/Ch4 were corrected with the gait parameters. However, as the disease progressed to HY stage > 2, bilateral Ch123/Ch4 nuclei showed correlations with gait performance, with more extensive significant correlations were observed in the right side. CONCLUSIONS Our study demonstrated the progressive association between cholinergic nuclei degeneration and gait impairment across different stages of PD, and highlighting the potential lateralization of the cholinergic nuclei's impact on gait impairment. These findings offer insights for the design and implementation of future clinical trials investigating cholinergic treatments as a promising approach to address gait impairments in PD.
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Affiliation(s)
- Xiaodan Zhang
- Department of Neurology, Ningbo NO.2 Hospital, NO.6 Building, 41 Xibei Street, Haishu District, Ningbo, Zhejiang Province, China
- Department of Emergency Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Mateng Wang
- Department of General Surgery, Yinzhou NO.2 Hospital, Ningbo, Zhejiang Province, China
| | - Shi Yeow Lee
- Department of Emergency Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yumei Yue
- Department of Neurology of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Zhaoying Chen
- Department of Neurology, Ningbo NO.2 Hospital, NO.6 Building, 41 Xibei Street, Haishu District, Ningbo, Zhejiang Province, China
| | - Yilin Zhang
- Department of Emergency Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Lulu Wang
- Department of Neurology, Ningbo NO.2 Hospital, NO.6 Building, 41 Xibei Street, Haishu District, Ningbo, Zhejiang Province, China
| | - Qiongfeng Guan
- Department of Neurology, Ningbo NO.2 Hospital, NO.6 Building, 41 Xibei Street, Haishu District, Ningbo, Zhejiang Province, China
| | - Weinv Fan
- Department of Neurology, Ningbo NO.2 Hospital, NO.6 Building, 41 Xibei Street, Haishu District, Ningbo, Zhejiang Province, China.
| | - Ting Shen
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Espinoza-Araneda J, Caparros-Manosalva C, da Cunha M, Marzuca-Nassr GN, Fritz-Silva N, Pagnussat AS. Nordic walking and arm swing asymmetry in people with Parkinson's disease: protocol for a randomised clinical trial. BMJ Open Sport Exerc Med 2024; 10:e002029. [PMID: 38808265 PMCID: PMC11131108 DOI: 10.1136/bmjsem-2024-002029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/30/2024] Open
Abstract
People with Parkinson's disease (PD) face disruptions in arm swing (AS) motion during walking, including a reduction in amplitude and an increase in asymmetry. Both conditions are detrimental to gait performance. Nordic walking (NW) is a walking modality that uses poles and can positively affect the parameters of AS. This study aims to compare an NW with a free walking (FW) protocol and investigate its effects on AS asymmetry, AS amplitude and gait parameters in people with PD. Twenty-eight people with PD, stages 1-3 on the Hoehn and Yahr Scale, will be randomly assigned to the NW training group (n=14) or the FW training group (n=14). The primary outcomes are amplitude asymmetry of AS (%) and AS amplitude (deg). We will also analyse temporospatial measurements during walking, functional mobility and quality of life. Blinded researchers will conduct evaluations at baseline (T0), postintervention (T1) and at 1 month follow-up (T2). Participants will complete 24 supervised NW or FW training sessions for 12 weeks. This is the first study to address the effects of NW on the asymmetry of AS, AS amplitude and its influence on gait parameters. We hypothesise that an NW programme in PD will reduce the asymmetry and increase the AS amplitude during gait to a greater extent than FW. The results of this study may provide new evidence to understand the effects of NW on gait in people with PD. The study was registered in ClinicalTrial.gov (NCT06342271).
