1
|
Palmisano C, Farinelli V, Camuncoli F, Favata A, Pezzoli G, Frigo CA, Isaias IU. Dynamic evaluation of spine kinematics in individuals with Parkinson's disease and freezing of gait. Gait Posture 2024; 108:199-207. [PMID: 37993298 DOI: 10.1016/j.gaitpost.2023.10.017] [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: 10/02/2023] [Accepted: 10/23/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Freezing of gait (FoG) is an episodic failure of gait exposing people with Parkinson's disease (PD) to a high risk of falling. Despite growing evidence of the interconnection between impaired trunk control and FoG, a detailed description of spinal kinematics during walking is still lacking in this population. RESEARCH QUESTION Do spinal alterations impact gait performance in individuals with PD and FoG? METHODS We analyzed kinematic data of 47 PD participants suffering (PD-FOG, N = 24) or not suffering from FoG (PD-NFOG, N = 23) and 15 healthy controls (HCO) during quiet standing and unperturbed walking. We estimated the main spinal variables (i.e., spinal length, lordosis and kyphosis angles, trunk inclination), the pelvis angles, and the shoulder-pelvis angles during gait and standing. We studied differences across conditions and groups and the relationships between postural and gait parameters using linear regression methods. RESULTS During standing and walking, both PD groups showed increased trunk inclination and decreased lordosis angle with respect to HCO, as well as a decreased range in variation of kyphosis angle, pelvic obliquity, and shoulder-pelvis angles. Only PD-FOG participants showed reduced range of lordosis angle and spinal length compared to HCO. PD-FOG individuals were also not able to straighten their spine during walking compared to standing. Stride length and velocity were decreased in both patient groups compared to HCO, while swing duration was reduced only in the PD-FOG group. In individuals with FoG, trunk inclination and lordosis angle showed moderate but significant positive correlations with all gait alterations. SIGNIFICANCE Spine alterations impacted gait performance in individuals with PD suffering from FoG. Excessive trunk inclination and poor mastering of the lordosis spinal region may create an unfavourable postural precondition for forward walking. Physical therapy should target combined spinal and stepping alterations in these individuals.
Collapse
Affiliation(s)
- C Palmisano
- Department of Neurology, University Hospital of Würzburg and Julius Maximilian University of Würzburg, Würzburg, Germany.
| | - V Farinelli
- Human Physiology Section of the DePT, Università degli Studi di Milano, Milano, Italy
| | - F Camuncoli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - A Favata
- Biomechanical Engineering Lab, Department of Mechanical Engineering and Research Centre for Biomedical Engineering, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - G Pezzoli
- Parkinson Institute Milan, ASST G. Pini-CTO, Milano, Italy
| | - C A Frigo
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - I U Isaias
- Department of Neurology, University Hospital of Würzburg and Julius Maximilian University of Würzburg, Würzburg, Germany; Parkinson Institute Milan, ASST G. Pini-CTO, Milano, Italy
| |
Collapse
|
2
|
Turner A, Markey M, Le P, Reiter A, Cox C, Simmons S, Rao M, Altman L, Davis K, Huber D, Dufour JS, Marras W, Bhattacharya A. Disorientation effects, circulating small ribonucleic acid, and genetic susceptibility on static postural stability. Heliyon 2023; 9:e14413. [PMID: 36967955 PMCID: PMC10036646 DOI: 10.1016/j.heliyon.2023.e14413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 03/12/2023] Open
Abstract
Background Motion Sickness increases risk of performance deficits and safety of flight concerns. The etiology of motion sickness is poorly understood. Here, we attempted to quantify the physiological effects of motion sickness on static balance and determine the genetic predictors associated with these effects. Methods 16 subjects underwent a disorientation stimulus to induce motion sickness. Motion sickness susceptibility was identified using the Motion Sickness Susceptibility Questionnaire. Postural balance outcomes were measured using two tasks, and small ribonucleic acid profiles were assessed with blood draws before motion sickness stimulus. Differences in postural sway before and after the stimulus as well as effect modification of susceptibility were assessed. A random forest followed by regression tree analysis was constructed for each postural sway variable to determine top genetic and covariate predictors. Findings Significant differences existed in mean postural balance responses between before and after stimulus. Individuals with longer stimulus survival experienced a greater (but insignificant) perception of sway, even if not displaying increased sway for all conditions. Circulation small ribonucleic acids were differentially expressed between individuals with long and short stimulus survival, many of these microRNA have purported targets in genes related to vestibular disorders. Interpretation We found motion sickness produces transient motor dysfunction in a healthy military population. Small ribonucleic acids were differentially expressed between subjects with long and short stimulus survival times.
Collapse
Affiliation(s)
- Ashley Turner
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Michael Markey
- Department of Biochemistry and Molecular Biology, Wright State University, Dayton, OH, USA
| | - Peter Le
- NAMRU-D and Air Force Research Laboratory, 711th Human Performance Wing, WPAFB, OH 45433, USA
| | - Ali Reiter
- Department of Biochemistry and Molecular Biology, Wright State University, Dayton, OH, USA
| | - Cyndy Cox
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Stacy Simmons
- Department of Biochemistry and Molecular Biology, Wright State University, Dayton, OH, USA
| | - M.B. Rao
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Lorenna Altman
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Kermit Davis
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Dustin Huber
- NAMRU-D and Air Force Research Laboratory, 711th Human Performance Wing, WPAFB, OH 45433, USA
| | | | - William Marras
- Spine Research Institute, The Ohio State University, Columbus, OH, USA
| | - Amit Bhattacharya
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| |
Collapse
|
3
|
Isenstein EL, Waz T, LoPrete A, Hernandez Y, Knight EJ, Busza A, Tadin D. Rapid assessment of hand reaching using virtual reality and application in cerebellar stroke. PLoS One 2022; 17:e0275220. [PMID: 36174027 PMCID: PMC9522266 DOI: 10.1371/journal.pone.0275220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 09/13/2022] [Indexed: 11/19/2022] Open
Abstract
The acquisition of sensory information about the world is a dynamic and interactive experience, yet the majority of sensory research focuses on perception without action and is conducted with participants who are passive observers with very limited control over their environment. This approach allows for highly controlled, repeatable experiments and has led to major advances in our understanding of basic sensory processing. Typical human perceptual experiences, however, are far more complex than conventional action-perception experiments and often involve bi-directional interactions between perception and action. Innovations in virtual reality (VR) technology offer an approach to close this notable disconnect between perceptual experiences and experiments. VR experiments can be conducted with a high level of empirical control while also allowing for movement and agency as well as controlled naturalistic environments. New VR technology also permits tracking of fine hand movements, allowing for seamless empirical integration of perception and action. Here, we used VR to assess how multisensory information and cognitive demands affect hand movements while reaching for virtual targets. First, we manipulated the visibility of the reaching hand to uncouple vision and proprioception in a task measuring accuracy while reaching toward a virtual target (n = 20, healthy young adults). The results, which as expected revealed multisensory facilitation, provided a rapid and a highly sensitive measure of isolated proprioceptive accuracy. In the second experiment, we presented the virtual target only briefly and showed that VR can be used as an efficient and robust measurement of spatial memory (n = 18, healthy young adults). Finally, to assess the feasibility of using VR to study perception and action in populations with physical disabilities, we showed that the results from the visual-proprioceptive task generalize to two patients with recent cerebellar stroke. Overall, we show that VR coupled with hand-tracking offers an efficient and adaptable way to study human perception and action.
