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Rabuffetti M, De Giovannini E, Carpinella I, Lencioni T, Fornia L, Ferrarin M. Association of 7-Day Profiles of Motor Activity in Marital Dyads with One Component Affected by Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2023; 23:1087. [PMID: 36772127 PMCID: PMC9921738 DOI: 10.3390/s23031087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: A noticeable association between the motor activity (MA) profiles of persons living together has been found in previous studies. Social actigraphy methods have shown that this association, in marital dyads composed of healthy individuals, is greater than that of a single person compared to itself. This study aims at verifying the association of MA profiles in dyads where one component is affected by Parkinson's disease (PD). (2) Methods: Using a wearable sensor-based social actigraphy approach, we continuously monitored, for 7 days, the activities of 27 marital dyads including one component with PD. (3) Results: The association of motor activity profiles within a marital dyad (cross-correlation coefficient 0.344) is comparable to the association of any participant with themselves (0.325). However, when considering the disease severity quantified by the UPDRS III score, it turns out that the less severe the symptoms, the more associated are the MA profiles. (4) Conclusions: Our findings suggest that PD treatment could be improved by leveraging the MA of the healthy spouse, thus promoting lifestyles also beneficial for the component affected by PD. The actigraphy approach provided valuable information on habitual functions and motor fluctuations, and could be useful in investigating the response to treatment.
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Affiliation(s)
| | - Ennio De Giovannini
- Centro Medico Riabilita Cooperativa Sociale Mano Amica Onlus, 36015 Schio, Italy
| | | | | | - Luca Fornia
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milano, Italy
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, 20133 Milano, Italy
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2
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Wang Y, Zhang Z, Li B, He B, Li L, Nice EC, Zhang W, Xu J. New Insights into the Gut Microbiota in Neurodegenerative Diseases from the Perspective of Redox Homeostasis. Antioxidants (Basel) 2022; 11:2287. [PMID: 36421473 PMCID: PMC9687622 DOI: 10.3390/antiox11112287] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 08/27/2023] Open
Abstract
An imbalance between oxidants and antioxidants in the body can lead to oxidative stress, which is one of the major causes of neurodegenerative diseases. The gut microbiota contains trillions of beneficial bacteria that play an important role in maintaining redox homeostasis. In the last decade, the microbiota-gut-brain axis has emerged as a new field that has revolutionized the study of the pathology, diagnosis, and treatment of neurodegenerative diseases. Indeed, a growing number of studies have found that communication between the brain and the gut microbiota can be accomplished through the endocrine, immune, and nervous systems. Importantly, dysregulation of the gut microbiota has been strongly associated with the development of oxidative stress-mediated neurodegenerative diseases. Therefore, a deeper understanding of the relationship between the gut microbiota and redox homeostasis will help explain the pathogenesis of neurodegenerative diseases from a new perspective and provide a theoretical basis for proposing new therapeutic strategies for neurodegenerative diseases. In this review, we will describe the role of oxidative stress and the gut microbiota in neurodegenerative diseases and the underlying mechanisms by which the gut microbiota affects redox homeostasis in the brain, leading to neurodegenerative diseases. In addition, we will discuss the potential applications of maintaining redox homeostasis by modulating the gut microbiota to treat neurodegenerative diseases, which could open the door for new therapeutic approaches to combat neurodegenerative diseases.
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Affiliation(s)
- Yu Wang
- West China School of Basic Medical Sciences & Forensic Medicine, and State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Zhe Zhang
- West China School of Basic Medical Sciences & Forensic Medicine, and State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Bowen Li
- West China School of Basic Medical Sciences & Forensic Medicine, and State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Bo He
- West China School of Basic Medical Sciences & Forensic Medicine, and State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Lei Li
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Edouard C. Nice
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC 3800, Australia
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, China
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu 610000, China
| | - Jia Xu
- School of Medicine, Ningbo University, Ningbo 315211, China
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3
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Dual task effect on upper and lower extremity skills in different stages of Parkinson's disease. Acta Neurol Belg 2022:10.1007/s13760-022-02007-x. [PMID: 35776407 DOI: 10.1007/s13760-022-02007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/09/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND PURPOSE Loss of automaticity and deteriorated executive function give rise to dual task deficits in Parkinson's disease (PD). This study aimed to compare single task and dual task upper and lower extremity skills in people with PD (PwPD) at different stages of PD and to examine the dual task effect (DTE) on upper and lower extremity skills in PwPD at different stages of PD. The second aim was to investigate the relationship between the DTE and the quality of life in PwPD. METHODS 30 patients divided into 2 groups as mild PD group and moderate PD group according to the Modified Hoehn & Yahr Scale. 15 age matched healthy adults were recruited as the control group. The Unified Parkinson's Disease Rating Scale (UPDRS), the Purdue Pegboard Test (PPT), the Timed Up and Go Test (TUG), the 10 Meter Walk Test (10MWT), and the Parkinson's Disease Questionnaire (PDQ-8) were used for assessments. RESULTS Single task and dual task scores of all assessments of all groups were significantly different. The DTE on PPT was greater in mild and moderate PD groups than control group and significantly lower in mild PD group than moderate PD group. However, DTE on the TUG and 10MWT was not different in mild PD group than control group and DTE significantly lower in both groups than moderate PD group. Significant correlations between the DTE on PPT, TUG and 10MWT and the PDQ-8 in PwPD were observed. CONCLUSION Dual task has a worsening effect on upper and lower extremity skills in PwPD. This effect can be observed earlier in upper extremity skills than lower extremity skills. Also, the DTE and the QoL in PwPD are related.