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Affiliation(s)
- Jessica Espinoza-Araneda
- Faculty of Health Science, Department of Human Movement Sciences, University of Talca, Talca, Chile
- Interuniversity Center for Healthy Aging RED21993, Chile
| | - Cristian Caparros-Manosalva
- Faculty of Health Science, Department of Human Movement Sciences, University of Talca, Talca, Chile
- Interuniversity Center for Healthy Aging RED21993, Chile
| | - Maira da Cunha
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
- Movement Analysis and Neurological Rehabilitation Laboratory, UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriel Nasri Marzuca-Nassr
- Interuniversity Center for Healthy Aging RED21993, Chile
- Departamento de Ciencias de la Rehabilitación, Universidad de La Frontera, Temuco, Chile
| | - Nicole Fritz-Silva
- Interuniversity Center for Healthy Aging RED21993, Chile
- Health Department, University of Los Lagos - Campus Puerto Montt, Puerto Montt, Chile
| | - Aline S Pagnussat
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
- Movement Analysis and Neurological Rehabilitation Laboratory, UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil
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Bhat SG, Shin AY, Kaufman KR. Upper extremity asymmetry due to nerve injuries or central neurologic conditions: a scoping review. J Neuroeng Rehabil 2023; 20:151. [PMID: 37940959 PMCID: PMC10634143 DOI: 10.1186/s12984-023-01277-7] [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: 10/21/2022] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Peripheral nerve injuries and central neurologic conditions can result in extensive disabilities. In cases with unilateral impairment, assessing the asymmetry between the upper extremity has been used to assess outcomes of treatment and severity of injury. A wide variety of validated and novel tests and sensors have been utilized to determine the upper extremity asymmetry. The purpose of this article is to review the literature and define the current state of the art for describing upper extremity asymmetry in patients with peripheral nerve injuries or central neurologic conditions. METHOD An electronic literature search of PubMed, Scopus, Web of Science, OVID was performed for publications between 2000 to 2022. Eligibility criteria were subjects with neurological conditions/injuries who were analyzed for dissimilarities in use between the upper extremities. Data related to study population, target condition/injury, types of tests performed, sensors used, real-world data collection, outcome measures of interest, and results of the study were extracted. Sackett's Level of Evidence was used to judge the quality of the articles. RESULTS Of the 7281 unique articles, 112 articles met the inclusion criteria for the review. Eight target conditions/injuries were identified (Brachial Plexus Injury, Cerebral Palsy, Multiple Sclerosis, Parkinson's Disease, Peripheral Nerve Injury, Spinal Cord Injury, Schizophrenia, and stroke). The tests performed were classified into thirteen categories based on the nature of the test and data collected. The general results related to upper extremity asymmetry were listed for all the reviewed articles. Stroke was the most studied condition, followed by cerebral palsy, with kinematics and strength measurement tests being the most frequently used tests. Studies with a level of evidence level II and III increased between 2000 and 2021. The use of real-world evidence-based data, and objective data collection tests also increased in the same period. CONCLUSION Adequately powered randomized controlled trials should be used to study upper extremity asymmetry. Neurological conditions other than stroke should be studied further. Upper extremity asymmetry should be measured using objective outcome measures like motion tracking and activity monitoring in the patient's daily living environment.
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Affiliation(s)
- Sandesh G Bhat
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Alexander Y Shin
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kenton R Kaufman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
- Motion Analysis Laboratory, Mayo Clinic, DAHLC 4-214A, 200 First Street SW, Rochester, MN, 55905, USA.
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Espinoza-Araneda J, Caparrós-Manosalva C, Caballero PM, da Cunha MJ, Marchese RR, Pagnussat AS. Arm swing asymmetry in people with Parkinson's disease and its relationship with gait: A systematic review and meta-analysis. Braz J Phys Ther 2023; 27:100559. [PMID: 37980716 PMCID: PMC10695845 DOI: 10.1016/j.bjpt.2023.100559] [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: 08/04/2022] [Revised: 10/16/2023] [Accepted: 10/25/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Individuals with Parkinson's disease present arm swing alterations that can adversely affect their locomotion. OBJECTIVE To identify differences in arm swing asymmetry (ASA) between individuals with Parkinson's disease (PD) and healthy individuals and to investigate the relationship between ASA, temporal-spatial gait parameters, and disease progression. METHODS A literature search was conducted in PubMed, Scopus, ProQuest, Web of Science, and EBSCOhost up to February 2023. Cross-sectional studies evaluating parameters of arm swing (AS) and ASA were included. Methodological quality was assessed using the Critical Appraisal Checklist, and the quality of the evidence was measured with a modified Grading of Recommendations Assessment, Development, and Evaluation. RESULTS Fourteen studies were included in the systematic review (1130 participants). Irrespective of the medication phase (ON or OFF) and the type of walk test employed, the meta-analysis showed moderate-quality evidence that individuals with PD have increased ASA amplitude (SMD = 0.84; 95% CI: 0.69, 0.99; I²= 0%).Very low-quality evidence suggests higher ASA velocity (SMD=0.64; 95% CI: 0.24, 1.05; I²=59%) and lower AS amplitude on both the most affected (ES = -1.99, 95% CI: -3.04, -0.94, I2: 91%) and the least affected sides (ES = -0.75, 95% CI: -1.05, -0.44; I²=66%). Meta-regression indicated that ASA is inversely related to disease duration (Z: -2.4892, P< 0.05) and motor symptoms progression (Z: -2.1336, P< 0.05). CONCLUSIONS Regardless of the medication phase and the type of walk test employed, individuals with PD exhibited greater ASA and decreased AS amplitude than healthy individuals. ASA decreases as the disease progresses and symptoms worsen.