Collapse
Affiliation(s)
- E. L. Isenstein
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY, United States of America
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- Center for Visual Science, University of Rochester, Rochester, NY, United States of America
| | - T. Waz
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY, United States of America
| | - A. LoPrete
- Center for Visual Science, University of Rochester, Rochester, NY, United States of America
- Center for Neuroscience and Behavior, American University, Washington, DC, United States of America
- Bioengineering Graduate Group, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Y. Hernandez
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- The City College of New York, CUNY, New York, NY, United States of America
| | - E. J. Knight
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
| | - A. Busza
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - D. Tadin
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY, United States of America
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- Center for Visual Science, University of Rochester, Rochester, NY, United States of America
- Department of Ophthalmology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
| |
Collapse
|
4
|
Exley T, Moudy S, Patterson RM, Kim J, Albert MV. Predicting UPDRS Motor Symptoms in Individuals with Parkinsons Disease from Force Plates Using Machine Learning. IEEE J Biomed Health Inform 2022; 26:3486-3494. [PMID: 35259121 DOI: 10.1109/jbhi.2022.3157518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Parkinsons disease (PD) is a neurodegenerative disease that affects motor abilities with increasing severity as the disease progresses. Traditional methods for diagnosing PD include a section where a trained specialist scores qualitative symptoms using the motor subscale of the Unified Parkinsons Disease Rating Scale (UPDRS-III). The aim of this feasibility study was twofold. First, to evaluate quiet standing as an additional, out-of-clinic, objective feature to predict UPDRS-III subscores related to motor symptom severity; and second, to use quiet standing to detect the presence of motor symptoms. Force plate data were collected from 42 PD patients and 43 healthy controls during quiet standing (a task involving standing still with eyes open and closed) as a feasible task in clinics. Predicting each subscore of the UPDRS-III could aid in identifying progression of PD and provide specialists additional tools to make an informed diagnosis. Random Forest feature importance indicated that features correlated with range of center of pressure (i.e. the medial-lateral and anterior-posterior sway) were most useful in the prediction of the top PD prediction subscores of postural stability (r = 0.599; p = 0.014), hand tremor of the left hand (r = 0.650; p = 0.015), and tremor at rest of the left upper extremity (r = 0.703; p = 0.016). Quiet standing can detect body bradykinesia (AUC-ROC = 0.924) and postural stability (AUC-ROC = 0.967) with high predictability. Although there are limited data, these results should be used as a feasibility study that evaluates the predictability of individual UPDRS-III subscores using quiet standing data.
Collapse
|
5
|
Fasano A, Mazzoni A, Falotico E. Reaching and Grasping Movements in Parkinson's Disease: A Review. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1083-1113. [PMID: 35253780 PMCID: PMC9198782 DOI: 10.3233/jpd-213082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Parkinson's disease (PD) is known to affect the brain motor circuits involving the basal ganglia (BG) and to induce, among other signs, general slowness and paucity of movements. In upper limb movements, PD patients show a systematic prolongation of movement duration while maintaining a sufficient level of endpoint accuracy. PD appears to cause impairments not only in movement execution, but also in movement initiation and planning, as revealed by abnormal preparatory activity of motor-related brain areas. Grasping movement is affected as well, particularly in the coordination of the hand aperture with the transport phase. In the last fifty years, numerous behavioral studies attempted to clarify the mechanisms underlying these anomalies, speculating on the plausible role that the BG-thalamo-cortical circuitry may play in normal and pathological motor control. Still, many questions remain open, especially concerning the management of the speed-accuracy tradeoff and the online feedback control. In this review, we summarize the literature results on reaching and grasping in parkinsonian patients. We analyze the relevant hypotheses on the origins of dysfunction, by focusing on the motor control aspects involved in the different movement phases and the corresponding role played by the BG. We conclude with an insight into the innovative stimulation techniques and computational models recently proposed, which might be helpful in further clarifying the mechanisms through which PD affects reaching and grasping movements.
Collapse
Affiliation(s)
- Alessio Fasano
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, Pisa, Italy
- Correspondence to: Alessio Fasano and Egidio Falotico, The BioRobotics Institute, Scuola Superiore Sant’Anna, Polo Sant’Anna Valdera, Viale Rinaldo Piaggio, 34, 56025 Pontedera (PI), Italy. Tel.: +39 050 883 457; E-mails: and
| | - Alberto Mazzoni
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Egidio Falotico
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, Pisa, Italy
- Correspondence to: Alessio Fasano and Egidio Falotico, The BioRobotics Institute, Scuola Superiore Sant’Anna, Polo Sant’Anna Valdera, Viale Rinaldo Piaggio, 34, 56025 Pontedera (PI), Italy. Tel.: +39 050 883 457; E-mails: and
| |
Collapse
|
6
|
Kahya M, Lyons KE, Pahwa R, Akinwuntan AE, He J, Devos H. Pupillary Response to Postural Demand in Parkinson's Disease. Front Bioeng Biotechnol 2021; 9:617028. [PMID: 33987171 PMCID: PMC8111006 DOI: 10.3389/fbioe.2021.617028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/09/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Individuals with Parkinson’s disease (PD) may need to spend more mental and physical effort (i.e., cognitive workload) to maintain postural control. Pupillary response reflects cognitive workload during postural control tasks in healthy controls but has not been investigated as a measure of postural demand in PD. Objectives: To compare pupillary response during increased postural demand using vision occlusion and dual tasking between individuals with PD and healthy controls. Methods: Thirty-three individuals with PD and thirty-five healthy controls were recruited. The four conditions lasted 60 s and involved single balance task with eyes open; single balance task with eyes occluded; dual task with eyes open; dual task with eyes occluded. The dual task comprised the Auditory Stroop test. Pupillary response was recorded using an eye tracker. The balance was assessed by using a force plate. Two-way Repeated Measures ANOVA and LSD post-hoc tests were employed to compare pupillary response and Center of Pressure (CoP) displacement across the four conditions and between individuals with PD and healthy controls. Results: Pupillary response was higher in individuals with PD compared to healthy controls (p = 0.009) and increased with more challenging postural conditions in both groups (p < 0.001). The post-hoc analysis demonstrated increased pupillary response in the single balance eyes occluded (p < 0.001), dual task eyes open (p = 0.01), and dual task eyes occluded (p < 0.001) conditions compared to single task eyes open condition. Conclusion: Overall, the PD group had increased pupillary response with increased postural demand compared to the healthy controls. In the future, pupillary response can be a potential tool to understand the neurophysiological underpinnings of falls risk in the PD population.
Collapse
Affiliation(s)
- Melike Kahya
- Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States
| | - Kelly E Lyons
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Rajesh Pahwa
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Abiodun E Akinwuntan
- Office of the Dean, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States.,Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jianghua He
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States
| | - Hannes Devos
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
| |
Collapse
|
7
|
Abraham A, Duncan RP, Earhart GM. The Role of Mental Imagery in Parkinson's Disease Rehabilitation. Brain Sci 2021; 11:brainsci11020185. [PMID: 33540883 PMCID: PMC7913152 DOI: 10.3390/brainsci11020185] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 02/06/2023] Open
Abstract
Parkinson’s disease (PD) is a disabling neurodegenerative disease whose manifestations span motor, sensorimotor, and sensory domains. While current therapies for PD include pharmacological, invasive, and physical interventions, there is a constant need for developing additional approaches for optimizing rehabilitation gains. Mental imagery is an emerging field in neurorehabilitation and has the potential to serve as an adjunct therapy to enhance patient function. Yet, the literature on this topic is sparse. The current paper reviews the motor, sensorimotor, and sensory domains impacted by PD using gait, balance, and pain as examples, respectively. Then, mental imagery and its potential for PD motor and non-motor rehabilitation is discussed, with an emphasis on its suitability for addressing gait, balance, and pain deficits in people with PD. Lastly, future research directions are suggested.
Collapse
Affiliation(s)
- Amit Abraham
- Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel 4077625, Israel
- Navigation and Accessibility Research Center of Ariel University (NARCA), Ariel University, Ariel 4077625, Israel
- Correspondence:
| | - Ryan P. Duncan
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO 63108, USA; (R.P.D.); (G.M.E.)
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Gammon M. Earhart
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO 63108, USA; (R.P.D.); (G.M.E.)
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- Department of Neuroscience, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| |
Collapse
|
8
|
Qiu F, Wu Y, Cao H, Liu B, Du M, Jiang H, Li S. Changes of Peripheral Nerve Function and Vitamin B 12 Level in People With Parkinson's Disease. Front Neurol 2020; 11:549159. [PMID: 33192978 PMCID: PMC7658102 DOI: 10.3389/fneur.2020.549159] [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: 04/06/2020] [Accepted: 09/28/2020] [Indexed: 11/21/2022] Open
Abstract
Background and Purpose: Peripheral nerve function plays an important role in balance control. Impairment of peripheral sensory information appears in people with Parkinson's disease (PD). Furthermore, there is a link between peripheral nerve disorders and vitamin B12 level. Here, we studied whether there were deficits of peripheral nerve function and vitamin B12 level, which may lead to decreased postural stability in PD. Methods: Fifty PD and 50 age-matched healthy subjects were enrolled in the study. This study evaluated folic acid and vitamin B12 levels in serum. Postural balance was studied according to the clinical Tinetti scale. Some comprehensive physiological assessments of peripheral nerve functions, including peripheral sensation, the perception of temperature, pain, and touch sensations, were also undertaken in this study. Results: Compared with the control group, vitamin B12 and folic acid were decreased in PD (P < 0.05). Furthermore, the PD group exhibited declines in peripheral nerve functions, including touch, temperature, pain, and nerve conduction velocity (P < 0.05). Statistical tests identified a significant association between decreased peripheral nerve function and poor balance according to the Tinetti scale (P < 0.05). Low vitamin B12 levels were also associated with deficits of peripheral nerve function, cumulative levodopa dose, and poor balance in PD (P < 0.05). Conclusions: Data suggested that peripheral nerve function was impaired in people with PD. Deficits of sensory input and low vitamin B12 level may contribute to balance deficits in PD.
