1
|
Taniguchi S, Yamamoto A, D'cruz N. Assessing impaired bed mobility in patients with Parkinson's disease: a scoping review. Physiotherapy 2024; 124:29-39. [PMID: 38870620 DOI: 10.1016/j.physio.2023.10.005] [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: 09/20/2022] [Revised: 05/25/2023] [Accepted: 10/19/2023] [Indexed: 06/15/2024]
Abstract
BACKGROUND Although most patients with Parkinson's disease (PD) experience difficulties in bed mobility, evidence on the suitability of the methods for assessing impaired bed mobility in PD are lacking. OBJECTIVES To identify objective methods for assessing impaired bed mobility in PD and to discuss their clinimetric properties and feasibility for use in clinical practice. DATA SOURCES PubMed, Web of Science, and Cochrane Library were searched between 1995 and 2022. SELECTION CRITERIA Studies were included if they described an objective assessment method for assessing impaired bed mobility in PD. DATA EXTRACTION AND DATA SYNTHESIS Characteristics of the identified measurement methods such as clinimetric properties and feasibility were extracted by two authors. The methodological quality of studies was evaluated using the Appraisal of studies tool. RESULTS Twenty-three studies were included and categorised into three assessment methods: sensor-based assessments (48%), rating scales (39%), and timed-tests (13%). The risk of bias was low for all but one study, which was medium. LIMITATIONS Despite applying wide selection criteria, a relatively small number of studies were identified in our results. CONCLUSION Rating scales may be the most preferred for assessing impaired bed mobility in PD in clinical practice, until clinimetric validity are adequately demonstrated in the other assessment methods. CONTRIBUTION OF PAPER.
Collapse
Affiliation(s)
- Seira Taniguchi
- Department of Neurology, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita, Osaka, Japan.
| | - Ariko Yamamoto
- Department of Rehabilitation, Tekijyu Rehabilitation Hospital, Hanayamacho 2-11-32, Kobe, Hyogo, Japan
| | - Nicholas D'cruz
- Department of Rehabilitation Sciences, Neurorehabilitation Research Group, KU Leuven, Tervuursevest 101, PO Box1501, Leuven, Belgium
| |
Collapse
|
2
|
Kaya Aytutuldu G, Ersoz Huseyinsinoglu B, Karagoz Sakalli N, Sen A, Yeldan I. LSVT® BIG versus progressive structured mobility training through synchronous telerehabilitation in Parkinson's disease: A randomized controlled trial. Neurol Sci 2024; 45:3163-3172. [PMID: 38267603 PMCID: PMC11176092 DOI: 10.1007/s10072-024-07322-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Parkinson's disease (PD) is a common neurodegenerative illness associated with motor symptoms. AIM The aim of study was to compare the effects of synchronous telerehabilitation-based Lee Silverman Voice Treatment® BIG (LSVT® BIG) protocol and progressive structured mobility training in patients with Parkinson's disease (PD). METHODS Thirty-two patients diagnosed with PD (aged 40-72 years, Hoehn-Yahr stage 1-3) were randomly allocated into LSVT® BIG (Group 1) and Progressive Structured Mobility Training (Group 2) groups. Exercises were performed in both groups for 60 min a day, 4 days a week, for 4 weeks under the supervision of a physiotherapist with synchronous online videoconference method. Dynamic balance was assessed with Mini-Balance Evaluation Systems Test (Mini-BESTest) as a primary outcome measure. The secondary outcome measurements were Timed Up and Go Test (TUG), spatiotemporal parameters of gait from Kinovea® software, and postural stability from the Biodex Balance System. Other outcome measures were Activity-Specific Balance Confidence Scale-Short Form (ABC-SF), Parkinson's Activity Scale (PAS), and Parkinson's Disease Quality of Life Questionnaire (PDQ-39). RESULTS This study showed significant group-by-time interactions on Mini-BEST (p = 0.042), ABC-SF (p = 0.029), and PAS (p = 0.022) in favor of group 1. Also, TUG (p < 0.01), spatiotemporal parameters of gait (p < 0.01), and PDQ-39 (p < 0.01) were improved in both groups. CONCLUSION Both synchronous telerehabilitation-based exercise protocols enhanced balance and gait, as well as activity level and quality of life in patients with PD. LSVT® BIG may be preferred to improve dynamic balance, balance confidence, and activity status in the early stages of PD. These results should be confirmed in future studies with more robust methodology. TRIAL REGISTRATION NCT04694872.
