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Mortada H, Ali Zahreldin A, Shafiek Saleh M, Shahien M, Elfeky A, Ibrahim Abdelhamed A, Elaraby A, Elzalabany A, Samir Hammad Y, Elshennawy S. The Efficacy of Whole-Body Vibration in Managing Postburn Victims' Complications: A Systematic Review. J Burn Care Res 2024; 45:48-54. [PMID: 37791999 DOI: 10.1093/jbcr/irad151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Indexed: 10/05/2023]
Abstract
Burn injury is a complicated traumatic event with both systemic and local consequences. These complications include long periods of bed rest, pain, muscle weakness, vitamin D deficiency, and bone mineral density loss. Whole-body vibration demonstrated effectiveness in improving muscle power and bone mineral density in various musculoskeletal populations. This systematic review of randomized controlled trials aims to assess evidence for the effectiveness of using whole-body vibration on postburn survivors with at least 1% total body surface area on sensory and motor outcomes. A systematic search was conducted across six databases, which are, PubMed, Cochrane, PEDro, Scopus, Web of Science, and Google Scholar, from inception till March 2022. Retrieved studies were screened by title and abstract and full-text in two stages using Rayyan web-based. Included studies were assessed for risk of bias using the Cochrane risk of bias tool ROB 2.0. Six randomized controlled trials with 203 participants were included. Five of the included studies demonstrated an overall high risk of bias. Compared to conventional physiotherapy programs, whole-body vibration demonstrated improvement in functional mobility and balance using timed up and go and Biodex balance assessment, respectively. However, there were no differences between whole-body vibration and conventional physiotherapy program alone in bone mineral density and muscle power. Although the current evidence of whole-body vibration is limited, whole-body vibration combined with traditional physical therapy programs may improve functional mobility and balance in postburn survivors compared to physical therapy programs alone.
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Affiliation(s)
- Hossam Mortada
- Biomechanics Unit, Faculty of Physical Therapy, Ahram Canadian University, Giza, Egypt
| | | | - Marwa Shafiek Saleh
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Al-Zaytoonah University of Jordan, Amman, Jordan
| | | | - Amr Elfeky
- Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | | | | | - Ahmed Elzalabany
- Faculty of Physical Therapy, Egyptian Chinese University, Cairo, Egypt
| | - Yara Samir Hammad
- College of Physical Therapy, Misr University for Science and Technology, Giza, Egypt
| | - Shorouk Elshennawy
- Faculty of Physical Therapy, Cairo University, Giza, Egypt
- College of Physical Therapy, Misr University for Science and Technology, Giza, Egypt
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Slower velocity perception with stronger optokinetic nystagmus: A paradoxical perception in virtual reality. J Neurol Sci 2022; 441:120384. [PMID: 36027643 DOI: 10.1016/j.jns.2022.120384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/14/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Optokinetic nystagmus (OKN) was studied in an immersive virtual reality (VR) environment with both typical optokinetic stimulation (OKs) wherein the head-tracking is active (similar to be sitting in front of a rotating drum) or a unique stimulus (VR-OKs) wherein the head-tracking is turned off, so head movements do not update the visual image (which moves with the head). OBJECTIVE To study both the perception of the stimulus velocity and eye movements while subjects rotated their head from side to side and the visual scene was either a typical OKs or VR-OKs. METHODS 9 healthy participants (aged 23 ± 2.4 y/o) had head and eye movements recorded under typical OKs and VR-OKS while smoothly rotating their head horizontally from side to side. Stimulation was delivered using a virtual reality setup on top of an eye movements recording system. RESULTS Under VR-OKs participants perceived faster stimulus velocity when the head and stimulus had the same direction as compared to the head and stimulus in opposite directions. When the head turned in the same direction as the stimulus, there were fewer fast phase eye movements than when it rotated counter to stimulus motion direction. Conversely, with typical OKs, participants perceived faster stimulus velocity when the head and stimulus had opposite directions as compared to the head and stimulus having the same direction. CONCLUSIONS The seemingly paradoxical results in which slower stimulus velocity is perceived in tandem with stronger nystagmus can be explained by the simultaneous activation of the Vestibulo-Ocular Reflex and OKN in accordance with the various visual and vestibular stimuli.