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Koyanagi Y, Fukushi I, Nakamura M, Suzuki K, Oda N, Aita T, Seki H. The effect of body weight-supported overground gait training for patients with Parkinson's disease: A retrospective case-control observational study. PLoS One 2021; 16:e0254415. [PMID: 34283843 PMCID: PMC8291710 DOI: 10.1371/journal.pone.0254415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 06/25/2021] [Indexed: 11/28/2022] Open
Abstract
Objective To evaluate the effects of body weight-supported overground gait training (BWSOGT) on motor abilities, such as gait and balance, in patients with Parkinson’s disease (PD). Design Retrospective case-controlled observational study with a 4-week follow-up. Setting Inpatient rehabilitation. Participants We selected 37 of 68 patients with PD. Inclusion criteria were (1) Hoehn & Yahr stage II–IV, (2) no medication adjustment during the study period, (3) at least 1 week since last medication adjustment, and (4) ability to walk more than 10 meters on their own. Exclusion criteria were (1) cerebrovascular disease or other complications affecting movement, (2) difficulty in measurement, (3) early discharge, (4) medication change during the study, and (5) development of complications. Interventions Patients were divided into two groups. Patients in Group I underwent 20 minutes of BWSOGT with a mobile hoist in addition to the standard exercises; Group II performed 20 minutes of gait training in place of BWSOGT. In both groups, training was performed for a total of 15 times/4 weeks. Main outcome measure(s) Participants were evaluated using the Unified Parkinson’s Disease Rating Scale total, part II, and part III; 10-m walk test; velocity; stride length; 6-minute walk test; timed up and go test; Berg Balance Scale; and freezing of gait before and after the intervention. Results There were significant decreases in the Unified Parkinson’s Disease Rating Scale total, part II, and part III in both groups; however, 6-minute walk test, timed up and go test, and freezing of gait results only improved in Group I. Conclusions BWSOGT for patients with PD improves gait ability and dynamic balance more than standard gait training.
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Affiliation(s)
- Yasuki Koyanagi
- Department of Rehabilitation, National Hospital Organization Sendai Medical Center, Sendai, Japan
- Department of Neurology and Rehabilitation, National Hospital Organization Iwaki Hospital, Iwaki, Japan
- * E-mail:
| | - Isato Fukushi
- Faculty of Health Sciences, Uekusa Gakuen University, Chiba, Japan
- Clinical Research Center, Murayama Medical Center, Musashimurayama, Japan
| | - Masatoshi Nakamura
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Kouji Suzuki
- Department of Neurology and Rehabilitation, National Hospital Organization Iwaki Hospital, Iwaki, Japan
| | - Nobuhito Oda
- Department of Neurology and Rehabilitation, National Hospital Organization Iwaki Hospital, Iwaki, Japan
| | - Takashi Aita
- Department of Neurology and Rehabilitation, National Hospital Organization Iwaki Hospital, Iwaki, Japan
| | - Hareaki Seki
- Department of Neurology and Rehabilitation, National Hospital Organization Iwaki Hospital, Iwaki, Japan
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Machine learning classifies predictive kinematic features in a mouse model of neurodegeneration. Sci Rep 2021; 11:3950. [PMID: 33597593 PMCID: PMC7889656 DOI: 10.1038/s41598-021-82694-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 01/21/2021] [Indexed: 01/31/2023] Open
Abstract
Motor deficits are observed in Alzheimer's disease (AD) prior to the appearance of cognitive symptoms. To investigate the role of amyloid proteins in gait disturbances, we characterized locomotion in APP-overexpressing transgenic J20 mice. We used three-dimensional motion capture to characterize quadrupedal locomotion on a treadmill in J20 and wild-type mice. Sixteen J20 mice and fifteen wild-type mice were studied at two ages (4- and 13-month). A random forest (RF) classification algorithm discriminated between the genotypes within each age group using a leave-one-out cross-validation. The balanced accuracy of the RF classification was 92.3 ± 5.2% and 93.3 ± 4.5% as well as False Negative Rate (FNR) of 0.0 ± 0.0% and 0.0 ± 0.0% for the 4-month and 13-month groups, respectively. Feature ranking algorithms identified kinematic features that when considered simultaneously, achieved high genotype classification accuracy. The identified features demonstrated an age-specific kinematic profile of the impact of APP-overexpression. Trunk tilt and unstable hip movement patterns were important in classifying the 4-month J20 mice, whereas patterns of shoulder and iliac crest movement were critical for classifying 13-month J20 mice. Examining multiple kinematic features of gait simultaneously could also be developed to classify motor disorders in humans.