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Affiliation(s)
- Jessica Espinoza-Araneda
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Department of Human Movement Sciences, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Cristian Caparrós-Manosalva
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Department of Human Movement Sciences, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Paula M Caballero
- Department of Human Movement Sciences, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Maira J da Cunha
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil
| | - Ritchele R Marchese
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil
| | - Aline S Pagnussat
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil.
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Kang B, Jung GH, Kholinne E, Jeon IH, Kwak JM. The elbow is the load-bearing joint during arm swing. Clin Shoulder Elb 2023; 26:126-130. [PMID: 37316173 DOI: 10.5397/cise.2023.00101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/02/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Arm swing plays a role in gait by accommodating forward movement through trunk balance. This study evaluates the biomechanical characteristics of arm swing during gait. METHODS The study performed computational musculoskeletal modeling based on motion tracking in 15 participants without musculoskeletal or gait disorder. A three-dimensional (3D) motion tracking system using three Azure Kinect (Microsoft) modules was used to obtain information in the 3D location of shoulder and elbow joints. Computational modeling using AnyBody Modeling System was performed to calculate the joint moment and range of motion (ROM) during arm swing. RESULTS The mean ROM of the dominant elbow was 29.7°±10.2° and 14.2°±3.2° in flexion-extension and pronation-supination, respectively. The mean joint moment of the dominant elbow was 56.4±12.7 Nm, 25.6±5.2 Nm, and 19.8±4.6 Nm in flexion-extension, rotation, and abduction-adduction, respectively. CONCLUSIONS The elbow bears the load created by gravity and muscle contracture in dynamic arm swing movement.
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Affiliation(s)
- Bokku Kang
- School of Mechanical Engineering, Kyungpook National University, Daegu, Korea
| | - Gu-Hee Jung
- Department of Orthopedic Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Erica Kholinne
- Department of Orthopedic Surgery, Faculty of Medicine, Universitas Trisakti, St. Carolus Hospital, Jakarta, Indonesia
| | - In-Ho Jeon
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Jae-Man Kwak
- Department of Orthopedic Surgery, Uijeongbu Eulji Medical Center, Eulji University College of Medicine, Uijeongbu, Korea
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Zhang X, Fan W, Yu H, Li L, Chen Z, Guan Q. Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease. Front Neurol 2022; 13:974985. [PMID: 36313494 PMCID: PMC9615249 DOI: 10.3389/fneur.2022.974985] [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: 06/21/2022] [Accepted: 09/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background Gait parameters are considered potential diagnostic markers of Parkinson's disease (PD). We aimed to 1) assess the gait impairment in early-stage PD and its related factors in the single-task (ST) and dual-task (DT) walking tests and 2) evaluate and compare the diagnostic value of gait parameters for early-stage PD under ST and DT conditions. Methods A total of 97 early-stage PD patients and 41 healthy controls (HC) were enrolled at Hwa Mei hospital. Gait parameters were gathered and compared between the two groups in the ST and DT walking test, controlling for covariates. Utilizing the receiver operating characteristic curve, diagnostic parameters were investigated. Results In the ST walking test, significantly altered gait patterns could be observed in early-stage PD patients in all domains of gait, except for asymmetry (P < 0.05). Compared to the ST walking test, the early-stage PD group performed poorly in the DT walking test in the pace, rhythm, variability and postural control domain (P < 0.05). Older, heavier subjects, as well as those with lower height, lower level of education and lower gait velocity, were found to have a poorer gait performance (P < 0.05). Stride length (AUC = 0.823, sensitivity, 68.0%; specificity, 85.4%; P < 0.001) and heel strike angle (AUC = 0.796, sensitivity, 71.1%; specificity, 80.5%; P < 0.001) could distinguish early-stage PD patients from HCs with moderate accuracy, independent of covariates. The diagnostic accuracy of gait parameters under ST conditions were statistically noninferior to those under DT conditions(P>0.05). Combining all gait parameters with diagnostic values under ST and DT walking test, the predictive power significantly increased with an AUC of 0.924 (sensitivity, 85.4%; specificity, 92.7%; P < 0.001). Conclusion Gait patterns altered in patients with early-stage PD but the gait symmetry remained preserved. Stride length and heel strike angle were the two most prominent gait parameters of altered gait in early-stage of PD that could serve as diagnostic markers of early-stage PD. Our findings are helpful to understand the gait pattern of early-stage PD and its related factors and can be conducive to the development of new diagnostic tools for early-stage PD.