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Zheng JH, Sun WH, Ma JJ, Wang ZD, Chang QQ, Dong LR, Shi XX, Li MJ, Gu Q, Chen SY, Li DS. Differences in neuroanatomy and functional connectivity between motor subtypes of Parkinson’s disease. Front Neurosci 2022; 16:905709. [PMID: 35937868 PMCID: PMC9354573 DOI: 10.3389/fnins.2022.905709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe “postural instability/gait difficulty” (PIGD) and “tremor-dominant” (TD) motor subtypes of Parkinson’s disease (PD) differ in their clinical manifestations. The neurological basis of these differences is unclear.MethodsWe performed voxel-based morphometric analysis and measured amplitudes of low-frequency fluctuation (ALFF) on 87 PIGD patients and 51 TD patients. We complemented this neuroanatomical comparison with seed-to-voxel analysis to explore differences in functional connectivity.ResultsThe PIGD group showed significantly smaller gray matter volume in the medial frontal gyrus (mainly on the right side) than the TD group. Across all patients, gray matter volume in the medial frontal gyrus correlated negatively with severity of PIGD symptoms after controlling for age (r = −0.250, p = 0.003), but this correlation was not observed in separate analyses of only PIGD or TD patients. The PIGD group showed greater functional connectivity of the right superior frontal gyrus with the left lingual gyrus, right lateral occipital cortex, and right lingual gyrus. ALFF did not differ significantly between the two groups.ConclusionPostural instability/gait difficulty may be associated with smaller gray matter volume in medial frontal gyrus than TD, as well as with greater functional connectivity between the right superior frontal gyrus and occipital cortex. These results may help explain the clinical differences between the two motor subtypes of PD.
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Affiliation(s)
- Jin Hua Zheng
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
| | - Wen Hua Sun
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian Jun Ma
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
- *Correspondence: Jian Jun Ma,
| | - Zhi Dong Wang
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Qing Qing Chang
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Lin Rui Dong
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao Xue Shi
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Ming Jian Li
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
| | - Qi Gu
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
| | - Si Yuan Chen
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
| | - Dong Sheng Li
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
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Shen YT, Wang JW, Wang M, Zhi Y, Li JY, Yuan YS, Wang XX, Zhang H, Zhang KZ. BST1 rs4698412 allelic variant increases the risk of gait or balance deficits in patients with Parkinson's disease. CNS Neurosci Ther 2019; 25:422-429. [PMID: 30676692 PMCID: PMC6488919 DOI: 10.1111/cns.13099] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/12/2018] [Accepted: 12/17/2018] [Indexed: 01/04/2023] Open
Abstract
Aims We aimed to explore effects of bone marrow stromal cell antigen‐1 (BST1) rs4698412 allelic variant on brain activation and associative clinical symptoms in Parkinson’s disease (PD). Methods A total of 49 PD patients and 47 healthy control (HC) subjects were recruited for clinical evaluations, blood samples collection for genotypes, and resting‐state functional MRI (rs‐fMRI) scans. Based on BST1 rs4698412 allelic variant (G → A), participants were further divided into 18 PD‐GG, 31 PD‐GA/AA, 20 HC‐GG, and 27 HC‐GA/AA carriers, which respectively indicated subjects carrying ancestral or risk allele in that locus in PD or HC. Two‐way analysis of covariance (ANCOVA) was applied to investigate main effects and interactions between PD and BST1 rs4698412 allelic variant on brain function via amplitude of low‐frequency fluctuations (ALFF). Spearman’s correlations were then utilized to detect associations between interactive brain regions and clinical symptoms. Results Compared to HC subjects, PD patients exhibited increased ALFF values in left cerebellum_8 and cerebellum_9. Significant interaction was in right lingual gyrus, where there were the lowest ALFF values and ALFF values were only negatively associated with Timed Up and Go (TUG) test time in PD‐GA/AA subgroup. Conclusion BST1 rs4698412‐modulated lingual gyrus functional alterations could be related to gait and balance dysfunction in PD.