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Ambike S, Penedo T, Kulkarni A, Santinelli FB, Barbieri FA. Step length synergy while crossing obstacles is weaker in patients with Parkinson's disease. Gait Posture 2021; 84:340-345. [PMID: 33454501 DOI: 10.1016/j.gaitpost.2021.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/23/2020] [Accepted: 01/04/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Impaired movement stability is a common symptom of Parkinson's disease (PD) that leads to falls and mishandled objects. Decline in synergistic stabilization of movement in PD patients has been observed in manual and postural tasks. However, locomotor synergies have not been quantified in PD patients. RESEARCH QUESTION The purpose of this work was to quantify the strength of the synergy stabilizing the step length while crossing an obstacle in PD patients. We hypothesized that (1) the distances of the front and rear feet relative to the obstacle would display compensatory across-trial co-variance that stabilizes step length in PD patients and age-matched controls, and (2) the step-length stabilization would be weaker in PD patients. METHODS Thirteen PD patients and eleven healthy age-matched controls walked up to and stepped over a 15 cm high obstacle fifteen times.We measured the distances of the rear and front foot toes from the obstacle during the crossing step. We used the uncontrolled manifold method to parse the across-trial variance in toe distances into a component that maintains the step length and a component that changes the step length. These variance components yielded the synergy index that quantified the stability of step length. RESULTS Step length was stabilized in PD patients as well as controls. However, the synergy index was 53% lower in the PD patients (p < 0.01). Thus, both our hypotheses were supported. SIGNIFICANCE This is the first study reporting impaired locomotor synergies in PD patients. Most PD patients in our sample were early stage (10 out of 13 patients were Hoehn-Yahr ≤ 2). Therefore, this result motivates further studies to establish step-length synergy during adaptive locomotor tasks as a biomarker for early detection of locomotor impairments in PD patients.
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Affiliation(s)
- Satyajit Ambike
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States; Center on Aging and the Life Course, Purdue University, West Lafayette, IN, United States.
| | - Tiago Penedo
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, Graduate Program in Movement Sciences, School of Sciences, São Paulo State University (UNESP), Bauru, Brazil
| | - Ashwini Kulkarni
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States; Center on Aging and the Life Course, Purdue University, West Lafayette, IN, United States
| | - Felipe Balistieri Santinelli
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, Graduate Program in Movement Sciences, School of Sciences, São Paulo State University (UNESP), Bauru, Brazil
| | - Fabio A Barbieri
- Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, Graduate Program in Movement Sciences, School of Sciences, São Paulo State University (UNESP), Bauru, Brazil
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Kamieniarz A, Michalska J, Marszałek W, Akbaş A, Słomka KJ, Krzak-Kubica A, Rudzińska-Bar M, Juras G. Transitional Locomotor Tasks in People With Mild to Moderate Parkinson's Disease. Front Neurol 2020; 11:405. [PMID: 32499752 PMCID: PMC7242736 DOI: 10.3389/fneur.2020.00405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/17/2020] [Indexed: 12/12/2022] Open
Abstract
Background: People with Parkinson's disease (PD) exhibit deficits in maintaining balance both during quiet standing and during walking, turning, standing up from sitting, and step initiation. Objective: The purpose of this study was to examine balance disorders during a transitional task under different conditions in participants with PD. Methods: The research was conducted on 15 PD-II (mild) and 15 PD-III (moderate) individuals (H&Y II-III stage) and 30 healthy elderly. The transitional task was measured on two force platforms (A and B). The procedure consisted of three phases: (1) quiet standing on platform A, (2) crossing to platform B, and (3) quiet standing on platform B, each until measurements were completed. There were four conditions: crossing without an obstacle, crossing with an obstacle, and walking up and down the step. Results: There were no significant differences between mild PD individuals and healthy elderly during quiet standing before the transitional task and after completing the task. The temporal aspects describing the different transitional tasks were comparable between mild PD and healthy subjects. Moderate PD participants presented a significantly higher COP velocity after the transitional task compared to the healthy older adults (p < 0.05). Additionally, the moderate PD group showed significantly higher values for transit time relative to healthy subjects during the transitional task in all conditions (p < 0.05). Conclusions: Disease severity affects the temporal aspects of different transitional tasks in people with PD. The procedure of completing a transitional task under different conditions allowed differences between moderate and mild PD stages and healthy subjects to be observed.
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Affiliation(s)
- Anna Kamieniarz
- Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Justyna Michalska
- Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Wojciech Marszałek
- Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Anna Akbaş
- Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Kajetan J. Słomka
- Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Agnieszka Krzak-Kubica
- Department of Neurology, Medical University of Silesia in Katowice, University Clinical Center, Katowice, Poland
| | - Monika Rudzińska-Bar
- Department of Neurology, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kraków University, Kraków, Poland
| | - Grzegorz Juras
- Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
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Godi M, Giardini M, Schieppati M. Walking Along Curved Trajectories. Changes With Age and Parkinson's Disease. Hints to Rehabilitation. Front Neurol 2019; 10:532. [PMID: 31178816 PMCID: PMC6543918 DOI: 10.3389/fneur.2019.00532] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/03/2019] [Indexed: 01/11/2023] Open
Abstract
In this review, we briefly recall the fundamental processes allowing us to change locomotion trajectory and keep walking along a curved path and provide a review of contemporary literature on turning in older adults and people with Parkinson's Disease (PD). The first part briefly summarizes the way the body exploits the physical laws to produce a curved walking trajectory. Then, the changes in muscle and brain activation underpinning this task, and the promoting role of proprioception, are briefly considered. Another section is devoted to the gait changes occurring in curved walking and steering with aging. Further, freezing during turning and rehabilitation of curved walking in patients with PD is mentioned in the last part. Obviously, as the research on body steering while walking or turning has boomed in the last 10 years, the relevant critical issues have been tackled and ways to improve this locomotor task proposed. Rationale and evidences for successful training procedures are available, to potentially reduce the risk of falling in both older adults and patients with PD. A better understanding of the pathophysiology of steering, of the subtle but vital interaction between posture, balance, and progression along non-linear trajectories, and of the residual motor learning capacities in these cohorts may provide solid bases for new rehabilitative approaches.