Collapse
Affiliation(s)
- Guzin Kaya Aytutuldu
- Department of Physiotherapy and Rehabilitation (English), Faculty of Health Sciences, Biruni University, Istanbul, Turkey
- Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Burcu Ersoz Huseyinsinoglu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
| | - Nazan Karagoz Sakalli
- Department of Neurology, Bakırkoy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul, Turkey
| | - Aysu Sen
- Department of Neurology, Bakırkoy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul, Turkey
| | - Ipek Yeldan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
3
|
Hardeman LES, Geerse DJ, Hoogendoorn EM, Nonnekes J, Roerdink M. Remotely prescribed, monitored, and tailored home-based gait-and-balance exergaming using augmented reality glasses: a clinical feasibility study in people with Parkinson's disease. Front Neurol 2024; 15:1373740. [PMID: 38872812 PMCID: PMC11172158 DOI: 10.3389/fneur.2024.1373740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/04/2024] [Indexed: 06/15/2024] Open
Abstract
Background Exergaming has the potential to increase adherence to exercise through play, individually tailored training, and (online) remote monitoring. Reality Digital Therapeutics (Reality DTx®) is a digital therapeutic software platform for augmented reality (AR) glasses that enables a home-based gait-and-balance exergaming intervention specifically designed for people with Parkinson's disease (pwPD). Objective The primary objective was to evaluate the feasibility and potential efficacy of Reality DTx® AR exergaming intervention for improving gait, balance, and walking-adaptability fall-risk indicators. The secondary objective was to evaluate the potential superiority of AR glasses [Magic Leap 2 (ML2) vs. HoloLens 2 (HL2)]. Methods This waitlist-controlled clinical feasibility study comprised three laboratory visits (baseline; pre-intervention; and post-intervention), a home visit, and a 6-week AR exergaming intervention. Five complementary gait-and-balance exergames were remotely prescribed (default five sessions/week of 30 active minutes/session), monitored, and tailored. Feasibility was assessed in terms of safety, adherence, and user experience. During laboratory visits, gait-and-balance capacity was assessed using standard clinical gait-and-balance tests and advanced walking-adaptability fall-risk assessments. Results In total, 24 pwPD participated. No falls and four near falls were reported. Session adherence was 104%. The User Experience Questionnaire scores for Reality DTx® ranged from above average to excellent, with superior scores for HL2 over ML2 for Perspicuity and Dependability. Intervention effects were observed for the Timed Up and Go test (albeit small), the Five Times Sit to Stand test, and walking speed. Walking-adaptability fall-risk indicators all improved post-intervention. Conclusion Reality DTx® is a safe, adherable, usable, well-accepted, and potentially effective intervention in pwPD. These promising results warrant future randomized controlled trials on the (cost-)effectiveness of home-based AR exergaming interventions for improving gait, balance, and fall risk. Clinical trial registration ClinicalTrials.gov, identifier NCT05605249.
Collapse
Affiliation(s)
- Lotte E. S. Hardeman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Daphne J. Geerse
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Eva M. Hoogendoorn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Jorik Nonnekes
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Centre of Expertise for Parkinson and Movement Disorders, Nijmegen, Netherlands
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, Netherlands
| | - Melvyn Roerdink
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| |
Collapse
|
4
|
Vitale C, Rosa R, Agosti V, Siciliano M, Barra G, Maggi G, Santangelo G. Effects of Biodanza ® SRT on Motor, Cognitive, and Behavioral Symptoms in Patients with Parkinson's Disease: A Randomized Controlled Study. J Pers Med 2024; 14:588. [PMID: 38929809 PMCID: PMC11204495 DOI: 10.3390/jpm14060588] [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: 05/14/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
Rolando Toro's Biodanza (SRT) is a therapeutic strategy that uses movement, music, and emotions to induce integrative living experiences. The present study aims to explore the efficacy of a three-month SRT intervention on motor, cognitive, and behavioral symptoms in patients with Parkinson's disease (PD). This study employed a randomized between-group design. Twenty-eight non-demented PD patients were enrolled in this study. Out of these, fourteen patients were assigned to the active treatment group using the Biodanza SRT system and fourteen to the untreated control group. The study group attended 2 h SRT classes once a week, completing twelve lessons in twelve weeks. All patients underwent: (i) a neurological examination to measure the severity of motor symptoms, balance, mobility, and risk of falls, and (ii) a neuropsychological battery to assess cognitive status, apathy, depressive symptomatology, and perceived quality of life (QoL), at study entry (T0) and at twelve weeks (T1, end of dance training). At T1, we observed a significant improvement in motor (i.e., severity of motor symptoms and balance) and cognitive parameters (i.e., working memory and delayed verbal memory) in all treated patients compared with the controls. Furthermore, a significant improvement in the social support dimension was found in all treated patients compared to the controls. A trend toward increased apathy was found in untreated patients at T1. The three-month Biodanza intervention significantly ameliorated the motor parameters of PD patients, with a parallel improvement in cognitive and QoL status. Hence, Biodanza intervention can, in the short term, represent a useful personalized medical intervention for the management of Parkinson's disease.