Collapse
Affiliation(s)
- Feng Qiu
- Cerebrovascular Disease Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Yue Wu
- Neonatal Medical Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Cao
- Cerebrovascular Disease Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Ben Liu
- Department of Physical Diagnosis, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Mingyang Du
- Cerebrovascular Disease Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Haibo Jiang
- Cerebrovascular Disease Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Shun Li
- Cerebrovascular Disease Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| |
Collapse
|
9
|
Reliability and Validity of Pupillary Response During Dual-Task Balance in Parkinson Disease. Arch Phys Med Rehabil 2020; 102:448-455. [PMID: 32950465 DOI: 10.1016/j.apmr.2020.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/21/2020] [Accepted: 08/12/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the reliability and validity of pupillary response during dual-task balance conditions in individuals with Parkinson disease (PD). DESIGN Cross-sectional study. SETTING University of Kansas Medical Center Parkinson's Disease and Movement Disorder Center. PARTICIPANTS Participants (N=68) included individuals with PD (n=33) and healthy controls (n=35). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Pupillary response was the main outcome measure that was measured during the following conditions: single-task balance eyes open, single-task balance eyes occluded, dual-task eyes open, and dual-task eyes occluded. After each condition, the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) was administered to assess self-reported cognitive workload. To examine the test-retest reliability of the pupillary response, the conditions were administered twice for each individual within 2 hours. Intraclass correlation coefficients (ICC) were used to analyze the test-retest reliability of pupillary response in each condition for both groups. Pearson's r correlation was used to assess the convergent validity of pupillary response against the NASA-TLX. RESULTS The test-retest reliability was excellent for both groups in almost all conditions (ICC>0.75). There were no correlations between pupillary response and the NASA-TLX. However, increased mental demand (a subitem of the NASA-TLX) significantly correlated with increased pupillary response in individuals with PD (r=0.38; P=.03). CONCLUSIONS Pupillary response showed excellent test-retest reliability and validity during dual-task balance for individuals with PD and healthy controls. Overall, these results suggest that pupillary response represents a stable index of cognitive workload during dual-task balance in individuals with PD.
Collapse
|
10
|
Cabrera-Martos I, Jiménez-Martín AT, López-López L, Rodríguez-Torres J, Ortiz-Rubio A, Valenza MC. Effects of a core stabilization training program on balance ability in persons with Parkinson's disease: a randomized controlled trial. Clin Rehabil 2020; 34:764-772. [PMID: 32349543 DOI: 10.1177/0269215520918631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the effects of an eight-week core stability program on balance ability in persons with Parkinson's disease. DESIGN Randomized controlled trial. SETTING A local Parkinson's association. SUBJECTS A total of 44 participants with a clinical diagnosis of Parkinson's disease were randomly assigned to an experimental (n = 22) or control group (n = 22). INTERVENTION The experimental group received 24 sessions of core training, while the control group received an intervention including active joint mobilization, muscle stretching, and motor coordination exercises. MAIN MEASURES The primary outcome measure was dynamic balance evaluated using the Mini-Balance Evaluation Systems Test. Secondary outcomes included the balance confidence assessed with the Activities-specific Balance Confidence Scale and standing balance assessed by the maximal excursion of center of pressure during the Modified Clinical Test of Sensory Interaction on Balance and the Limits of Stability test. RESULTS After treatment, a significant between-group improvement in dynamic balance was observed in the experimental group compared to the control group (change, 2.75 ± 1.80 vs 0.38 ± 2.15, P = 0.002). The experimental group also showed a significant improvement in confidence (change, 16.48 ± 16.21 vs 3.05 ± 13.53, P = 0.047) and maximal excursion of center of pressure in forward (change, 0.86 ± 1.89 cm vs 0.17 ± 0.26 cm, P = 0.048), left (change, 0.88 ± 2.63 cm vs 0.07 ± 0.48 cm, P = 0.010), and right (change, 1.63 ± 2.82 cm vs 0.05 ± 0.17 cm, P = 0.046) directions of limits of stability compared to the control group. CONCLUSION A program based on core stability in comparison with non-specific exercise benefits dynamic balance and confidence and increases center of mass excursion in patients with Parkinson's disease.
Collapse
Affiliation(s)
- Irene Cabrera-Martos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - Laura López-López
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Janet Rodríguez-Torres
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Araceli Ortiz-Rubio
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Marie Carmen Valenza
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| |
Collapse
|
11
|
Halperin O, Israeli‐Korn S, Yakubovich S, Hassin‐Baer S, Zaidel A. Self‐motion perception in Parkinson's disease. Eur J Neurosci 2020; 53:2376-2387. [DOI: 10.1111/ejn.14716] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Orly Halperin
- Gonda Multidisciplinary Brain Research Center Bar Ilan University Ramat Gan Israel
| | - Simon Israeli‐Korn
- Department of Neurology Movement Disorders Institute Sheba Medical Center Ramat Gan Israel
- The Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Sol Yakubovich
- Gonda Multidisciplinary Brain Research Center Bar Ilan University Ramat Gan Israel
| | - Sharon Hassin‐Baer
- Department of Neurology Movement Disorders Institute Sheba Medical Center Ramat Gan Israel
- The Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Adam Zaidel
- Gonda Multidisciplinary Brain Research Center Bar Ilan University Ramat Gan Israel
| |
Collapse
|
12
|
Bong SM, McKay JL, Factor SA, Ting LH. Perception of whole-body motion during balance perturbations is impaired in Parkinson's disease and is associated with balance impairment. Gait Posture 2020; 76:44-50. [PMID: 31731133 PMCID: PMC7015810 DOI: 10.1016/j.gaitpost.2019.10.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 09/09/2019] [Accepted: 10/22/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND In addition to motor deficits, Parkinson's disease (PD) may cause perceptual impairments. The role of perceptual impairments in sensorimotor function is unclear, and has typically been studied in single-joint motions. RESEARCH QUESTION We hypothesized that perception of whole-body motion is impaired in PD and contributes to balance impairments. We tested (1) whether directional acuity to whole body perturbations during standing was worse in people with PD compared to neurotypical older adults (NOA), and (2) whether balance ability, as assessed by the MiniBESTest, was associated with poor directional acuity in either group. METHODS Participants were exposed to pairs of support-surface translation perturbations in a two-alternative forced choice testing paradigm developed previously in a young healthy population. The first perturbation of each pair that was to be judged by participants was directly backward, and the second perturbation deviated from the left or right from the backward direction by 1°-44°. Participants reported whether the perturbations in each pair were in the "same" or "different" direction. Judgements from 24 to 67 perturbation pairs were used to calculate directional acuity thresholds corresponding to "just-noticeable differences" in perturbation direction. Linear mixed models determined associations between directional thresholds and clinical variables including MDS-UPDRS-III score, age, and MiniBESTest score. RESULTS 20 PD (64 ± 7 y, 12 male, ≥12 h since last intake of antiparkinsonian medications) and 12 NOA (64 ± 8, 6 male) were assessed. Directional thresholds were higher (worse) among PD participants (17.6 ± 5.9° vs. 12.8 ± 3.3°, P < 0.01). Linear mixed models further showed that higher thresholds were associated with MDS-UPDRS-III score (P < 0.01), and were associated with poorer balance ability among PD participants (P < 0.01), but not among NOA participants (P = 0.40). SIGNIFICANCE Perception of whole-body motion is impaired in PD and may contribute to impaired balance and falls.
Collapse
Affiliation(s)
- Sistania M. Bong
- Wallace H. Coulter Department of Biomedical Engineering,
Emory University and Georgia Tech, Atlanta, Georgia, USA
| | - J. Lucas McKay
- Wallace H. Coulter Department of Biomedical Engineering,
Emory University and Georgia Tech, Atlanta, Georgia, USA
| | - Stewart A. Factor
- Jean & Paul Amos PD & Movement Disorders Program,
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia,
USA
| | - Lena H. Ting
- Wallace H. Coulter Department of Biomedical Engineering,
Emory University and Georgia Tech, Atlanta, Georgia, USA.,Division of Physical Therapy, Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Georgia, USA,Corresponding author Lena H. Ting PhD, Wallace H.