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Affiliation(s)
- Marco Godi
- Division of Physical Medicine and Rehabilitation, ICS Maugeri SPA SB, Pavia, Italy
| | - Marica Giardini
- Division of Physical Medicine and Rehabilitation, ICS Maugeri SPA SB, Pavia, Italy
| | - Marco Schieppati
- Department of Exercise and Sport Science, International University of Health, Exercise and Sports, LUNEX University, Differdange, Luxembourg
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Lebel K, Duval C, Nguyen HP, Plamondon R, Boissy P. Cranio-Caudal Kinematic Turn Signature Assessed with Inertial Systems As a Marker of Mobility Deficits in Parkinson's Disease. Front Neurol 2018; 9:22. [PMID: 29434569 PMCID: PMC5796912 DOI: 10.3389/fneur.2018.00022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/11/2018] [Indexed: 11/13/2022] Open
Abstract
Background Turning is a challenging mobility task requiring proper planning, coordination, and postural stability to be executed efficiently. Turn deficits can impair mobility and lead to falls in patients with neurodegenerative disease, such as Parkinson's disease (PD). It was previously shown that the cranio-caudal sequence involved during a turn (i.e., motion is initiated by the head, followed by the trunk) exhibits a signature that can be captured using an inertial system and analyzed through the Kinematics Theory. The so-called cranio-caudal kinematic turn signature (CCKS) metrics derived from this approach could, therefore, be a promising avenue to develop and track markers to measure early mobility deficits. Objective The current study aims at exploring the discriminative validity and sensitivity of CCKS metrics extracted during turning tasks performed by patients with PD. Methods Thirty-one participants (16 asymptomatic older adults (OA): mean age = 69.1 ± 7.5 years old; 15 OA diagnosed with early PD ON and OFF medication, mean age = 65.8 ± 8.4 years old) performed repeated timed up-and-go (TUG) tasks while wearing a portable inertial system. CCKS metrics (maximum head to trunk angle reached and commanded amplitudes of the head to trunk neuromuscular system, estimated from a sigma-lognormal model) were extracted from kinematic data recorded during the turn phase of the TUG tasks. For comparison purposes, common metrics used to analyze the quality of a turn using inertial systems were also calculated over the same trials (i.e., the number of steps required to complete the turn and the turn mean and maximum velocities). Results All CCKS metrics discriminated between OA and patients (p ≤ 0.041) and were sensitive to change in PD medication state (p ≤ 0.033). Common metrics were also able to discriminate between OA and patients (p < 0.014), but they were unable to capture the change in medication state this early in the disease (p ≥ 0.173). Conclusion The enhanced sensitivity to change of the proposed CCKS metrics suggests a potential use of these metrics for mobility impairments identification and fluctuation assessment, even in the early stages of the disease.