Collapse
Affiliation(s)
- Carmine Vitale
- Department of Medical, Motor and Wellbeing Sciences, University of Naples “Parthenope”, 80133 Naples, Italy
- ICS Maugeri Hermitage Napoli, 80145 Naples, Italy;
| | - Roberta Rosa
- Department of Primary Education Sciences, European University of Rome, 00163 Roma, Italy;
| | - Valeria Agosti
- Department of Human, Philosophical and Educational Sciences, University of Salerno, 84084 Fisciano, Italy;
| | - Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
- Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy;
| | | | - Gianpaolo Maggi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
- Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy;
| | - Gabriella Santangelo
- Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy;
| |
Collapse
|
5
|
Bonde-Jensen F, Dalgas U, Hvid LG, Langeskov-Christensen M. Validity and reliability of linear encoder muscle power testing in persons with Parkinson's disease. Clin Rehabil 2024; 38:678-687. [PMID: 38193269 DOI: 10.1177/02692155231224987] [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] [Indexed: 01/10/2024]
Abstract
OBJECTIVE To investigate the construct validity ON medication and the reliability both ON and OFF medication of linear encoder muscle power testing in persons with Parkinson's disease (pwPD). DESIGN A study using baseline data from one randomized controlled trial (study 1) and one cohort study (study 2). SETTING University exercise lab. PARTICIPANTS Study 1: 35 healthy controls and 70 pwPD. Study 2: 20 pwPD. INTERVENTION Study 1: baseline data. Study 2: 4 chair rise tests (2 ON and 2 OFF medication), in a randomized order, separated by 4 to 16 days. MAIN MEASURES Linear encoder data were collected from a chair rise test. Known groups validity and convergent validity (i.e., construct validity) were assessed by comparing peak power between pwPD and healthy controls and associations between peak power and functional performance (i.e., 6-Min Walk Test, Timed Up and Go Test, Six-Spot Step Test), respectively. Reliability was assessed as day-to-day variation and by intraclass correlation coefficients. RESULTS Peak power was comparable between pwPD and healthy controls (-7.2%, p = 0.17), but lower in moderately impaired pwPD compared to mildly impaired pwPD (-27%, p < 0.01) and healthy controls (-23%, p < 0.01). Moderate to strong associations were observed between peak power and functional performance (r2 = 0.44-0.51). Day-to-day variation ON and OFF medication were 1.0 and 1.3 W/kg, respectively, while intraclass correlation coefficients were 0.95 (0.87;0.98) and 0.93 (0.82;0.97), respectively. CONCLUSION Linear encoder muscle power testing shows inconsistent known groups validity, acceptable convergent validity ON medication, and excellent day-to-day reliability ON and OFF medication in pwPD.