Coulter Department of Biomedical Engineering, Emory University and the Georgia
Institute of Technology, 1760 Haygood Drive, Suite W200, Atlanta, Georgia,
30322, USA,
| |
Collapse
|
13
|
Tabatabaee M, Cheraghifard M, Shamsoddini A. The effects of kinesio taping of lower limbs on functional mobility, spasticity, and range of motion of children with spastic cerebral palsy. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2019. [DOI: 10.1186/s41983-019-0118-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cerebral palsy (CP) is a non-progressive neurological disease in a growing brain.
Objective
The aim of this study was to explore the effects of kinesio taping (KT) of the lower limbs on functional mobility, spasticity, and range of motion (ROM) of children with cerebral palsy.
Methods
Thirty children with spastic cerebral palsy aged 3 to 10 years old were selected from pediatric rehabilitation clinics. Subjects were divided randomly into intervention and control groups. Each group contains 15 subjects. Both groups received kinesio taping along with occupational therapy for 2 weeks. In the intervention group, kinesio taping was applied in a treatment mode with suitable tension; however, taping was applied in the control group in a sham mode. Timed get up and go (TUG), Modified Modified Ashworth (MMA), and goniometer tests were used prior to the intervention and 2 days and 2 weeks after the intervention.
Results
Short-term application of kinesio taping in the intervention group did not lead to significant changes in ROM (P = 0.582), muscle tone (P = 0.317), and functional mobility (P = 0.320). However, long-term application of kinesio taping improved the range of motion, muscle tone, and functional mobility (P < 0.05). No significant change has been observed in the control group in different intervals.
Conclusion
The findings indicated that kinesio taping can increase ROM of the knee and reduce spasticity. It also can improve the functional mobility. Therefore, it seems that kinesio taping is efficient for rehabilitation of spastic CP as a reliable treatment method.
Trial registration
IRCT, IRCT2017082135822N1, Registered 19 September 2017, https://fa.irct.ir/IRCT2017082135822N1.
Collapse
|
14
|
Mori L, Putzolu M, Bonassi G, Galeoto G, Mezzarobba S, Trompetto C, Avanzino L, Marchese R, Abbruzzese G, Pelosin E. Haptic perception of verticality correlates with postural and balance deficits in patients with Parkinson's disease. Parkinsonism Relat Disord 2019; 66:45-50. [DOI: 10.1016/j.parkreldis.2019.06.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/30/2019] [Accepted: 06/30/2019] [Indexed: 01/09/2023]
|
15
|
Feller KJ, Peterka RJ, Horak FB. Sensory Re-weighting for Postural Control in Parkinson's Disease. Front Hum Neurosci 2019; 13:126. [PMID: 31057379 PMCID: PMC6478764 DOI: 10.3389/fnhum.2019.00126] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 03/27/2019] [Indexed: 12/15/2022] Open
Abstract
Postural instability in Parkinson's disease (PD) is characterized by impaired postural responses to transient perturbations, increased postural sway in stance and difficulty transitioning between tasks. In addition, some studies suggest that loss of dopamine in the basal ganglia due to PD results in difficulty in using proprioceptive information for motor control. Here, we quantify the ability of subjects with PD and age-matched control subjects to use and re-weight sensory information for postural control during steady-state conditions of continuous rotations of the stance surface or visual surround. We measure the postural sway of subjects in response to a pseudorandom, surface-tilt stimulus with eyes closed, and in response to a pseudorandom, visual-tilt stimulus. We use a feedback control model of the postural control system to interpret our results, focusing on sensory weighting as a function of stimulus amplitude. We find that subjects with PD can re-weight their dependence upon sensory information in response to changes in surface- or visual-stimulus amplitude. Specifically, subjects with PD behaved like age-matched control subjects by decreasing proprioceptive contribution to stance control with increasing surface-tilt amplitude and decreasing visual contribution with increasing visual-tilt amplitude. However, subjects with PD do not decrease their reliance on proprioception as much as age-matched controls for small increases in surface-stimulus amplitudes. Levodopa medication did not affect sensory re-weighting behaviors for postural control. The impairment in PD subject's ability to respond differently to small changes in surface rotation amplitudes is consistent with an increased threshold for perceiving proprioceptive signals, which may result from decreased signal-to-noise in the dopaminergic pathways associated with sensory processing and/or sensory integration.
Collapse
Affiliation(s)
- Kelly J. Feller
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, United States,Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Robert J. Peterka
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States,Veterans Adminstration Portland Health Care System, Portland, OR, United States
| | - Fay B. Horak
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, United States,Department of Neurology, Oregon Health & Science University, Portland, OR, United States,Veterans Adminstration Portland Health Care System, Portland, OR, United States,*Correspondence: Fay B. Horak
| |
Collapse
|
16
|
Zhang Z, Gao Y, Wang J. Effects of vision and cognitive load on anticipatory and compensatory postural control. Hum Mov Sci 2019; 64:398-408. [PMID: 30876761 DOI: 10.1016/j.humov.2019.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 02/01/2019] [Accepted: 02/19/2019] [Indexed: 11/30/2022]
Abstract
This study assessed the effects of vision and cognitive load on anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) in response to an externally triggered postural perturbation. A ball-hitting test was repeated under different visual conditions (eyes open, EO; eyes closed, EC) and cognitive loads (no load, 3-subtraction task, time-limited 3-subtraction task). Data were collected separately for I) surface electromyography from the right side of the biceps brachii (BIC) and erector spinae (ES) to detect the latency and response intensity (RI); and II) displacement of the centre of pressure (ΔCOP) to detect the standard deviation (ΔCOPSD) and maximum value (ΔCOPmax) in the anterior-posterior direction. Compared with the results under the EC condition, the ES latency was shorter and the RI of the BIC was lower under the EO condition. Accordingly, the ΔCOPSD and ΔCOPmax were increased in the APAs phase and decreased in the CPAs phase. Cognitive load had no effect on APAs and CPAs or on ΔCOP in the APAs phase. However, ΔCOPmax was decreased in the CPAs phase during the EC condition. In conclusion, vision played an important role in APAs and CPAs for muscle activation and ΔCOP. Cognitive load had no effect on neuromuscular APAs or CPAs except when the postural perturbation occurred when visually unexpected.
Collapse
Affiliation(s)
- Zhi Zhang
- Department of Investigation, Zhejiang Police College, China
| | - Ying Gao
- Education College, Zhejiang University, China
| | - Jian Wang
- Education College, Zhejiang University, China; Center for Psychological Sciences at Zhejiang University, Zhejiang University, China.
| |
Collapse
|
17
|
Jehu DA, Cantù H, Hill A, Paquette C, Côté JN, Nantel J. Medication and trial duration influence postural and pointing parameters during a standing repetitive pointing task in individuals with Parkinson's disease. PLoS One 2018; 13:e0195322. [PMID: 29621320 PMCID: PMC5886485 DOI: 10.1371/journal.pone.0195322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 03/20/2018] [Indexed: 11/18/2022] Open
Abstract
We aimed to determine the effects of levodopa medication on the performance of a repetitive pointing task while standing, and to investigate the optimal trial duration in individuals with Parkinson’s disease, and older adults. Seventeen individuals with Parkinson’s disease (5 freezers) and 9 older adults stood on force platforms for 30 s and 120 s while performing a bilateral repetitive pointing task, tracked by motion capture. Participants with Parkinson’s disease were assessed on and off medication and older adults were also assessed on separate days. The main findings were that: 1) on medication, participants with Parkinson’s exhibited greater center of pressure root mean square in the medial-lateral direction, greater velocity in the medial-lateral and anterior-posterior directions, and greater range in the medial-lateral direction than off medication; 2) longer trial durations resulted in greater center of pressure range in the medial-lateral and anterior-posterior directions and greater coefficient of variation in finger pointing on the least affected side; 3) Parkinson’s participants exhibited larger range in the medial-lateral direction compared to older adults; 4) off medication, freezers presented with less range and root mean square in the anterior-posterior direction than non-freezers; and 5) a correlation emerged between the freezing of gait questionnaire and pointing asymmetry and the coefficient of variation of pointing on the most affected side. Therefore, Parkinson’s medication may increase instability during a repetitive pointing task. Longer trials may provide a better depiction of sway by discriminating between those with and without neurological impairment. Individuals with Parkinson’s were less stable than older adults, supporting that they are at a greater risk for falls. The greater restrictive postural strategy in freezers compared to non-freezers is likely a factor that augments fall-risk. Lastly, the link between freezing of gait and upper-limb movement indicates that freezing may manifest first in the lower-limbs.