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Affiliation(s)
| | | | | | | | - Zhaoying Chen
- Department of Neurology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Qiongfeng Guan
- Department of Neurology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
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Navarro-López V, Fernández-Vázquez D, Molina-Rueda F, Cuesta-Gómez A, García-Prados P, Del-Valle-Gratacós M, Carratalá-Tejada M. Arm-swing kinematics in Parkinson's disease: A systematic review and meta-analysis. Gait Posture 2022; 98:85-95. [PMID: 36088898 DOI: 10.1016/j.gaitpost.2022.08.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/10/2022] [Accepted: 08/22/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Parkinson's disease (PD) causes postural instability and gait abnormalities that may be associated with an arm swing reduction. OBJECTIVE To conduct systematic review and meta-analysis to determine the kinematic patterns of arm-swing during gait in people with PD METHODS: A computer literature search of the PubMed, EMBASE, WOS, PEDro, SCOPUS and SciELO databases was conducted. Terms related to PD and arm-swing were combined to find studies that performed a free walking evaluation of the arm-swing of PD patients on or off medication compared to healthy controls. After a standardized evaluation by three examiners, fifteen articles met inclusion criteria. Random effects meta-analysis models were utilized to quantify (1) the arm-swing range of motion (RoM); (2) the arm-swing amplitude; (3) the arm-swing velocity; and (4) the arm-swing asymmetry. RESULTS On average, arm-swing RoM (7.07°), amplitude (0.8 cm), and velocity (0.31 m/s) were significantly decreased in PD compared to healthy controls. Healthy subjects had significantly more symmetrical arm-swing (8.16%) than people with PD. Effect sizes were moderate-large. CONCLUSIONS People with PD have significant differences in RoM, amplitude, velocity, and asymmetry of arm-swing during gait compared to the healthy control group. Medication phase does not significantly influence arm-swing characteristics. Further studies will be needed to determine whether different disease characteristics influence the biomechanics of arm-swing during gait.
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Affiliation(s)
- Víctor Navarro-López
- International Doctoral School, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Diego Fernández-Vázquez
- International Doctoral School, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Francisco Molina-Rueda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Alicia Cuesta-Gómez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Pablo García-Prados
- EOS Health group S.L. Physiotherapy Center. Pozuelo de Alarcón, Madrid, Spain
| | | | - María Carratalá-Tejada
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
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Ferraris C, Amprimo G, Masi G, Vismara L, Cremascoli R, Sinagra S, Pettiti G, Mauro A, Priano L. Evaluation of Arm Swing Features and Asymmetry during Gait in Parkinson's Disease Using the Azure Kinect Sensor. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22166282. [PMID: 36016043 PMCID: PMC9412494 DOI: 10.3390/s22166282] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/13/2022] [Accepted: 08/19/2022] [Indexed: 05/27/2023]
Abstract
Arm swinging is a typical feature of human walking: Continuous and rhythmic movement of the upper limbs is important to ensure postural stability and walking efficiency. However, several factors can interfere with arm swings, making walking more risky and unstable: These include aging, neurological diseases, hemiplegia, and other comorbidities that affect motor control and coordination. Objective assessment of arm swings during walking could play a role in preventing adverse consequences, allowing appropriate treatments and rehabilitation protocols to be activated for recovery and improvement. This paper presents a system for gait analysis based on Microsoft Azure Kinect DK sensor and its body-tracking algorithm: It allows noninvasive full-body tracking, thus enabling simultaneous analysis of different aspects of walking, including arm swing characteristics. Sixteen subjects with Parkinson's disease and 13 healthy controls were recruited with the aim of evaluating differences in arm swing features and correlating them with traditional gait parameters. Preliminary results show significant differences between the two groups and a strong correlation between the parameters. The study thus highlights the ability of the proposed system to quantify arm swing features, thus offering a simple tool to provide a more comprehensive gait assessment.