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Affiliation(s)
- Yu-Ting Shen
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jian-Wei Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Min Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yan Zhi
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jun-Yi Li
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yong-Sheng Yuan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xi-Xi Wang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ke-Zhong Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Harro CC, Kelch A, Hargis C, DeWitt A. Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson's Disease and Healthy Adults. PARKINSON'S DISEASE 2018; 2018:6142579. [PMID: 30687494 PMCID: PMC6304814 DOI: 10.1155/2018/6142579] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/23/2018] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Postural instability is a known contributing factor to balance dysfunction and increased fall risk in those with Parkinson's disease (PD). Computerized posturography employing a force platform system provides objective, quantitative assessments of postural control impairments. This study examines balance performance as measured by force platform (FP) tests in persons with PD compared to age-matched healthy adults. Secondarily, we examine if these FP measures provide diagnostic and clinically meaningful information about the underlying balance impairments in the PD population. METHODS Participants-42 individuals with PD (Hoehn and Yahr stage = 2.33 ± 0.77) and 55 age-matched healthy adults-were assessed on three standardized balance measures on a computerized force platform system. Between groups, comparisons of FP performance were analyzed using independent t-test. Within the group, comparisons for the PD cohort were analyzed using ANOVA for comparing disease stage and Mann-Whitney U test for PD subtypes. RESULTS The PD cohort demonstrated significantly greater postural instability on the sensory organization test (SOT) measures (P=0.013, CI-95% = 1.286 to 10.37) and slower movement velocity on the limits of stability (LOS) test (P=0.001, CI-95% = 0.597 to 1.595) than the healthy cohort, suggesting that these tests were sensitive to detect sensory integration and voluntary postural control deficits in the PD cohort. Within the PD group, the SOT differentiated between H&Y stages 1-3. The motor control test (MCT) detected changes in reactive postural control mainly in later disease stages. All three FP tests distinguished between PD subtypes, with the Posture Gait Instability subtype demonstrating poorer balance performance than Tremor Dominant subtype. CONCLUSION These findings suggest FP measures provide clinically meaningful, diagnostic information in the examination of balance impairments in individuals with PD. FP measures may inform clinicians regarding intrinsic balance deficits and guide them in designing targeted balance interventions to reduce fall risk in persons with PD.
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Affiliation(s)
- Cathy C. Harro
- Assistance Professor, Physical Therapy, College of Health Professions, Grand Valley State University, Cook DeVos Center for Health Sciences, 301 Michigan Street NE, Suite 268, Grand Rapids, MI 49503, USA
| | - Amanda Kelch
- Mary Free Bed Rehabilitation Hospital, 235 Wealthy Street SE, Grand Rapids, MI 49503, USA
| | - Cora Hargis
- Mary Free Bed Rehabilitation Hospital, 235 Wealthy Street SE, Grand Rapids, MI 49503, USA
| | - Abigail DeWitt
- PT Solutions, 1321 Tusculum Blvd., Greeneville, TN 37743, USA
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Berg-Poppe P, Cesar GM, Tao H, Johnson C, Landry J. Concurrent validity between a portable force plate and instrumented walkway when measuring limits of stability. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.6.272] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Patti Berg-Poppe
- Professor, University of South Dakota Department of Physical Therapy, Vermillion, South Dakota, USA
| | - Guilherme M. Cesar
- Assistant Research Director, Movement and Neurosciences Center, Madonna Rehabilitation Hospitals, Lincoln, Nebraska, USA
| | - Hanz Tao
- Assistant Professor, University of South Dakota Department of Physical Therapy, Vermillion, South Dakota, USA
| | - Cal Johnson
- Student, University of South Dakota Department of Physical Therapy, Vermillion, South Dakota, USA
| | - Jessica Landry
- Student, University of South Dakota Department of Physical Therapy, Vermillion, South Dakota, USA