Collapse
Affiliation(s)
- Deborah A. Jehu
- University of Ottawa, School of Human Kinetics, Ottawa, Ontario, Canada
| | - Hiram Cantù
- McGill University, Department of Kinesiology and Physical Education, Montréal, Québec, Canada
| | - Allen Hill
- University of Ottawa, School of Human Kinetics, Ottawa, Ontario, Canada
| | - Caroline Paquette
- McGill University, Department of Kinesiology and Physical Education, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), Montréal, Québec, Canada
| | - Julie N. Côté
- McGill University, Department of Kinesiology and Physical Education, Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), Montréal, Québec, Canada
| | - Julie Nantel
- University of Ottawa, School of Human Kinetics, Ottawa, Ontario, Canada
- * E-mail:
| |
Collapse
|
18
|
An Overview of the Physiology and Pathophysiology of Postural Control. BIOSYSTEMS & BIOROBOTICS 2018. [DOI: 10.1007/978-3-319-72736-3_1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
19
|
Tomita Y, Rodrigues MRM, Levin MF. Upper Limb Coordination in Individuals With Stroke: Poorly Defined and Poorly Quantified. Neurorehabil Neural Repair 2017; 31:885-897. [DOI: 10.1177/1545968317739998] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background. The identification of deficits in interjoint coordination is important in order to better focus upper limb rehabilitative treatment after stroke. The majority of standardized clinical measures characterize endpoint performance, such as accuracy, speed, and smoothness, based on the assumption that endpoint performance reflects interjoint coordination, without measuring the underlying temporal and spatial sequences of joint recruitment directly. However, this assumption is questioned since improvements of endpoint performance can be achieved through different degrees of restitution or compensation of upper limb motor impairments based on the available kinematic redundancy of the system. Confusion about adequate measurement may stem from a lack a definition of interjoint coordination during reaching. Methods and Results. We suggest an operational definition of interjoint coordination during reaching as a goal-oriented process in which joint degrees of freedom are organized in both spatial and temporal domains such that the endpoint reaches a desired location in a context-dependent manner. Conclusions. In this point-of-view article, we consider how current approaches to laboratory and clinical measures of coordination comply with our definition. We propose future study directions and specific research strategies to develop clinical measures of interjoint coordination with better construct and content validity than those currently in use.
Collapse
Affiliation(s)
- Yosuke Tomita
- McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Laval, Quebec, Canada
| | - Marcos R. M. Rodrigues
- McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Laval, Quebec, Canada
| | - Mindy F. Levin
- McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Laval, Quebec, Canada
| |
Collapse
|
20
|
Mikami K, Shiraishi M, Kawasaki T, Kamo T. Forward flexion of trunk in Parkinson's disease patients is affected by subjective vertical position. PLoS One 2017; 12:e0181210. [PMID: 28700731 PMCID: PMC5507338 DOI: 10.1371/journal.pone.0181210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 06/27/2017] [Indexed: 02/03/2023] Open
Abstract
PURPOSE No method has been established to evaluate the dissociation between subjective and objective vertical positions with respect to the self-awareness of postural deformity in patients with Parkinson's disease (PD). The purpose of this study was to demonstrate, from the relationship between an assessment of the dissociation of subjective and objective vertical positions of PD patients and an assessment based on established PD clinical evaluation scales, that the dissociation regarding vertical position is a factor in the severity of the forward flexion of trunk (FFT). METHODS Subjects were 39 PD patients and 15 age-matched healthy individuals (control group). Posture was evaluated with measurement of FFT angle during static standing and the subjective vertical position (SV) of the patient. For evaluation of motor function, the Modified Hoehn & Yahr scale, Unified Parkinson's Disease Rating Scale (UPDRS), 3-m Timed Up and Go Test (TUG), and Functional Reach Test (FRT) were used. RESULTS In PD patients, FFT angle in the 3rd tertile of patients was 13.8±9.7°, significantly greater than those in the control group and the 1st and 2nd tertiles of PD patients (control group vs 3rd tertile, p = 0.008; 1st tertile vs 3rd tertile, p<0.001; 2nd vs 3rd tertile, p = 0.008). In multiple regression analysis for factors in the FFT angle, significant factors were SV, disease duration, and the standard deviation of each SV angle measurement. CONCLUSION The dissociation between SV and objective vertical position affects the FFT of PD patients, suggesting an involvement of non-basal ganglia pathologies.
Collapse
Affiliation(s)
- Kyohei Mikami
- Department of Rehabilitation, Noborito Neurology Clinic, Kawasaki, Kanagawa, Japan
| | - Makoto Shiraishi
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Tsubasa Kawasaki
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University, Urayasu, Chiba, Japan
| | - Tsutomu Kamo
- Department of Neurology, Noborito Neurology Clinic, Kawasaki, Kanagawa, Japan
| |
Collapse
|
21
|
Casellato C, Pedrocchi A, Ferrigno G. Whole-Body Movements in Long-Term Weightlessness: Hierarchies of the Controlled Variables Are Gravity-Dependent. J Mot Behav 2016; 49:568-579. [PMID: 28027021 DOI: 10.1080/00222895.2016.1247032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Switching between contexts affects the mechanisms underlying motion planning, in particular it may entail reranking the variables to be controlled in defining the motor solutions. Three astronauts performed multiple sessions of whole-body pointing, in normogravity before launch, in prolonged weightlessness onboard the International Space Station, and after return. The effect of gravity context on kinematic and dynamic components was evaluated. Hand trajectory was gravity independent; center-of-mass excursion was highly variable within and between subjects. The body-environment effort exchange, expressed as inertial ankle momentum, was systematically lower in weightlessness than in normogravity. After return on Earth, the system underwent a rapid 1-week readaptation. The study indicates that minimizing the control effort is given greater weight when optimizing the motor plan in weightlessness compared to normogravity: the hierarchies of the controlled variables are gravity dependent.
Collapse
Affiliation(s)
| | - Alessandra Pedrocchi
- a NeuroEngineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering , Politecnico di Milano , Milano , Italy
| | - Giancarlo Ferrigno
- a NeuroEngineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering , Politecnico di Milano , Milano , Italy
| |
Collapse
|
22
|
Evaluation of Knee Proprioception and Factors Related to Parkinson's Disease. NEUROSCIENCE JOURNAL 2016; 2016:6746010. [PMID: 27672650 PMCID: PMC5031852 DOI: 10.1155/2016/6746010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/21/2016] [Indexed: 11/17/2022]
Abstract
Background. Changes in proprioception may contribute to postural instability in individuals with neurological disorders. Objectives. Evaluate proprioception in the lower limbs of patients with Parkinson's disease (PD) and the association between proprioception and cognitive ability, motor symptoms, postural instability, and disease severity. Methods. This is a cross-sectional, controlled study that evaluated proprioception in PD patients and healthy age- and sex-matched individuals. Kinetic postural proprioception of the knee was evaluated using an isokinetic dynamometer (Biodex® Multi-Joint System 4 Pro). Participants were evaluated using the Montreal Cognitive Assessment (MoCA), the Hoehn and Yahr rating scale and postural instability (pull test and stabilometric analysis), and motor function (UPDRS-III) tests. Results. A total of 40 individuals were enrolled in the study: 20 PD patients and 20 healthy controls (CG). The PD patients had higher angular errors on the proprioceptive ratings than the CG participants (p = 0.002). Oscillations of the center of pressure (p = 0.002) were higher in individuals with PD than in the controls. Proprioceptive errors in the PD patients were associated with the presence of tremors as the dominant symptom and more impaired motor performance. Conclusion. These findings show that individuals with PD have proprioceptive deficits, which are related to decreased cognitive ability and impaired motor symptoms.
Collapse
|
23
|
Pilgram LM, Earhart GM, Pickett KA. Impact of limiting visual input on gait: Individuals with Parkinson disease, age-matched controls, and healthy young participants. Somatosens Mot Res 2016; 33:29-34. [PMID: 26987577 DOI: 10.3109/08990220.2016.1152237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Normal and limited vision gait was investigated in individuals with Parkinson disease (PD), healthy older and healthy young individuals. Participants walked a GAITRite mat with normal vision or vision of lower limbs occluded. Results indicate individuals with PD walked more slowly, with shorter and wider steps, and spent more time in double support with limited vision as compared to full vision. Healthy young and old individuals took shorter steps but were otherwise unchanged between conditions.