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Affiliation(s)
- Claudia Ferraris
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Gianluca Amprimo
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
- Department of Control and Computer Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Giulia Masi
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
| | - Luca Vismara
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Riccardo Cremascoli
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Serena Sinagra
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Giuseppe Pettiti
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Alessandro Mauro
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Lorenzo Priano
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
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Kuciel M, Rutkowski S, Szary P, Kiper P, Rutkowska A. Effect of PNF and NDT Bobath Concepts on Ischemic Strokes Patients for Trunk Rehabilitation – A Randomized Pilot Study. REHABILITACJA MEDYCZNA 2021. [DOI: 10.5604/01.3001.0015.2537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Recently, various systematic reviews and evidence-based clinical practice guidelines have evaluated the efficacy of stroke rehabilitation interventions. Across them proprioceptive neuromuscular facilitation (PNF) and neuro-developmental treatment (NDT) Bobath resulted to be an effective and widely used therapeutic approaches.
Objective of the work: The aim of the study was to evaluate the therapeutic effectiveness of PNF and NDT Bobath concept for improvement of trunk motor control in patients after ischemic stroke.
Materials and methods: The study consisted of 30 patients up to 3 months after ischemic stroke. Participants were randomly assigned to two study groups. Both group consisted of 15 patients underwent rehabilitation according to the PNF or NDT Bobath concept. Comparison of the changes in the Trunk Impairment Scale was the primary outcome.
Results: The analysis of the values of total TIS scale showed a statistically significant improvement in both group. Within group analysis showed statistical significance among baseline and intermediate measurement, and among baseline and final measurement within both groups. The analysis of total TIS scale indicators between the PNF and Bobath groups showed no statistically significant differences.
Conclusions: Both the PNF and Bobath concepts have proven to be effective in the treatment of posture control and there have been significant improvements in patients from both groups.
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Affiliation(s)
- Michał Kuciel
- Department of Nurorehabilitation of the Public Hospital in Chrzanów, Poland
| | - Sebastian Rutkowski
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Patryk Szary
- Student scientific circle Descartes' Error, Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Paweł Kiper
- Laboratory of Neurorehabilitation Technologies, Fondazione Ospedale San Camillo IRCCS, Venice, Italy
| | - Anna Rutkowska
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
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Mild Gait Impairment and Its Potential Diagnostic Value in Patients with Early-Stage Parkinson's Disease. Behav Neurol 2021; 2021:6696454. [PMID: 33884040 PMCID: PMC8041560 DOI: 10.1155/2021/6696454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/20/2021] [Indexed: 11/17/2022] Open
Abstract
Methods 32 patients with early-stage PD and 30 healthy control subjects (HC) were enrolled. All participants completed the instrumented stand and walk test, and gait data was collected using wearable sensors. Results We observed increased variability of stride length (SL) (P < 0.001), stance phase time (StPT) (P = 0.004), and swing phase time (SwPT) (P = 0.011) in PD. There were decreased heel strike (HS) (P = 0.001), range of motion of knee (P = 0.036), and hip joints (P < 0.001) in PD. In symmetry analysis, no difference was found in any of the assessed gait parameters between HC and PD. Only total steps (AUC = 0.763, P < 0.001), SL (AUC = 0.701, P = 0.007), SL variability (AUC = 0.769, P < 0.001), StPT variability (AUC = 0.712, P = 0.004), and SwPT variability (AUC = 0.688, P = 0.011) had potential diagnostic value. When these five gait parameters were combined, the predictive power was found to increase, with the highest AUC of 0.802 (P < 0.001). Conclusions Patients with early-stage PD presented increased variability but still symmetrical gait pattern. Some specific gait parameters can be applied to diagnose early-stage PD which may increase diagnosis accuracy. Our findings are helpful to improve patient's quality of life.