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Kammermeier S, Maierbeck K, Dietrich L, Plate A, Lorenzl S, Singh A, Bötzel K, Maurer C. Qualitative postural control differences in Idiopathic Parkinson's Disease vs. Progressive Supranuclear Palsy with dynamic-on-static platform tilt. Clin Neurophysiol 2018; 129:1137-1147. [PMID: 29631169 DOI: 10.1016/j.clinph.2018.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 03/05/2018] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES We aimed to assess whether postural abnormalities in Progressive Supranuclear Palsy (PSP) and Idiopathic Parkinson's Disease (IPD) are qualitatively different by analysing spontaneous and reactive postural control. METHODS We assessed postural control upon platform tilts in 17 PSP, 11 IPD patients and 18 healthy control subjects using a systems analysis approach. RESULTS Spontaneous sway abnormalities in PSP resembled those of IPD patients. Spontaneous sway was smaller, slower and contained lower frequencies in both PSP and IPD as compared to healthy subjects. The amount of angular body excursions as a function of platform angular excursions (GAIN) in PSP was qualitatively different from both IPD and healthy subjects (GAIN cut-off value: 2.9, sensitivity of 94%, specificity of 72%). This effect was pronounced at the upper body level and at low as well as high frequencies. In contrast, IPD patients' stimulus-related body excursions were smaller compared to healthy subjects. Using a systems analysis approach, we were able to allocate these different postural strategies to differences in the use of sensory information as well as to different error correction efforts. CONCLUSIONS While both PSP and IPD patients show abnormal postural control, the underlying pathology seems to be different. SIGNIFICANCE The identification of disease-specific postural abnormalities shown here may be helpful for diagnostic as well as therapeutic discriminations of PSP vs. IPD.
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Affiliation(s)
- Stefan Kammermeier
- Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany.
| | - Kathrin Maierbeck
- Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany; Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Klinik für Anästhesiologie, Marchioninistraße 15, 81377 München, Germany
| | - Lucia Dietrich
- Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany; Abteilung für Allgemeinchirurgie, Kliniken Ostallgäu-Kaufbeuren, Dr.-Gutermann-Straße 2, 87600 Kaufbeuren, Germany
| | - Annika Plate
- Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany
| | - Stefan Lorenzl
- Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany; Abteilung für Neurologie, Krankenhaus Agatharied, Norbert-Kerkel-Platz, 83734 Hausham, Germany
| | - Arun Singh
- Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany; Department of Neurology, University of Iowa, Iowa, IA, United States
| | - Kai Bötzel
- Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Neurologische Klinik und Poliklinik, Marchioninistraße 15, 81377 München, Germany
| | - Christoph Maurer
- Klinik für Neurologie und Neurophysiologie, Universitätsklinikum Freiburg, Breisacher Str. 64, 79106 Freiburg im Breisgau, Germany
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Kammermeier S, Dietrich L, Maierbeck K, Plate A, Lorenzl S, Singh A, Bötzel K. Neck Vibration Proprioceptive Postural Response Intact in Progressive Supranuclear Palsy unlike Idiopathic Parkinson's Disease. Front Neurol 2017; 8:689. [PMID: 29326649 PMCID: PMC5742483 DOI: 10.3389/fneur.2017.00689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 12/01/2017] [Indexed: 12/03/2022] Open
Abstract
Progressive supranuclear palsy (PSP) and late-stage idiopathic Parkinson’s disease (IPD) are neurodegenerative movement disorders resulting in different postural instability and falling symptoms. IPD falls occur usually forward in late stage, whereas PSP falls happen in early stages, mostly backward, unprovoked, and with high morbidity. Postural responses to sensory anteroposterior tilt illusion by bilateral dorsal neck vibration were probed in both groups versus healthy controls on a static recording posture platform. Three distinct anteroposterior body mass excursion peaks (P1–P3) were observed. 18 IPD subjects exhibited well-known excessive response amplitudes, whereas 21 PSP subjects’ responses remained unaltered to 22 control subjects. Neither IPD nor PSP showed response latency deficits, despite brainstem degeneration especially in PSP. The observed response patterns suggest that PSP brainstem pathology might spare the involved proprioceptive pathways and implies viability of neck vibration for possible biofeedback and augmentation therapy in PSP postural instability.