Collapse
Affiliation(s)
- Laura M Pilgram
- a Program in Physical Therapy , Washington University School of Medicine in St Louis , St Louis , USA
| | - Gammon M Earhart
- a Program in Physical Therapy , Washington University School of Medicine in St Louis , St Louis , USA ;,b Department of Neurology-Movement Disorders Section , Washington University School of Medicine in St Louis , St Louis , USA ;,c Department of Neuroscience , Washington University School of Medicine in St Louis , St Louis , USA
| | - Kristen A Pickett
- a Program in Physical Therapy , Washington University School of Medicine in St Louis , St Louis , USA ;,b Department of Neurology-Movement Disorders Section , Washington University School of Medicine in St Louis , St Louis , USA
| |
Collapse
|
24
|
Bonnet CT, Delval A, Defebvre L. Parkinson's Disease-Related Impairments in Body Movement, Coordination and Postural Control Mechanisms When Performing 80$^{\circ}$ Lateral Gaze Shifts. IEEE Trans Neural Syst Rehabil Eng 2015; 23:849-56. [PMID: 25423653 DOI: 10.1109/tnsre.2014.2369455] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
25
|
Downs ME, Buch A, Sierra C, Karakatsani ME, Chen S, Konofagou EE, Ferrera VP. Long-Term Safety of Repeated Blood-Brain Barrier Opening via Focused Ultrasound with Microbubbles in Non-Human Primates Performing a Cognitive Task. PLoS One 2015; 10:e0125911. [PMID: 25945493 PMCID: PMC4422704 DOI: 10.1371/journal.pone.0125911] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 03/23/2015] [Indexed: 01/11/2023] Open
Abstract
Focused Ultrasound (FUS) coupled with intravenous administration of microbubbles (MB) is a non-invasive technique that has been shown to reliably open (increase the permeability of) the blood-brain barrier (BBB) in multiple in vivo models including non-human primates (NHP). This procedure has shown promise for clinical and basic science applications, yet the safety and potential neurological effects of long term application in NHP requires further investigation under parameters shown to be efficacious in that species (500kHz, 200–400 kPa, 4–5μm MB, 2 minute sonication). In this study, we repeatedly opened the BBB in the caudate and putamen regions of the basal ganglia of 4 NHP using FUS with systemically-administered MB over 4–20 months. We assessed the safety of the FUS with MB procedure using MRI to detect edema or hemorrhaging in the brain. Contrast enhanced T1-weighted MRI sequences showed a 98% success rate for openings in the targeted regions. T2-weighted and SWI sequences indicated a lack edema in the majority of the cases. We investigated potential neurological effects of the FUS with MB procedure through quantitative cognitive testing of’ visual, cognitive, motivational, and motor function using a random dot motion task with reward magnitude bias presented on a touchpanel display. Reaction times during the task significantly increased on the day of the FUS with MB procedure. This increase returned to baseline within 4–5 days after the procedure. Visual motion discrimination thresholds were unaffected. Our results indicate FUS with MB can be a safe method for repeated opening of the BBB at the basal ganglia in NHP for up to 20 months without any long-term negative physiological or neurological effects with the parameters used.
Collapse
Affiliation(s)
- Matthew E. Downs
- Department of Biomedical Engineering, Columbia University, New York, New York, United States of America
- * E-mail:
| | - Amanda Buch
- Department of Biomedical Engineering, Columbia University, New York, New York, United States of America
| | - Carlos Sierra
- Department of Biomedical Engineering, Columbia University, New York, New York, United States of America
| | - Maria Eleni Karakatsani
- Department of Biomedical Engineering, Columbia University, New York, New York, United States of America
| | - Shangshang Chen
- Department of Neuroscience, Columbia University, New York, New York, United States of America
| | - Elisa E. Konofagou
- Department of Biomedical Engineering, Columbia University, New York, New York, United States of America
- Department of Radiology, Columbia University, New York, New York, United States of America
| | - Vincent P. Ferrera
- Department of Neuroscience, Columbia University, New York, New York, United States of America
| |
Collapse
|
26
|
Early postural changes in individuals with idiopathic Parkinson's disease. PARKINSONS DISEASE 2015; 2015:369454. [PMID: 25922785 PMCID: PMC4397425 DOI: 10.1155/2015/369454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 03/15/2015] [Indexed: 11/17/2022]
Abstract
Background and Objectives. Postural changes are frequent and disabling complications of Parkinson's disease (PD). Many contributing factors have been evident either related to disease pathology or to adaptive changes. This study aimed at studying the postural changes in subjects with Parkinson's disease and its relation to duration of illness and disease severity. Methods. Eighteen patients with PD and 18 healthy matched volunteers represented the sample of the study. The patients were at stage 1 or 1.5 according to the Modified Hoehn and Yahr Staging with duration of illness between 18 and 36 months. Three-dimensional analysis of the back surface was conducted to explore the postural changes in the sagittal and frontal planes in both the patients and the healthy subjects. Results. Kyphotic angle, lordotic angle, fleche cervicale, fleche lombaire, scoliotic angle, and associated vertebral rotation and pelvic obliquity were significantly increased in patients with PD compared to the healthy subjects (P ≤ 0.05). There was no association between the measured postural changes and duration of illness as well as the severity of the IPD (P ≤ 0.05). Conclusion. Postural changes start in the early stages of idiopathic PD and they have no relationship to the duration of illness and disease severity.
Collapse
|
27
|
Cohen RG, Gurfinkel VS, Kwak E, Warden AC, Horak FB. Lighten Up: Specific Postural Instructions Affect Axial Rigidity and Step Initiation in Patients With Parkinson's Disease. Neurorehabil Neural Repair 2015; 29:878-88. [PMID: 25665828 DOI: 10.1177/1545968315570323] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is associated with stooped postural alignment, increased postural sway, and reduced mobility. The Alexander Technique (AT) is a mindfulness-based approach to improving posture and mobility by reducing muscular interference while maintaining upward intentions. Evidence suggests that AT can reduce disability associated with PD, but a mechanism for this effect has not yet been established. OBJECTIVE We investigated whether AT-based instructions reduce axial rigidity and increase upright postural alignment, and whether these instructions have different effects on postural alignment, axial rigidity, postural sway, and mobility than effort-based instructions regarding posture. METHOD Twenty subjects with PD practiced 2 sets of instructions and then attempted to implement both approaches (as well as a relaxed control condition) during quiet standing and step initiation. The "Lighten Up" instructions relied on AT principles of reducing excess tension while encouraging length. The "Pull Up" instructions relied on popular concepts of effortful posture correction. We measured kinematics, resistance to axial rotation, and ground reaction forces. RESULTS Both sets of experimental instructions led to increases in upright postural alignment relative to the control condition. Only the Lighten Up instructions led to reduced postural sway, reduced axial postural tone, greater modifiability of tone, and a smoother center of pressure trajectory during step initiation, possibly indicating greater movement efficiency. CONCLUSION Mindful movement approaches such as AT may benefit balance and mobility in subjects with PD by acutely facilitating increased upright postural alignment while decreasing rigidity.
Collapse
Affiliation(s)
| | | | | | | | - Fay B Horak
- Oregon Health & Science University, Beaverton, OR, USA Portland Veterans' Administration Medical Center, Portland, OR, USA
| |
Collapse
|
28
|
Lefaivre SC, Almeida QJ. Can sensory attention focused exercise facilitate the utilization of proprioception for improved balance control in PD? Gait Posture 2015; 41:630-3. [PMID: 25655836 DOI: 10.1016/j.gaitpost.2015.01.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/05/2014] [Accepted: 01/12/2015] [Indexed: 02/02/2023]
Abstract
Impaired sensory processing in Parkinson's disease (PD) has been argued to contribute to balance deficits. Exercises aimed at improving sensory feedback and body awareness have the potential to ameliorate balance deficits in PD. Recently, PD SAFEx™, a sensory and attention focused rehabilitation program, has been shown to improve motor deficits in PD, although balance control has never been evaluated. The objective of this study was to measure the effects of PD SAFEx™ on balance control in PD. Twenty-one participants with mild to moderate idiopathic PD completed 12 weeks of PD SAFEx™ training (three times/week) in a group setting. Prior to training, participants completed a pre-assessment evaluating balance in accordance with an objective, computerized test of balance (modified clinical test of sensory integration and balance (m-CTSIB) and postural stability testing (PST)) protocols. The m-CTSIB was our primary outcome measure, which allowed assessment of balance in both eyes open and closed conditions, thus enabling evaluation of specific sensory contributions to balance improvement. At post-test, a significant interaction between time of assessment and vision condition (p=.014) demonstrated that all participants significantly improved balance control, specifically when eyes were closed. Balance control did not change from pre to post with eyes open. These results provide evidence that PD SAFEx™ is effective at improving the ability to utilize proprioceptive information, resulting in improved balance control in the absence of vision. Enhancing the ability to utilize proprioception for individuals with PD is an important intermediary to improving balance deficits.