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Wu Z, Xu H, Zhu S, Gu R, Zhong M, Jiang X, Shen B, Zhu J, Pan Y, Dong J, Yan J, Zhang W, Zhang L. Gait Analysis of Old Individuals with Mild Parkinsonian Signs and Those Individuals' Gait Performance Benefits Little from Levodopa. Risk Manag Healthc Policy 2021; 14:1109-1118. [PMID: 33758563 PMCID: PMC7979347 DOI: 10.2147/rmhp.s291669] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/24/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Purpose Gait analysis and the effects of levodopa on the gait characteristics in Mild parkinsonian signs (MPS) are rarely published. The present research aimed to (1) analyze the gait characteristics in MPS; (2) explore the effects of levodopa on the gait performance of MPS. Methods We enrolled 22 inpatients with MPS and 20 healthy control subjects (HC) from Nanjing Brain Hospital. The Unified Parkinson’s Disease Rating Scale was used to evaluate motor symptoms. Acute levodopa challenge test was performed to explore the effects of levodopa on the gait performance of MPS. The instrumented stand and walk test was conducted for each participant and the JiBuEn gait analysis system was used to collect gait data. Results For spatiotemporal parameters: Compared with HC, the state before taking levodopa/benserazide in MPS group (meds-off) demonstrated a decrease in stride length (SL) (p≤0.001), an increase in SL variability (p≤0.001), and swing phase time variability (p=0.016). Compared with meds-off, the state after 1 hour of taking levodopa/benserazide in MPS group (meds-on) exhibited an increase in SL (p≤0.001), a decrease in SL variability (p≤0.001). For kinematic parameters: Compared with HC, meds-off demonstrated a decrease in heel strike angle (p=0.008), range of motion (ROM) of knee joint (p=0.011) and ROM of hip joint (p=0.007). Compared with meds-off, meds-on exhibited an increase in HS (p≤0.001). Bradykinesia and rigidity scores were significantly correlated with gait parameters. Conclusion Although the clinical symptoms of the MPS group are mild, their gait damage is obvious and they exhibited a decreased SL and joints movement, and a more variable gait pattern. Levodopa had little effect on the gait performance of those individuals.
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Affiliation(s)
- Zhuang Wu
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Hang Xu
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, Yancheng, People's Republic of China
| | - Sha Zhu
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Ruxin Gu
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Min Zhong
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Xu Jiang
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Bo Shen
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Jun Zhu
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Yang Pan
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Jingde Dong
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Jun Yan
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Wenbin Zhang
- Department of Neurosurgery, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Li Zhang
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
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Troisi Lopez E, Minino R, Sorrentino P, Rucco R, Carotenuto A, Agosti V, Tafuri D, Manzo V, Liparoti M, Sorrentino G. A synthetic kinematic index of trunk displacement conveying the overall motor condition in Parkinson's disease. Sci Rep 2021; 11:2736. [PMID: 33531608 PMCID: PMC7854606 DOI: 10.1038/s41598-021-82348-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/15/2021] [Indexed: 12/21/2022] Open
Abstract
Parkinson's disease (PD) is characterized by motor impairment, affecting quality of life and increasing fall risk, due to ineffective postural control. To this day, the diagnosis remains based on clinical approach. Similarly, motor evaluation is based on heterogeneous, operator-dependent observational criteria. A synthetic, replicable index to quantify motor impairment is still lacking. Hence, we have designed a new measure of postural stability which assesses the trunk displacement in relation to the center of mass, that we named trunk displacement index (TDI). Twenty-three PD patients and twenty-three healthy controls underwent motor examination through a stereophotogrammetric system. A correlation analysis was performed to assess the relationship of TDI with gait parameters and clinical motor scale (UPDRS-III). The TDI sensitivity was estimated, comparing pre- and post- L-DOPA subclinical dose intake. The TDI showed significant correlations with many gait parameters and with the UPDRS-III. Furthermore, the TDI resulted capable in discriminating between off and on state in PD, whereas gait parameters failed two show any difference between those two conditions. Our results suggest that the TDI may be considered a highly sensitive biomechanical index, reflecting the overall motor condition in PD, and provided of clinical relevance due to the correlation with the clinical evaluation.