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Affiliation(s)
- Karina Lebel
- Department of Surgery, Faculty of Medicine and Health Sciences, Orthopedic Service, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Centre on Aging, Sherbrooke, QC, Canada
| | - Christian Duval
- Département des Sciences de l'activité Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Centre de Recherche Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Hung Phuc Nguyen
- Département des Sciences de l'activité Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Centre de Recherche Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Réjean Plamondon
- Laboratoire Scribens, Département de génie Électrique, École Polytechnique de Montréal, Montréal, QC, Canada
| | - Patrick Boissy
- Department of Surgery, Faculty of Medicine and Health Sciences, Orthopedic Service, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Centre on Aging, Sherbrooke, QC, Canada
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10
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Lebel K, Nguyen H, Duval C, Plamondon R, Boissy P. Capturing the Cranio-Caudal Signature of a Turn with Inertial Measurement Systems: Methods, Parameters Robustness and Reliability. Front Bioeng Biotechnol 2017; 5:51. [PMID: 28879179 PMCID: PMC5572419 DOI: 10.3389/fbioe.2017.00051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/04/2017] [Indexed: 11/30/2022] Open
Abstract
Background Turning is a challenging mobility task requiring coordination and postural stability. Optimal turning involves a cranio-caudal sequence (i.e., the head initiates the motion, followed by the trunk and the pelvis), which has been shown to be altered in patients with neurodegenerative diseases, such as Parkinson’s disease as well as in fallers and frails. Previous studies have suggested that the cranio-caudal sequence exhibits a specific signature corresponding to the adopted turn strategy. Currently, the assessment of cranio-caudal sequence is limited to biomechanical labs which use camera-based systems; however, there is a growing trend to assess human kinematics with wearable sensors, such as attitude and heading reference systems (AHRS), which enable recording of raw inertial signals (acceleration and angular velocity) from which the orientation of the platform is estimated. In order to enhance the comprehension of complex processes, such as turning, signal modeling can be performed. Aim The current study investigates the use of a kinematic-based model, the sigma-lognormal model, to characterize the turn cranio-caudal signature as assessed with AHRS. Methods Sixteen asymptomatic adults (mean age = 69.1 ± 7.5 years old) performed repeated 10-m Timed-Up-and-Go (TUG) with 180° turns, at varying speed. Head and trunk kinematics were assessed with AHRS positioned on each segments. Relative orientation of the head to the trunk was then computed for each trial and relative angular velocity profile was derived for the turn phase. Peak relative angle (variable) and relative velocity profiles modeled using a sigma-lognormal approach (variables: Neuromuscular command amplitudes and timing parameters) were used to extract and characterize the cranio-caudal signature of each individual during the turn phase. Results The methodology has shown good ability to reconstruct the cranio-caudal signature (signal-to-noise median of 17.7). All variables were robust to speed variations (p > 0.124). Peak relative angle and commanded amplitudes demonstrated moderate to strong reliability (ICC between 0.640 and 0.808). Conclusion The cranio-caudal signature assessed with the sigma-lognormal model appears to be a promising avenue to assess the efficiency of turns.
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Affiliation(s)
- Karina Lebel
- Faculty of Medicine and Health Sciences, Orthopedic Service, Department of Surgery, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Centre on Aging, Sherbrooke, QC, Canada
| | - Hung Nguyen
- Département des Sciences de l'activité Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Centre de Recherche Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Christian Duval
- Département des Sciences de l'activité Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Centre de Recherche Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Réjean Plamondon
- Laboratoire Scribens, Département de génie Électrique, École Polytechnique de Montréal, Montréal, QC, Canada
| | - Patrick Boissy
- Faculty of Medicine and Health Sciences, Orthopedic Service, Department of Surgery, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Centre on Aging, Sherbrooke, QC, Canada
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11
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Hulbert S, Ashburn A, Robert L, Verheyden G. A narrative review of turning deficits in people with Parkinson’s disease. Disabil Rehabil 2014; 37:1382-9. [DOI: 10.3109/09638288.2014.961661] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sophia Hulbert
- Faculty of Health Sciences, University of Southampton, Southampton, UK,
| | - Ann Ashburn
- Faculty of Health Sciences, University of Southampton, Southampton, UK,
| | - Lisa Robert
- Faculty of Health Sciences, University of Southampton, Southampton, UK,
- Department of Physiotherapy, University Hospital Southampton NHS Foundation Trust, Southampton, UK, and
| | - Geert Verheyden
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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12
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McNeely ME, Earhart GM. The effects of medication on turning in people with Parkinson disease with and without freezing of gait. JOURNAL OF PARKINSONS DISEASE 2014; 1:259-70. [PMID: 23939306 DOI: 10.3233/jpd-2011-11030] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Turning difficulty is prevalent in Parkinson disease (PD) and may lead to falls or freezing. Medication improves motor symptoms of PD, but its effects on turning in people with PD with (PD+FOG) and without (PD-FOG) freezing of gait are unclear. This study evaluated the effects of medication on turning in PD compared to healthy older adults (controls), and in PD+FOG compared to PD-FOG. We assessed timed-up-and-go (TUG), and in-place turns in 16 controls and 20 people with PD (10 PD+FOG, 10 PD-FOG) OFF and ON medication. PD+FOG performed worse than PD-FOG (p < 0.05) in TUG, turn duration, step count, and had earlier head rotation onset (HTO). These measures improved ON medication in PD+FOG and PD-FOG (p < 0.05). Turn duration and step count improved more with medication in PD+FOG than PD-FOG (p < 0.005). There were subtle differences in gastrocnemius and sternocleidomastoid onsets, with PD OFF or ON activating muscles earlier than controls. Tibialis anterior, gastrocnemius, and sternocleidomastoid initial onset times were similar between PD+FOG and PD-FOG. Though medication improved turning, turn duration and step count impairments still existed in PD ON, compared to controls. Relative to PD-FOG, PD+FOG turned worse, but improved more with medication, potentially because PD+FOG were initially more impaired than PD-FOG or were taking higher medication dosages. Further treatment options may be needed to address ON medication turning deficits.