Collapse
Affiliation(s)
- Shannon C Lefaivre
- Sun Life Financial Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Quincy J Almeida
- Sun Life Financial Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, Waterloo, Ontario, Canada.
| |
Collapse
|
29
|
Balance dysfunction in Parkinson's disease. BIOMED RESEARCH INTERNATIONAL 2015; 2015:434683. [PMID: 25654100 PMCID: PMC4310258 DOI: 10.1155/2015/434683] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 09/15/2014] [Accepted: 09/22/2014] [Indexed: 11/18/2022]
Abstract
Stability and mobility in functional motor activities depend on a precise regulation of phasic and tonic muscular activity that is carried out automatically, without conscious awareness. The sensorimotor control of posture involves a complex integration of multisensory inputs that results in a final motor adjustment process. All or some of the components of this system may be dysfunctional in Parkinsonian patients, rendering postural instability one of the most disabling features of Parkinson's disease (PD). Balance control is critical for moving safely in and adapting to the environment. PD induces a multilevel impairment of this function, therefore worsening the patients' physical and psychosocial disability. In this review, we describe the complex ways in which PD impairs posture and balance, collecting and reviewing the available experimental evidence.
Collapse
|
30
|
Diab KS, Hale LA, Waters DL, Skinner MA. Factors contributing to postural instability in patients with idiopathic Parkinson’s disease. PHYSICAL THERAPY REVIEWS 2014. [DOI: 10.1179/1743288x14y.0000000148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
31
|
Blanchet M, Prince F, Chouinard S, Messier J. Postural stability limits in manifest and premanifest Huntington’s disease under different sensory conditions. Neuroscience 2014; 279:102-12. [DOI: 10.1016/j.neuroscience.2014.07.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 07/16/2014] [Accepted: 07/28/2014] [Indexed: 10/24/2022]
|
32
|
Chong RK, Adams K, Fenton K, Gibson M, Hodges K, Horne J, Kirby J, Raisor A, Steiner K, Do MC, Wakade C. Postural adaptation to a slow sensorimotor set-changing task in Parkinson's disease1. ACTA ACUST UNITED AC 2014. [DOI: 10.2466/15.26.cp.3.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
33
|
Han J, Jung J, Lee J, Kim E, Lee M, Lee K. Effect of muscle vibration on postural balance of Parkinson's diseases patients in bipedal quiet standing. J Phys Ther Sci 2013; 25:1433-5. [PMID: 24396205 PMCID: PMC3881472 DOI: 10.1589/jpts.25.1433] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 06/20/2013] [Indexed: 11/25/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the effect of muscle vibration
applied to the lower extremities on static postural balance of patients with Parkinson’s
disease (PD). [Subjects] Seven subjects with Parkinson’s disease participated in this
study. [Methods] The oscillators of vibration were attached to the muscle bellies of the
tibialis anterior, gastrocnemius, biceps femoris, and rectus femoris on both sides of the
lower extremities with adhesive tape. A vibration frequency of 60 Hz was used to induce
static postural reactions. Subjects’ center of pressure (COP) sway and peak ground
reaction force (GRF) were measured with their eyes open with and without vibration. COP
sway and peak GRF (Fx, Fy, Fz) were measured using a force plate (AMTI, Newton, USA),
which provides x, y and z coordinates of body movement. [Results] The area of COP sway
with vibration was significantly smaller than that with no vibration, but the length of
COP sway showed no difference between two conditions. Peak medial-lateral maximum force
(Fy) with vibration was significantly higher than that with no vibration, but peak
anterior-posterior force (Fx) and peak vertical force (Fz) showed no differences.
[Conclusion] These results suggest that vibration applied to the lower extremities can
help PD patients control postural balance during quiet standing.
Collapse
Affiliation(s)
- Jintae Han
- Department of Physical Therapy, College of Science, Kyungsung University, Republic of Korea
| | - Jaemin Jung
- Department of Physical Therapy, Gimhae University, Republic of Korea
| | - Junghoon Lee
- Department of Physical Therapy, Inje University Pusan Paik Hospital, Republic of Korea
| | - Eunjung Kim
- Department of Physical Therapy, Masan University, Republic of Korea
| | - Myunghee Lee
- Department of Physical Therapy, College of Science, Kyungsung University, Republic of Korea
| | - Keunhee Lee
- Lee Keun Hee's Pediatric Development Research Institute, Republic of Korea
| |
Collapse
|
34
|
Lucas M, Chaves F, Teixeira S, Carvalho D, Peressutti C, Bittencourt J, Velasques B, Menéndez-González M, Cagy M, Piedade R, Nardi AE, Machado S, Ribeiro P, Arias-Carrión O. Time perception impairs sensory-motor integration in Parkinson's disease. Int Arch Med 2013; 6:39. [PMID: 24131660 PMCID: PMC3856585 DOI: 10.1186/1755-7682-6-39] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 10/12/2013] [Indexed: 11/10/2022] Open
Abstract
It is well known that perception and estimation of time are fundamental for the relationship between humans and their environment. However, this temporal information processing is inefficient in patients with Parkinson' disease (PD), resulting in temporal judgment deficits. In general, the pathophysiology of PD has been described as a dysfunction in the basal ganglia, which is a multisensory integration station. Thus, a deficit in the sensorimotor integration process could explain many of the Parkinson symptoms, such as changes in time perception. This physiological distortion may be better understood if we analyze the neurobiological model of interval timing, expressed within the conceptual framework of a traditional information-processing model called "Scalar Expectancy Theory". Therefore, in this review we discuss the pathophysiology and sensorimotor integration process in PD, the theories and neural basic mechanisms involved in temporal processing, and the main clinical findings about the impact of time perception in PD.
Collapse
Affiliation(s)
- Marina Lucas
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
- Physiotherapy Laboratory, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil
| | - Fernanda Chaves
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
- Physiotherapy Laboratory, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil
| | - Silmar Teixeira
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
- Physiotherapy Laboratory, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil
| | - Diana Carvalho
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
- Physiotherapy Laboratory, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil
| | - Caroline Peressutti
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
- Institute of Applied Neuroscience (INA), Rio de Janeiro, Brazil
| | - Juliana Bittencourt
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
| | - Bruna Velasques
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
- Institute of Applied Neuroscience (INA), Rio de Janeiro, Brazil
| | | | - Mauricio Cagy
- Division of Epidemiology and Biostatistic, Institute of Health Community, Federal Fluminense University (UFF), Rio de Janeiro, Brazil
| | - Roberto Piedade
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
| | - Antonio Egidio Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
- National Institute of Translational Medicine (INCT-TM), Rio de Janeiro, Brazil
| | - Sergio Machado
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
- National Institute of Translational Medicine (INCT-TM), Rio de Janeiro, Brazil
- Faculty of Medical Sciences, Quiropraxia Program, Central University, Santiago, Chile
- Physical Activity Neuroscience, Physical Activity Postgraduate Program, Salgado de Oliveira University (UNIVERSO), Niterói, Brazil
| | - Pedro Ribeiro
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil
- School of Physical Education, Bioscience Department (EEFD/UFRJ), Rio de Janeiro, Brazil
- Institute of Applied Neuroscience (INA), Rio de Janeiro, Brazil
| | - Oscar Arias-Carrión
- Sleep and Movement Disorders Clinic and Transcranial Magnetic Stimulation Unit, Hospital General Dr. Manuel Gea González, México D.F., Mexico
- Sleep and Movement Disorders Clinic and Transcranial Magnetic Stimulation Unit, Hospital General Ajusco Medio, México D.F., Mexico
| |
Collapse
|
35
|
de Lima-Pardini AC, Papegaaij S, Cohen RG, Teixeira LA, Smith BA, Horak FB. The interaction of postural and voluntary strategies for stability in Parkinson's disease. J Neurophysiol 2012; 108:1244-52. [PMID: 22673326 PMCID: PMC3544957 DOI: 10.1152/jn.00118.2012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 06/05/2012] [Indexed: 11/22/2022] Open
Abstract
This study assessed the effects of stability constraints of a voluntary task on postural responses to an external perturbation in subjects with Parkinson's disease (PD) and healthy elderly participants. Eleven PD subjects and twelve control subjects were perturbed with backward surface translations while standing and performing two versions of a voluntary task: holding a tray with a cylinder placed with the flat side down [low constraint (LC)] or with the rolling, round side down [high constraint (HC)]. Participants performed alternating blocks of LC and HC trials. PD participants accomplished the voluntary task as well as control subjects, showing slower tray velocity in the HC condition compared with the LC condition. However, the latency of postural responses was longer in the HC condition only for control subjects. Control subjects presented different patterns of hip-shoulder coordination as a function of task constraint, whereas PD subjects had a relatively invariant pattern. Initiating the experiment with the HC task led to 1) decreased postural stability in PD subjects only and 2) reduced peak hip flexion in control subjects only. These results suggest that PD impairs the capacity to adapt postural responses to constraints imposed by a voluntary task.