Collapse
Affiliation(s)
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lars Grøndahl Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- The Danish Multiple Sclerosis Hospitals, Ry and Haslev, Denmark
| | - Martin Langeskov-Christensen
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Neurology, Viborg Regional Hospital, Viborg, Denmark
| |
Collapse
|
6
|
Eldemir S, Eldemir K, Saygili F, Ozkul C, Yilmaz R, Akbostancı MC, Guclu‐Gunduz A. The effects of standard and modified LSVT BIG therapy protocols on balance and gait in Parkinson's disease: A randomized controlled trial. Brain Behav 2024; 14:e3458. [PMID: 38451007 PMCID: PMC10918598 DOI: 10.1002/brb3.3458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/02/2024] [Accepted: 02/10/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Lee Silverman voice treatment (LSVT) BIG is an exercise program developed for patients with Parkinson's disease (PwPD), consisting of sets of exercises performed for 4 consecutive days a week for 4 weeks. However, the standard protocol suggests a treatment frequency difficult to follow for most patients who have difficulties reaching rehabilitation clinics. Our aim was to compare the standard LSVT BIG protocol with a modified LSVT (m-LSVT) BIG protocol (twice a week in the clinic for 4 weeks and twice a week at home for 4 weeks). METHODS In this randomized controlled trial, 16 PwPD (aged 18-80 years, Hoehn and Yahr stages I-III) were recruited into two groups. The LSVT group received standard LSVT BIG training (four times per week for 4 weeks at the clinic). The other group was given m-LSVT BIG exercises, but unlike the LSVT group, the m-LSVT group exercised twice a week at the clinic and twice a week at home for 4 weeks. The Berg Balance Scale was used to assess functional balance. Biodex Balance System was used to assess laboratory balance measures. Timed Up and Go test and G-Walk sensor system were used to assess functional mobility and spatiotemporal gait analysis. RESULTS Significant group-by-time interactions on the eyes open-firm surface score of the modified clinical test of sensory integration of balance (F = 10.138, p = .007) and gait cycle symmetry index (F = 10.470, p = .010) were found to be in favor of the LSVT group. Additionally, post hoc analyses revealed that both groups significantly improved postural stability, gait speed, motor symptoms, and functional mobility (p < .05). CONCLUSION The results revealed the beneficial effects of the modified protocol on balance and gait in PwPD, as well as the superiority of the standard LSVT BIG protocol. The m-LSVT BIG protocol may be an effective intervention method, especially for PwPD who have difficulty adapting to the treatment frequency of the standard protocol.
Collapse
Affiliation(s)
- Sefa Eldemir
- Department of Physiotherapy and Rehabilitation, Faculty of Health SciencesSivas Cumhuriyet UniversitySivasTürkiye
| | - Kader Eldemir
- Department of Physiotherapy and Rehabilitation, Faculty of Health SciencesOrdu UniversityOrduTürkiye
| | - Fettah Saygili
- Department of Physiotherapy and Rehabilitation, Faculty of Health SciencesAydın Adnan Menderes UniversityAydınTürkiye
| | - Cagla Ozkul
- Department of Physiotherapy and Rehabilitation, Faculty of Health SciencesGazi UniversityAnkaraTürkiye
| | - Rezzak Yilmaz
- Department of Neurology and Ankara University Brain Research CenterAnkara University, School of MedicineAnkaraTürkiye
| | - Muhittin Cenk Akbostancı
- Department of Neurology and Ankara University Brain Research CenterAnkara University, School of MedicineAnkaraTürkiye
| | - Arzu Guclu‐Gunduz
- Department of Physiotherapy and Rehabilitation, Faculty of Health SciencesGazi UniversityAnkaraTürkiye
| |
Collapse
|
7
|
Hara M, Murakawa Y, Wagatsuma T, Shinmoto K, Tamaki M. Feasibility of Somato-Cognitive Coordination Therapy Using Virtual Reality for Patients with Advanced Severe Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:895-898. [PMID: 38607764 PMCID: PMC11191467 DOI: 10.3233/jpd-240011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/14/2024]
Abstract
This feasibility study enrolled 20 patients with advanced severe Parkinson's disease (PD) to evaluate somato-cognitive coordination therapy (SCCT) using virtual reality. Focusing on the safety and tolerability of SCCT, 17 patients (76±9 years old and 64.7% male) completed the 3-month trial. Key observations included absence of adverse events and tolerability of the participants to SCCT despite initial apprehensions and minor adjustments in medication. Physical functions showed no significant deterioration, suggesting the safety of SCCT. In conclusion, SCCT emerges as feasible and well-tolerated intervention in advanced severe PD, requiring further research to assess its therapeutic efficacy.