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Affiliation(s)
- Marie E McNeely
- Program in Physical Therapy, Washington University in St. Louis, MO, USA
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Ashburn A, Kampshoff C, Burnett M, Stack E, Pickering RM, Verheyden G. Sequence and onset of whole-body coordination when turning in response to a visual trigger: comparing people with Parkinson's disease and healthy adults. Gait Posture 2014; 39:278-83. [PMID: 23973355 DOI: 10.1016/j.gaitpost.2013.07.128] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 06/11/2013] [Accepted: 07/26/2013] [Indexed: 02/02/2023]
Abstract
Turning round is a routine everyday activity that can often lead to instability. The purpose of this study was to investigate abnormalities of turning among people with Parkinson's disease (PwPD) through the measurement of sequence of body segments and latency response. Participants were asked to turn 180° and whole-body movements were recorded using CODAmotion and Visio Fast eye tracking equipment. Thirty-one independently mobile PwPD and 15 age-matched healthy controls participated in the study. We found that contrary to common belief, the head preceded movement of all other body segments (eyes, shoulders, pelvis, first and second foot). We also found interaction between group and body segment (P=0.005), indicating that overall, PwPD took longer to move from head to second foot than age-matched healthy controls. For PwPD only, interactions were found between disease severity and body segment (P<0.0001), between age group and body segment (P<0.0001) and between gender and body segments (P<0.0001). For each interaction, longer time periods were noted between moving the first foot after the pelvis, and moving the second foot after the first, and this was noted for PwPD in Hoehn and Yahr stage III-IV (in comparison to Hoehn and Yahr stage I-II); for PwPD who were under 70 years (in comparison with 70 years or over); and for ladies (in comparison with men). Our results indicate that in PwPD and healthy elderly, turning-on-the-spot might not follow the top-to-bottom approach we know from previous research.
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Affiliation(s)
- A Ashburn
- Faculty of Health Sciences, University of Southampton, UK.
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Abstract
OBJECTIVE Many of the falls among people with Parkinson's disease (PD) occur during sudden, on-the-spot turning which requires systematic reorientation of axial segments towards the new direction. We examined whether a disturbance in the coordination of segmental reorientation is an important cause of turning difficulty in individuals with PD and is altered by dopaminergic medication. METHODS The sequence and timing of segmental reorientation during 45° and 90° on-the-spot turns was examined in fourteen individuals with PD while "off" and "on" medication and nineteen healthy controls (HC). RESULTS Regardless of the magnitude of the turn, HC reoriented their head, shoulder, and pelvis simultaneously followed by mediolateral foot displacement. PD patients displayed temporal coordination patterns similar to the HC. PD however, reduced the velocity and early magnitude of reorientation of each body segment which were both slightly improved by dopaminergic medication. CONCLUSION Our finding that the HC and PD patients turn en bloc when the turn is predictable and there are no time constraints shows that the strategy of en bloc turning is not wrong if the movement parameters are unconstrained. However, in real life situations, which usually require quick and unpredictable turns, the en bloc strategy may be unsafe and more likely to result in falls. While in such situations HC are able to change the strategy from en bloc to sequential segmental turning, PD patients may not be able to do so and continue to turn en bloc.
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Abstract
OBJECTIVE Individuals with Parkinson's disease (PD) show poorer balance and greater incidence of falls while turning. We investigated whether a disturbance in timing and sequence of reorientation of body segments is a potential cause of turning difficulty in PD and is altered by levodopa. METHODS The sequence and timing of segmental reorientation during 45° and 90° walking turns were recorded in nineteen healthy controls and fourteen individuals with PD "off" and "on" medication. RESULTS Both healthy elderly and PD patients "off" medication displayed a top-down sequence of segment reorientation, but differed with respect to the delay time between segments: PD "off" medication displayed a shorter delay between the onset of head and shoulder reorientation and longer delays for pelvis and foot reorientation. Furthermore, for all segments the peak angular velocities were lower for PD patients than healthy controls, with greater difference between the two groups during larger turns. While for both groups the velocity and magnitude of rotation of all segments were greater during larger turns, the relative timing of reorientation of segments remained the same during small and large turns. Medication had no significant effect on the timing and sequence of reorientation of segments and caused only a small and non-significant increase to segment velocities. CONCLUSION This study further characterized the turning performance of individuals with PD. Our findings have clinical applications and therapeutic value for PD patients with difficulty turning. Understanding the specific deficiencies of turning performance of PD patients allows the therapists to opt for the most effective rehabilitation techniques.
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Panyakaew P, Bhidayasiri R. The spectrum of preclinical gait disorders in early Parkinson’s disease: subclinical gait abnormalities and compensatory mechanisms revealed with dual tasking. J Neural Transm (Vienna) 2013; 120:1665-72. [DOI: 10.1007/s00702-013-1051-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 06/10/2013] [Indexed: 11/30/2022]
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Altered Dynamic Postural Control during Step Turning in Persons with Early-Stage Parkinson's Disease. PARKINSONS DISEASE 2012; 2012:386962. [PMID: 22518349 PMCID: PMC3306994 DOI: 10.1155/2012/386962] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Revised: 09/26/2011] [Accepted: 10/17/2011] [Indexed: 11/17/2022]
Abstract
Persons with early-stage Parkinson's disease (EPD) do not typically experience marked functional deficits but may have difficulty with turning tasks. Studies evaluating turning have focused on individuals in advanced stages of the disease. The purpose of this study was to compare postural control strategies adopted during turning in persons with EPD to those used by healthy control (HC) subjects. Fifteen persons with EPD, diagnosed within 3 years, and 10 HC participated. Participants walked 4 meters and then turned 90°. Dynamic postural control was quantified as the distance between the center of pressure (COP) and the extrapolated center of mass (eCOM). Individuals with EPD demonstrated significantly shorter COP-eCOM distances compared to HC. These findings suggest that dynamic postural control during turning is altered even in the early stages of PD.