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Affiliation(s)
- Emahnuel Troisi Lopez
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
| | - Roberta Minino
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
| | - Pierpaolo Sorrentino
- Institut de Neurosciences Des Systemès, Aix-Marseille University, Marseille, France
- Institute of Applied Sciences and Intelligent Systems, CNR, Pozzuoli, Italy
| | - Rosaria Rucco
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
- Institute of Applied Sciences and Intelligent Systems, CNR, Pozzuoli, Italy
| | - Anna Carotenuto
- Alzheimer Unit and Movement Disorders Clinic, Department of Neurology, Cardarelli Hospital, Naples, Italy
| | - Valeria Agosti
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Domenico Tafuri
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
| | - Valentino Manzo
- Alzheimer Unit and Movement Disorders Clinic, Department of Neurology, Cardarelli Hospital, Naples, Italy
| | - Marianna Liparoti
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", Naples, Italy.
| | - Giuseppe Sorrentino
- Department of Motor Sciences and Wellness, University of Naples "Parthenope", Naples, Italy
- Institute of Applied Sciences and Intelligent Systems, CNR, Pozzuoli, Italy
- Institute for Diagnosis and Care, Hermitage Capodimonte, Naples, Italy
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Cano-de-la-Cuerda R, Vela-Desojo L, Moreno-Verdú M, Ferreira-Sánchez MDR, Macías-Macías Y, Miangolarra-Page JC. Trunk Range of Motion Is Related to Axial Rigidity, Functional Mobility and Quality of Life in Parkinson's Disease: An Exploratory Study. SENSORS (BASEL, SWITZERLAND) 2020; 20:E2482. [PMID: 32349394 PMCID: PMC7248848 DOI: 10.3390/s20092482] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/15/2020] [Accepted: 04/25/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND People with Parkinson's disease (PD) present deficits of the active range of motion (ROM), prominently in their trunk. However, if these deficits are associated with axial rigidity, the functional mobility or health related quality of life (HRQoL), remains unknown. The aim of this paper is to study the relationship between axial ROM and axial rigidity, the functional mobility and HRQoL in patients with mild to moderate PD. METHODS An exploratory study was conducted. Non-probabilistic sampling of consecutive cases was used. Active trunk ROM was assessed by a universal goniometer. A Biodex System isokinetic dynamometer was used to measure the rigidity of the trunk. Functional mobility was determined by the Get Up and Go (GUG) test, and HRQoL was assessed with the PDQ-39 and EuroQol-5D questionnaires. RESULTS Thirty-six mild to moderate patients with PD were evaluated. Significant correlations were observed between trunk extensors rigidity and trunk flexion and extension ROM. Significant correlations were observed between trunk flexion, extension and rotation ROM and GUG. Moreover, significant correlations were observed between trunk ROM for flexion, extension and rotations (both sides) and PDQ-39 total score. However, these correlations were considered poor. CONCLUSIONS Trunk ROM for flexion and extension movements, measured by a universal goniometer, were correlated with axial extensors rigidity, evaluated by a technological device at 30°/s and 45°/s, and functional mobility. Moreover, trunk ROM for trunk flexion, extension and rotations were correlated with HRQoL in patients with mild to moderate PD.
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Affiliation(s)
- Roberto Cano-de-la-Cuerda
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain; (R.C.-d.-l.-C.); (J.C.M.-P.)
| | - Lydia Vela-Desojo
- Neurology Service. Division of Movements Disorders, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, 28922 Madrid, Spain; (L.V.-D.); (Y.M.-M.)
| | - Marcos Moreno-Verdú
- Asociación Parkinson Madrid, 28014 Madrid, Spain
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain;
| | | | - Yolanda Macías-Macías
- Neurology Service. Division of Movements Disorders, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, 28922 Madrid, Spain; (L.V.-D.); (Y.M.-M.)
| | - Juan Carlos Miangolarra-Page
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain; (R.C.-d.-l.-C.); (J.C.M.-P.)
- Rehabilitation Unit, Hospital Universitario de Fuenlabrada, Fuenlabrada, 28942 Madrid, Spain
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