Collapse
Affiliation(s)
- Masahiko Hara
- Department of Neurology and Clinical Rehabilitation, mediVR Rehabilitation Center, Toyonaka, Japan
- Centre for Community-Based Healthcare Research and Education, Shimane University Faculty of Medicine, Izumo, Japan
| | - Yuichiro Murakawa
- Department of Neurology and Clinical Rehabilitation, mediVR Rehabilitation Center, Toyonaka, Japan
| | - Tomomi Wagatsuma
- Department of Neurology and Clinical Rehabilitation, mediVR Rehabilitation Center, Toyonaka, Japan
| | - Keito Shinmoto
- Department of Neurology and Clinical Rehabilitation, mediVR Rehabilitation Center, Toyonaka, Japan
| | - Masatake Tamaki
- Department of Neurology and Clinical Rehabilitation, mediVR Rehabilitation Center, Toyonaka, Japan
| |
Collapse
|
8
|
Santos GV, d'Alencar MS, Helene AF, Roque AC, Miranda JGV, Piemonte MEP. A non-expensive bidimensional kinematic balance assessment can detect early postural instability in people with Parkinson's disease. Front Neurol 2023; 14:1243445. [PMID: 38046589 PMCID: PMC10693416 DOI: 10.3389/fneur.2023.1243445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/04/2023] [Indexed: 12/05/2023] Open
Abstract
BackgroundPostural instability is a debilitating cardinal symptom of Parkinson’s disease (PD). Its onset marks a pivotal milestone in PD when balance impairment results in disability in many activities of daily living. Early detection of postural instability by non-expensive tools that can be widely used in clinical practice is a key factor in the prevention of falls in widespread population and their negative consequences.ObjectiveThis study aimed to investigate the effectiveness of a two-dimensional balance assessment to identify the decline in postural control associated with PD progression.MethodsThis study recruited 55 people with PD, of which 37 were men. Eleven participants were in stage I, twenty-three in stage II, and twenty-one in stage III. According to the Hoehn and Yahr (H&Y) rating scale, three clinical balance tests (Timed Up and Go test, Balance Evaluation Systems Test, and Push and Release test) were carried out in addition to a static stance test recorded by a two-dimensional movement analysis software. Based on kinematic variables generated by the software, a Postural Instability Index (PII) was created, allowing a comparison between its results and those obtained by clinical tests.ResultsThere were differences between sociodemographic variables directly related to PD evolution. Although all tests were correlated with H&Y stages, only the PII was able to differentiate the first three stages of disease evolution (H&Y I and II: p = 0.03; H&Y I and III: p = 0.00001; H&Y II and III: p = 0.02). Other clinical tests were able to differentiate only people in the moderate PD stage (H&Y III).ConclusionBased on the PII index, it was possible to differentiate the postural control decline among the first three stages of PD evolution. This study offers a promising possibility of a low-cost, early identification of subtle changes in postural control in people with PD in clinical practice.
Collapse
Affiliation(s)
- Gabriel Venas Santos
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Faculty of Medical Science, University of São Paulo, São Paulo, Brazil
| | - Matheus Silva d'Alencar
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Faculty of Medical Science, University of São Paulo, São Paulo, Brazil
| | - Andre Frazão Helene
- Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | - Antonio C. Roque
- Department of Physics, School of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Maria Elisa Pimentel Piemonte
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Faculty of Medical Science, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
9
|
Wang H, Hu B, Huang J, Chen L, Yuan M, Tian X, Shi T, Zhao J, Huang W. Predicting the fatigue in Parkinson's disease using inertial sensor gait data and clinical characteristics. Front Neurol 2023; 14:1172320. [PMID: 37388552 PMCID: PMC10303817 DOI: 10.3389/fneur.2023.1172320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/23/2023] [Indexed: 07/01/2023] Open
Abstract
Objectives The study aimed to analyze the clinical features and gait characteristics of patients with Parkinson's disease (PD) who also suffer from fatigue and to develop a model that can help identify fatigue states in the early stages of PD. Methodology A total of 81 PD patients have been enrolled for the Parkinson's Fatigue Scale (PFS-16) assessment and divided into two groups: patients with or without fatigue. Neuropsychological assessments of the two groups, including motor and non-motor symptoms, were collected. The patient's gait characteristics were collected using a wearable inertial sensor device. Results PD patients who experienced fatigue had a more significant impairment of motor symptoms than those who did not, and the experience of fatigue became more pronounced as the disease progressed. Patients with fatigue had more significant mood disorders and sleep disturbances, which can lead to a poorer quality of life. PD patients with fatigue had shorter step lengths, lower velocity, and stride length and increased stride length variability. As for kinematic parameters, PD patients with fatigue had lower shank-forward swing max, trunk-max sagittal angular velocity, and lumbar-max coronal angular velocity than PD patients without fatigue. The binary logistic analysis found that Movement Disorder Society-Unified Parkinson's Disease Rating Scale-I (MDS-UPDRS-I) scores, Hamilton Depression Scale (HAMD) scores, and stride length variability independently predicted fatigue in PD patients. The area under the curve (AUC) of these selected factors in the receiver operating characteristic (ROC) analysis was 0.900. Moreover, HAMD might completely mediate the association between Hamilton Anxiety Scale (HAMA) scores and fatigue (indirect effect: β = 0.032, 95% confidence interval: 0.001-0.062), with a percentage of mediation of 55.46%. Conclusion Combining clinical characteristics and gait cycle parameters, including MDS-UPDRS-I scores, HAMD scores, and stride length variability, can identify PD patients with a high fatigue risk.