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Lack of Short-Term Effectiveness of Rotating Treadmill Training on Turning in People with Mild-to-Moderate Parkinson's Disease and Healthy Older Adults: A Randomized, Controlled Study. PARKINSONS DISEASE 2011; 2012:623985. [PMID: 22191073 PMCID: PMC3236457 DOI: 10.1155/2012/623985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 09/05/2011] [Indexed: 11/18/2022]
Abstract
Since turning is often impaired in Parkinson's disease (PD) and may lead to falls, it is important to develop targeted treatment strategies for turning. We determined the effects of rotating treadmill training on turning in individuals with PD. This randomized controlled study evaluated 180°
in-place turns, functional turning (timed-up-and-go), and gait velocity before and after 15 minutes of rotating treadmill training or stepping in place in 26 people with PD and 27 age-matched controls. A subset of participants with PD (n = 3)
completed five consecutive days of rotating treadmill training. Fast as possible gait velocity, timed-up-and-go time, 180°
turn duration, and steps to turn 180°
were impaired in PD compared to controls (P < 0.05) and did not improve following either intervention (P > 0.05). Preferred pace gait velocity and timing of yaw rotation onset of body segments (head, trunk, pelvis) during 180°
turns were not different in PD (P > 0.05) and did not change following either intervention. No improvements in gait or turning occurred after five days of rotating treadmill training, compared to one day. The rotating treadmill is not recommended for short-term rehabilitation of impaired in-place turning in the general PD population.
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Cole MH, Silburn PA, Wood JM, Worringham CJ, Kerr GK. Falls in Parkinson's disease: kinematic evidence for impaired head and trunk control. Mov Disord 2011; 25:2369-78. [PMID: 20737542 DOI: 10.1002/mds.23292] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Changes in stride characteristics and gait rhythmicity characterize gait in Parkinson's disease and are widely believed to contribute to falls in this population. However, few studies have examined gait in PD patients who fall. This study reports on the complexities of walking in PD patients who reported falling during a 12-month follow-up. Forty-nine patients clinically diagnosed with idiopathic PD and 34 controls had their gait assessed using three-dimensional motion analysis. Of the PD patients, 32 (65%) reported at least one fall during the follow-up compared with 17 (50%) controls. The results showed that PD patients had increased stride timing variability, reduced arm swing and walked with a more stooped posture than controls. Additionally, PD fallers took shorter strides, walked slower, spent more time in double-support, had poorer gait stability ratios and did not project their center of mass as far forward of their base of support when compared with controls. These stride changes were accompanied by a reduced range of angular motion for the hip and knee joints. Relative to walking velocity, PD fallers had increased mediolateral head motion compared with PD nonfallers and controls. Therefore, head motion could exceed "normal" limits, if patients increased their walking speed to match healthy individuals. This could be a limiting factor for improving gait in PD and emphasizes the importance of clinically assessing gait to facilitate the early identification of PD patients with a higher risk of falling.
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Affiliation(s)
- Michael H Cole
- Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
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Akram SB, Frank JS, Fraser J. Coordination of segments reorientation during on-the-spot turns in healthy older adults in eyes-open and eyes-closed conditions. Gait Posture 2010; 32:632-6. [PMID: 20932763 DOI: 10.1016/j.gaitpost.2010.09.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 07/21/2010] [Accepted: 09/06/2010] [Indexed: 02/02/2023]
Abstract
Turning has frequent occurrence in everyday activities. Despite the prevalence of turning in everyday life and the challenge it poses to older adults, there is far less known about the multisegmental control of turning than the control of standing and straight walking, especially in elderly individuals. The purpose of this study was to examine the timing and sequence of segments reorientation in healthy older adults during 90° on-the-spot turns. The role of vision on segments coordination was also examined by testing the participants in eyes-open and eyes-closed conditions. When turning on-the-spot, healthy elderly reoriented their head, shoulder and pelvis simultaneously, followed by foot displacement. This was a robust behavior not affected by visual condition. Axial segments turned slower and more synchronously when vision was not available. While all segments started to turn together in both visual conditions, head turned faster and reached its peak velocity earlier than shoulder and pelvis. However, the difference in segmental velocity and the time to reach the peak velocity was smaller in eyes-closed than eyes-open condition. Without vision, the functional importance of a faster head turn is diminished. Participants may have adopted a tighter control of segments to simplify the control of movement by reducing the degrees of freedom.