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Affiliation(s)
- Stefan Kammermeier
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany
| | - Lucia Dietrich
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany.,Abteilung für Allgemeinchirurgie, Kliniken Ostallgäu-Kaufbeuren, Kaufbeuren, Germany
| | - Kathrin Maierbeck
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany.,Klinikum der Universität München, Klinik für Anästhesiologie, München, Germany
| | - Annika Plate
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany
| | - Stefan Lorenzl
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany.,Abteilung für Neurologie, Krankenhaus Agatharied, Hausham, Germany
| | - Arun Singh
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany.,Department of Neurology, University of Iowa, Iowa, IA, United States
| | - Kai Bötzel
- Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Germany
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Adaptation of postural recovery responses to a vestibular sensory illusion in individuals with Parkinson disease and healthy controls. Clin Biomech (Bristol, Avon) 2017; 48:73-79. [PMID: 28783491 DOI: 10.1016/j.clinbiomech.2017.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 07/12/2017] [Accepted: 07/17/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The ability to adapt postural responses to sensory illusions diminishes with age and is further impaired by Parkinson disease. However, limited information exists regarding training-related adaptions of sensory reweighting in these populations. METHODS This study sought to determine whether Parkinson disease or age would differentially affect acute postural recovery or adaptive postural responses to novel or repeated exposure to sensory illusions using galvanic vestibular stimulation during quiet stance. FINDINGS Acutely, individuals with Parkinson disease demonstrated larger center of pressure coefficient of variation compared to controls. Unlike individuals with Parkinson disease and asymptomatic older adults, healthy young adults acutely demonstrated a reduction in Sample Entropy to the sensory illusion. Following a period of consolidation Sample Entropy increased in the healthy young group, which coincided with a decreased center of pressure coefficient of variation. Similar changes were not observed in the Parkinson disease or older adult groups. INTERPRETATION Taken together, these results suggest that young adults learn to adapt to vestibular illusion in a more robust manner than older adults or those with Parkinson disease. Further investigation into the nature of this adaptive difference is warranted.
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Reliability and Validity of Force Platform Measures of Balance Impairment in Individuals With Parkinson Disease. Phys Ther 2016; 96:1955-1964. [PMID: 27417165 DOI: 10.2522/ptj.20160099] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 07/07/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Complex movement and balance impairments in people with Parkinson disease (PD) contribute to high fall risk. Comprehensive balance assessment is warranted to identify intrinsic fall risk factors and direct interventions. OBJECTIVE The purpose of this study was to examine the psychometric properties of 3 balance measures of a force platform (FP) system in people with PD. METHODS Forty-two community-dwelling individuals with idiopathic PD completed the testing protocol. Test-retest reliability was assessed for the Limits of Stability Test (LOS), Motor Control Test (MCT), and Sensory Organization Test (SOT). Intraclass correlation coefficients (ICC [2,1]) were calculated to determine test-retest reliability and minimal detectable change. Validity was assessed by comparing the FP measures with criterion gait and balance measures using Pearson product moment correlations. Multiple regression analyses examined the contribution of PD characteristics to FP measures. RESULTS All primary FP variables demonstrated excellent test-retest reliability (ICC=.78-.92). The SOT and LOS demonstrated fair to good correlations with criterion measures, whereas the MCT had fair correlations to balance measures only. Both SOT composite equilibrium and MCT average latency were moderately associated with disease severity. LIMITATIONS This study's sample had a relatively small number of participants with a positive fall history, which may limit the generalizability of the findings. CONCLUSIONS This study's findings provide support that FP measures are reliable and valid tests of balance impairment in people with PD. Disease severity was significantly associated with SOT and MCT measures, perhaps reflecting that these tests are meaningful indicators of decline in postural control with disease progression. Force platform measures may provide valuable quantitative information about underlying balance impairments in people with PD to guide therapeutic interventions for fall risk reduction.