Collapse
|
36
|
Cohen RG, Sternad D. State space analysis of timing: exploiting task redundancy to reduce sensitivity to timing. J Neurophysiol 2012; 107:618-27. [PMID: 22031769 PMCID: PMC3349626 DOI: 10.1152/jn.00568.2011] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 10/23/2011] [Indexed: 11/22/2022] Open
Abstract
Timing is central to many coordinated actions, and the temporal accuracy of central nervous system commands presents an important limit to skilled performance. Using target-oriented throwing in a virtual environment as an example task, this study presents a novel analysis that quantifies contributions of timing accuracy and shaping of hand trajectories to performance. Task analysis reveals that the result of a throw is fully determined by the projectile position and velocity at release; zero error can be achieved by a manifold of position and velocity combinations (solution manifold). Four predictions were tested. 1) Performers learn to release the projectile closer to the optimal moment for a given arm trajectory, achieving timing accuracy levels similar to those reported in other timing tasks (~10 ms). 2) Performers develop a hand trajectory that follows the solution manifold such that zero error can be achieved without perfect timing. 3) Skilled performers exploit both routes to improvement more than unskilled performers. 4) Long-term improvement in skilled performance relies on continued optimization of the arm trajectory as timing limits are reached. Average and skilled subjects practiced for 6 and 15 days, respectively. In 6 days, both timing and trajectory alignment improved for all subjects, and skilled subjects showed an advantage in timing. With extended practice, performance continued to improve due to continued shaping of the trajectory, whereas timing accuracy reached an asymptote at 9 ms. We conclude that skilled subjects first maximize timing accuracy and then optimize trajectory shaping to compensate for intrinsic limitations of timing accuracy.
Collapse
Affiliation(s)
- Rajal G Cohen
- Department of Neurology, Oregon Health & Science University, Beaverton, Oregon, USA
| | | |
Collapse
|
37
|
Kim JH, Lee JU, Kim MY, Kim IH, Kim B, Kim J. The Effect of Standing Posture-enhancing Exercise on Parkinson’s Disease Patients’ Turning Around Motion. J Phys Ther Sci 2012. [DOI: 10.1589/jpts.24.1047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ju-Hyun Kim
- Graduate School of Rehabilitation and Health Science, Doctoral Course, Yongin University
| | - Jeong-Uk Lee
- Graduate School of Rehabilitation and Health Science, Doctoral Course, Yongin University
| | - Mee-Young Kim
- Graduate School of Rehabilitation and Health Science, Doctoral Course, Yongin University
| | - Il-Hyun Kim
- Graduate School of Rehabilitation and Health Science, Doctoral Course, Yongin University
| | - Bokyung Kim
- Department of Physiology, Institute of Functional Genomics, School of Medicine, Konkuk University
| | - Junghwan Kim
- Department of Physical Therapy, College of Public Health and Welfare, Yongin University
| |
Collapse
|
38
|
Casellato C, Tagliabue M, Pedrocchi A, Papaxanthis C, Ferrigno G, Pozzo T. Reaching while standing in microgravity: a new postural solution to oversimplify movement control. Exp Brain Res 2011; 216:203-15. [PMID: 22159588 DOI: 10.1007/s00221-011-2918-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 10/21/2011] [Indexed: 10/14/2022]
Abstract
Many studies showed that both arm movements and postural control are characterized by strong invariants. Besides, when a movement requires simultaneous control of the hand trajectory and balance maintenance, these two movement components are highly coordinated. It is well known that the focal and postural invariants are individually tightly linked to gravity, much less is known about the role of gravity in their coordination. It is not clear whether the effect of gravity on different movement components is such as to keep a strong movement-posture coordination even in different gravitational conditions or whether gravitational information is necessary for maintaining motor synergism. We thus set out to analyze the movements of eleven standing subjects reaching for a target in front of them beyond arm's length in normal conditions and in microgravity. The results showed that subjects quickly adapted to microgravity and were able to successfully accomplish the task. In contrast to the hand trajectory, the postural strategy was strongly affected by microgravity, so to become incompatible with normo-gravity balance constraints. The distinct effects of gravity on the focal and postural components determined a significant decrease in their reciprocal coordination. This finding suggests that movement-posture coupling is affected by gravity, and thus, it does not represent a unique hardwired and invariant mode of control. Additional kinematic and dynamic analyses suggest that the new motor strategy corresponds to a global oversimplification of movement control, fulfilling the mechanical and sensory constraints of the microgravity environment.
Collapse
Affiliation(s)
- Claudia Casellato
- Bioengineering Department, NearLab, Politecnico di Milano, P.za Leonardo Da Vinci 32, 20133 Milan, Italy.
| | | | | | | | | | | |
Collapse
|
39
|
Trunk accelerometry reveals postural instability in untreated Parkinson's disease. Parkinsonism Relat Disord 2011; 17:557-62. [PMID: 21641263 DOI: 10.1016/j.parkreldis.2011.05.010] [Citation(s) in RCA: 192] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2010] [Revised: 05/11/2011] [Accepted: 05/14/2011] [Indexed: 11/22/2022]
Abstract
While several studies have shown that subjects with advanced Parkinson's disease (PD) exhibit abnormalities in sway parameters during quiet standing, abnormalities of postural sway associated with untreated PD have not been reported. Although not clinically apparent, we hypothesized that spontaneous sway in quiet stance is abnormal in people with untreated PD. We examined 13 subjects, recently diagnosed with PD, who were not yet taking any anti-parkinsonian medications and 12 healthy, age-matched control subjects. Postural sway was measured with a linear accelerometer on the posterior trunk (L5 level) and compared with traditional force plate measures of sway. Subjects stood for 2 min under two conditions: eyes open (EO) and eyes closed (EC). One of the most discriminative measures of postural changes in subjects with untreated PD was the increased 'JERK' of lower trunk in the EO condition, measured with the accelerometer. Root mean square and the frequency dispersion of postural sway in the EO condition also discriminated sway in untreated PD subjects compared to control subjects. We conclude that accelerometer-based sway metrics could be used as objective measures of postural instability in untreated PD. Accelerometer-based analysis of spontaneous sway may provide a powerful tool for early clinical trials and for monitoring the effects of treatment of balance disorders in subjects with PD.
Collapse
|
40
|
Equilibrium constraints do not affect the timing of muscular synergies during the initiation of a whole body reaching movement. Exp Brain Res 2010; 203:147-58. [DOI: 10.1007/s00221-010-2219-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Accepted: 03/05/2010] [Indexed: 10/19/2022]
|
41
|
Konczak J, Corcos DM, Horak F, Poizner H, Shapiro M, Tuite P, Volkmann J, Maschke M. Proprioception and motor control in Parkinson's disease. J Mot Behav 2010; 41:543-52. [PMID: 19592360 DOI: 10.3200/35-09-002] [Citation(s) in RCA: 197] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder that leads to a progressive decline in motor function. Growing evidence indicates that PD patients also experience an array of sensory problems that negatively impact motor function. This is especially true for proprioceptive deficits, which profoundly degrade motor performance. This review specifically address the relation between proprioception and motor impairments in PD. It is structured around 4 themes: (a) It examines whether the sensitivity of kinaesthetic perception, which is based on proprioceptive inputs, is actually altered in PD. (b) It discusses whether failed processes of proprioceptive-motor integration are central to the motor problems in PD. (c) It presents recent findings focusing on the link between the proprioception and the balance problems in PD. And (d) it discusses the current state of knowledge of how levodopa medication and deep brain stimulation affect proprioceptive and motor function in PD. The authors conclude that a failure to evaluate and to map proprioceptive information onto voluntary and reflexive motor commands is an integral part of the observed motor symptoms in PD.
Collapse
Affiliation(s)
- Jürgen Konczak
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA.
| | | | | | | | | | | | | | | |
Collapse
|