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Affiliation(s)
- Sakineh B Akram
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
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Abstract
BACKGROUND AND PURPOSE People with Parkinson's disease often have difficulty executing turns. To date, most studies of turning have examined subjects ON their anti-Parkinson medications. No studies have examined what specific aspects of turning are modified or remain unchanged when medication is administered. The purpose of this study was to determine how anti-Parkinson medications affect temporal and spatial features of turning performance in individuals with Parkinson's disease. METHODS We examined turning kinematics in 10 people with Parkinson's disease who were assessed both OFF and ON medication. For both conditions, participants were evaluated with the Unified Parkinson's Disease Rating Scale motor subscale, rated how well their medication was working on a visual analog scale, and performed straight-line walking and 180-degree in-place turns. We determined the average walking velocity, time and number of steps to execute turns, sequence of yaw rotation onsets of the head, trunk, and pelvis during turns, and amplitudes of yaw rotation of the head, trunk, and pelvis during turns. RESULTS Medication significantly improved the Unified Parkinson's Disease Rating Scale scores (P = 0.02), visual analog scale ratings (P = 0.03), and walking velocity (P = 0.02). Although improvements in turning were not statistically significant, medication did reduce the time and number of steps required to turn, slightly increased the amplitudes of yaw rotation of the various segments, and increased the rotation of the head relative to the other segments. Medication did not improve the timing of segment rotations, which showed en bloc turn initiation in both the OFF and ON medication conditions. DISCUSSION AND CONCLUSION These results suggest that only certain aspects of turning may be responsive to anti-Parkinson medications. As such, additional rehabilitative approaches to address turning are needed because turning may not be effectively addressed by pharmacologic approaches. These results should be interpreted cautiously given the small sample size.
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Effect of walking velocity on segment coordination during pre-planned turns in healthy older adults. Gait Posture 2010; 32:211-4. [PMID: 20605717 DOI: 10.1016/j.gaitpost.2010.04.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Revised: 04/15/2010] [Accepted: 04/20/2010] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite the prevalence of turning in daily activities and the challenges it poses to mobility-impaired individuals, far less is known about the multi-segmental control of turning than the control of straight walking. Gait slows with aging and neurological disorders such as Parkinson's disease and falls in these populations frequently occur when turning. Nevertheless, the influence of walking velocity on the complex inter-segmental coordination of the head, trunk and lower limbs during turning has not been examined. The purpose of this study was to examine the effect of walking velocity on the coordination of segment reorientation during turns embedded in locomotion in healthy older adults. METHODS Nineteen healthy older adults volunteered to participate. Participants made a 45 degrees or 90 degrees turn to their right while walking either at their natural self-selected speed or slower or faster than their natural speed. We quantified the timing and sequence of segments reorientation during the turns. RESULTS There was a top-down temporal sequence in initiation of segments reorientation during turning, i.e., head turned first, followed by shoulder, pelvis, and mediolateral foot displacement. Furthermore, results indicate that the top-down temporal sequence in segments reorientation during turning was a robust behavior which was not affected by the walking velocity or magnitude of the turn. CONCLUSIONS Walking velocity does not affect segment coordination during pre-planned turns in healthy elderly. Therefore, we conclude that changes in coordination of segments reorientation during pre-planned turns in individuals with neurological disorders such as Parkinson's disease is not due to their slower gait.
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Falls and gait disorders in geriatric neurology. Clin Neurol Neurosurg 2010; 112:265-74. [DOI: 10.1016/j.clineuro.2009.12.015] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 08/17/2009] [Accepted: 12/27/2009] [Indexed: 11/23/2022]
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Chan J, Leung H, Poizner H. Correlation among joint motions allows classification of Parkinsonian versus normal 3-D reaching. IEEE Trans Neural Syst Rehabil Eng 2009; 18:142-9. [PMID: 19497826 DOI: 10.1109/tnsre.2009.2023296] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this paper, an objective assessment for determining whether a person has Parkinson disease is proposed. This is achieved by analyzing the correlation between joint movements, since Parkinsonian patients often have trouble coordinating different joints in a movement. Thus, the auto-correlation coefficient of single joint movements and the cross-correlation between movements in a pair of joints (hand, wrist, elbow, and shoulder) were studied. These features were used to train and provide classification of subjects as having or not having Parkinson's disease using the least square support vector machine (LS-SVM). Experimental results showed that using either auto-correlation or cross-correlation features for classification provided over 91% correct classification. Using both features together provided better performance (96.0%) than using either feature alone. In addition, the performance of LS-SVM is better than that of self-organizing map (SOM) and k-nearest neighbor (KNN) in this case.
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Affiliation(s)
- Jacky Chan
- City University of Hong Kong, Kowloon, Hong Kong.
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Yeo SH, Tresch MC, Pai DK. Optimal design of musculoskeletal models using force field data. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2009; 2008:3710-4. [PMID: 19163518 DOI: 10.1109/iembs.2008.4650015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We propose an optimal design framework for a musculoskeletal model. A six degrees of freedom generalized force field at an end effector is measured by activating a specific muscle in-situ. Given that we have a musculoskeletal simulation model with a set of undetermined design parameters, the framework chooses the optimal parameters which minimize the difference between simulated and measured force field data. To ensure generality, the framework is model independent, which means that any type of musculoskeletal model can be applied. As a generalized method, a PID (Proportional-Integral-Derivative) controller and an empirical Jacobian are used to correctly simulate the force field without suffering from numerical issues such as stability and indeterminacy. Case studies of the muscles of the rat hind limb show a satisfactory capability of the framework.
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Affiliation(s)
- Sang Hoon Yeo
- Department of Computer Science, The University of British Columbia, 201-2366 Main Mall, Vancouver, BC, Canada.
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