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Changes in postural control in patients with Parkinson's disease: a posturographic study. Physiotherapy 2016; 102:272-9. [DOI: 10.1016/j.physio.2015.08.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 08/30/2015] [Indexed: 01/05/2023]
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Crossover versus Stabilometric Platform for the Treatment of Balance Dysfunction in Parkinson's Disease: A Randomized Study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:878472. [PMID: 26583142 PMCID: PMC4637085 DOI: 10.1155/2015/878472] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/17/2015] [Accepted: 05/04/2015] [Indexed: 11/18/2022]
Abstract
Balance dysfunctions are a major challenge in the treatment of Parkinson's disease (PD). Previous studies have shown that rehabilitation can play a role in their treatment. In this study, we have compared the efficacy of two different devices for balance training: stabilometric platform and crossover. We have enrolled 60 PD patients randomly assigned to two groups. The first one (stabilometric group) performed a 4-week cycle of balance training, using the stabilometric platform, whereas the second one (crossover group) performed a 4-week cycle of balance training, using the crossover. The outcome measures used were Unified Parkinson's Disease Rating Scale (UPDRS) part II, Berg Balance Scale (BBS), Timed Up and Go (TUG), and Six Minutes Walking Test (6MWT). Results showed that TUG, BBS, and UPDRS II improved in both groups. There was not difference in the efficacy of the two balance treatments. Patients in both groups improved also the meters walked in the 6MWT at the end of rehabilitation, but the improvement was better for patients performing crossover training. Our results show that the crossover and the stabilometric platform have the same effect on balance dysfunction of Parkinsonian patients, while crossover gets better results on the walking capacity.
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Lee NY, Lee DK, Song HS. Effect of virtual reality dance exercise on the balance, activities of daily living, and depressive disorder status of Parkinson's disease patients. J Phys Ther Sci 2015; 27:145-7. [PMID: 25642060 PMCID: PMC4305547 DOI: 10.1589/jpts.27.145] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 07/24/2014] [Indexed: 11/30/2022] Open
Abstract
[Purpose] In this study, we examined the effects of virtual reality dance exercise
on the balance, activities of daily living and depressive disorder status of Parkinson’s
disease patients. [Subjects] Twenty patients were assigned either the experimental group (n
= 10) or the control group (n = 10). All participants received 30 minutes of
neurodevelopment treatment and 15 minutes of functional electrical stimulation 5 times per
week for 6 weeks. The experimental group additionally performed 30 minutes of dance
exercise. Balance, activities of daily living, and depressive disorder status were assessed
before and after the 6-week treatment period using the Berg balance scale, the Modified
Barthel Index, and the Beck Depression Inventory. The paired t-test was used to detect
differences before and after treatment, and the independent t-test was used to detect
differences between the treatment groups. [Results] The values for balance, activities of
daily living, and depressive disorder status significantly differed between before and after
treatment in the experimental group, and significantly differed between the experimental
group and control group. [Conclusion] Virtual reality dance exercise has a positive effect
on balance, activities of daily living, and depressive disorder status of Parkinson’s
disease patients.
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Affiliation(s)
- Nam-Yong Lee
- Department of Physical Therapy, Graduate School of Physical Therapy, Daejeon University, Republic of Korea
| | - Dong-Kyu Lee
- Department of Physical Therapy, Yeol-Lin Hospital, Republic of Korea
| | - Hyun-Seung Song
- Department of Physical Therapy, Graduate School of Physical Therapy, Daejeon University, Republic of Korea
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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]
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Blanchet M, Prince F, Chouinard S, Messier J. Postural stability limits in manifest and premanifest Huntington’s disease under different sensory conditions. Neuroscience 2014; 279:102-12. [DOI: 10.1016/j.neuroscience.2014.07.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 07/16/2014] [Accepted: 07/28/2014] [Indexed: 10/24/2022]
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Rocchi L, Palmerini L, Weiss A, Herman T, Hausdorff JM. Balance Testing With Inertial Sensors in Patients With Parkinson's Disease: Assessment of Motor Subtypes. IEEE Trans Neural Syst Rehabil Eng 2014; 22:1064-71. [DOI: 10.1109/tnsre.2013.2292496] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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17
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Psychometric properties of four fear of falling rating scales in people with Parkinson's disease. BMC Geriatr 2014; 14:66. [PMID: 24884466 PMCID: PMC4035736 DOI: 10.1186/1471-2318-14-66] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 05/06/2014] [Indexed: 11/26/2022] Open
Abstract
Background Fear of falling (FOF) is commonly experienced in people with Parkinson’s disease (PD). It is a predictor of recurrent falls, a barrier to physical exercise, and negatively associated with health-related quality of life. A variety of rating scales exist that assess different aspects of FOF but comprehensive head-to-head comparisons of their psychometric properties in people with PD are lacking. The aim of this study was to evaluate the psychometric properties of four FOF rating scales in people with PD. More specifically, we investigated and compared the scales’ data completeness, scaling assumptions, targeting, and reliability. Methods The FOF rating scales were: the Falls Efficacy Scale-International (FES-I), the Swedish FES (FES(S)), the Activities-specific Balance Confidence scale (ABC), and the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE). A postal survey was administered to 174 persons with PD. Responders received a second survey after two weeks. Results The mean (SD) age and PD duration of the 102 responders were 73 (8) and 7 (6) years, respectively. ABC had worse data completeness than the other scales (6.9 vs. 0.9–1.3% missing data). All scales had corrected item-total correlations exceeding 0.4 and showed acceptable reliabilities (Cronbach’s alpha and Intraclass Correlation Coefficient (ICC) >0.80) but only FES-I had ICC >0.90. The standard error of measurements ranged from 7% (FES-I) to 12% (FES(S)), and the smallest detectable differences ranged from 20% (FES-I) to 33% (FES(S)) of the total score ranges. ABC and FES(S) had substantially more outliers than mSAFFE and FES-I (10 and 15 vs. 3 and 4, respectively) when the two test occasions were compared. Conclusions When assessing FOF in people with PD, the findings in the present study favoured the choice of FES-I or mSAFFE. However, FES-I was the only scale with ICC >0.90 which has been suggested as a minimum when using a scale for individual comparisons.
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Duque G, Boersma D, Loza-Diaz G, Hassan S, Suarez H, Geisinger D, Suriyaarachchi P, Sharma A, Demontiero O. Effects of balance training using a virtual-reality system in older fallers. Clin Interv Aging 2013; 8:257-63. [PMID: 23467506 PMCID: PMC3588606 DOI: 10.2147/cia.s41453] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Poor balance is considered a challenging risk factor for falls in older adults. Therefore, innovative interventions for balance improvement in this population are greatly needed. The aim of this study was to evaluate the effect of a new virtual-reality system (the Balance Rehabilitation Unit [BRU]) on balance, falls, and fear of falling in a population of community-dwelling older subjects with a known history of falls. In this study, 60 community-dwelling older subjects were recruited after being diagnosed with poor balance at the Falls and Fractures Clinic, Nepean Hospital (Penrith, NSW, Australia). Subjects were randomly assigned to either the BRU-training or control groups. Both groups received the usual falls prevention care. The BRU-training group attended balance training (two sessions/week for 6 weeks) using an established protocol. Change in balance parameters was assessed in the BRU-training group at the end of their 6-week training program. Both groups were assessed 9 months after their initial assessment (month 0). Adherence to the BRU-training program was 97%. Balance parameters were significantly improved in the BRU-training group (P < 0.01). This effect was also associated with a significant reduction in falls and lower levels of fear of falling (P < 0.01). Some components of balance that were improved by BRU training showed a decline after 9 months post-training. In conclusion, BRU training is an effective and well-accepted intervention to improve balance, increase confidence, and prevent falls in the elderly.
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Affiliation(s)
- Gustavo Duque
- Falls and Fractures Clinic, Department of Geriatric Medicine, Nepean Hospital, Penrith, NSW, Australia.
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Conradsson D, Löfgren N, Ståhle A, Hagströmer M, Franzén E. A novel conceptual framework for balance training in Parkinson's disease-study protocol for a randomised controlled trial. BMC Neurol 2012; 12:111. [PMID: 23017069 PMCID: PMC3482553 DOI: 10.1186/1471-2377-12-111] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 09/25/2012] [Indexed: 02/06/2023] Open
Abstract
Background There is increasing scientific knowledge about the interaction between physiological (musculoskeletal, neuromuscular, cognitive and sensory) systems and their influence on balance and walking impairments in Parkinson’s disease. We have developed a new conceptual framework for balance training, emphasising specific components of balance control related to Parkinson’s disease symptoms by using highly challenging, progressive and varying training conditions. The primary aim of this proposed randomised controlled trial will be to investigate the short-term and long-term effects of a 10-week balance training regime in elderly with Parkinson’s disease. Methods/Design Eighty participants with mild to moderate idiopathic Parkinson’s disease will be recruited and randomly allocated to an intervention group receiving balance training or a control group whose participants will continue to receive their usual care. The intervention will consist of a 10-week group training regime (1-hour training, three times per week), which will be led by two physiotherapists to ensure training progression and safety. The conceptual framework will be applied by addressing specific balance components (sensory integration, anticipatory postural adjustments, motor agility, stability limits) through varying training conditions and structured progression. Assessment will be conducted through a multi-dimensional battery of outcomes, prior to and immediately after the 10-week intervention, and at 9 and 15 months’ follow-up after entering the study. Primary outcome measures will be balance performance (assessed using the Mini Balance Evaluation Systems Test), change in gait velocity (m/s) between single and dual task walking, and fear of falling (evaluated using the Fall Efficacy Scale International). Discussion This study has the potential to provide new insight and knowledge of the effects of specific, varied and challenging balance training on a wide health spectrum in elderly with PD. If found to be effective, this pragmatic approach with translation of theory into practice, can be implemented in existing outpatient care. Trial registration NCT01417598
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Affiliation(s)
- David Conradsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, Huddinge, Sweden.
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Boersma D, Demontiero O, Mohtasham Amiri Z, Hassan S, Suarez H, Geisinger D, Suriyaarachchi P, Sharma A, Duque G. Vitamin D status in relation to postural stability in the elderly. J Nutr Health Aging 2012; 16:270-5. [PMID: 22456785 DOI: 10.1007/s12603-011-0345-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Postural instability (PI) is an important risk factor for falls, especially in the frail older population. In this study, we investigated the impact of vitamin D deficiency on PI in a sample of community dwelling older subjects. Our objective was to determine the potential association between vitamin D deficiency and PI in older fallers. DESIGN Cross-sectional study. SETTING Falls and Fractures Clinic, Department of Geriatric Medicine, Nepean Hospital, Penrith, Australia. PARTICIPANTS One hundred and forty-five adults aged 65 years and older who have had at least one episode of a fall within the six months prior to assessment at the Falls and Fractures Clinic. MEASUREMENTS Serum 25(OH) vitamin D3 [25(OH)D3] and parathyroid hormone concentrations were determined at baseline. Subjects were separated into 3 groups based on serum 25(OH)D3 levels with the following cut-off values: < 30 nmol/L (deficient), 30-50 nmol/L (insufficient) and > 50 nmol/L (normal). Other baseline measurements included body mass index, mini-nutritional assessment, grip strength, serum calcium concentration and creatinine clearance, which were used as covariables. PI was assessed using a computerized virtual reality system (Medicaa, Uruguay). Measured parameters included limits of stability (LOS) and centre of pressure (COP) under eyes closed on foam (ECF) and visio-vestibular stimulation. The estimated swaying area, computed from the ellipse of confidence under eyes closed standing on foam (ECF), was also used as a PI parameter. Gait velocity (GV) was measured using a GaitRITE walkway system. RESULTS Posture was impaired in vitamin D deficiency (<30 nmol/L) as indicated by lower LOS (90 +/- 18), higher ECF (25 +/- 10) and slower GV (55 +/- 7) as compared with the insufficient and normal groups. After adjustment for demographic, biochemical and anthropometric variables, vitamin D deficiency significantly correlated with low LOS and high COP under ECF. CONCLUSION Low levels of vitamin D were associated with PI. This association could also have an effect on slow GV and increased risk of falls. In conclusion, using an objective method to measure balance in older fallers we have identified a novel role of vitamin D in balance control. Prospective studies are required to confirm the effect of vitamin D on PI and elucidate the mechanisms of this association.
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Affiliation(s)
- D Boersma
- Department of Geriatric Medicine, Nepean Hospital, Penrith, NSW, Australia 2751
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