Collapse
Affiliation(s)
- Hui Wang
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Binbin Hu
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Juan Huang
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lin Chen
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Min Yuan
- Department of Neurology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Xingfu Tian
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ting Shi
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jiahao Zhao
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Huang
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| |
Collapse
|
10
|
Campo-Prieto P, Cancela-Carral JM, Rodríguez-Fuentes G. Immersive Virtual Reality Reaction Time Test and Relationship with the Risk of Falling in Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094529. [PMID: 37177733 PMCID: PMC10181617 DOI: 10.3390/s23094529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
Immersive virtual reality (IVR) uses customized and advanced software and hardware to create a digital 3D reality in which all of the user's senses are stimulated with computer-generated sensations and feedback. This technology is a promising tool that has already proven useful in Parkinson's disease (PD). The risk of falls is very high in people with PD, and reaction times and processing speed may be markers of postural instability and functionality, cognitive impairment and disease progression. An exploratory study was conducted to explore the feasibility of reaction time tests performed in IVR as predictors of falls. A total of 26 volunteers (79.2% male; 69.73 ± 6.32 years) diagnosed with PD (1.54 ± 0.90 H&Y stage; 26.92 ± 2.64 MMSE) took part in the study. IVR intervention was feasible, with no adverse effects (no Simulator Sickness Questionnaire symptoms). IVR reaction times were related (Spearman's rho) to functionality (timed up and go test (TUG) (rho = 0.537, p = 0.005); TUG-Cognitive (rho = 0.576, p = 0.020); cognitive impairment mini mental state exam (MMSE) (rho = -0.576, p = 0.002)) and the years of the patients (rho = 0.399, p = 0.043) but not with the first PD symptom or disease stage. IVR test is a complementary assessment tool that may contribute to preventing falls in the proposed sample. Additionally, based on the relationship between TUG and reaction times, a cut-off time is suggested that would be effective at predicting the risk of suffering a fall in PD patients using a simple and quick IVR test.
Collapse
Affiliation(s)
- Pablo Campo-Prieto
- Faculty of Physiotherapy, Department of Functional Biology and Health Sciences, University of Vigo, HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, E-36005 Pontevedra, Spain
| | - José Mª Cancela-Carral
- Faculty of Education and Sports Science, Department of Special Didactics, University of Vigo, HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, E-36005 Pontevedra, Spain
| | - Gustavo Rodríguez-Fuentes
- Faculty of Physiotherapy, Department of Functional Biology and Health Sciences, University of Vigo, HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, E-36005 Pontevedra, Spain
| |
Collapse
|
11
|
Sung CB, Danoudis M, Paul E, Iansek R. The Use of Liquid Sinemet in Routine Clinical Practice of Advanced Parkinson's Disease: A Comparison of Available Options. JOURNAL OF PARKINSON'S DISEASE 2023:JPD225117. [PMID: 37092237 DOI: 10.3233/jpd-225117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND Tablet formulations of Parkinson's disease (PD) medications may become ineffective at managing motor fluctuations in advanced PD. The liquid formulation, levodopa carbidopa ascorbic acid solution, or LCAS, is an effective and inexpensive treatment for motor fluctuations however it remains underutilized. OBJECTIVE We compared the efficacy of LCAS with tablet formulations and Duodopa jejunal infusion through routine inpatient management using hourly functional status measures, the Timed Up and Go Test (TUG). The TUG differentiates between 'off' and 'on' states and quantifies motor fluctuations. METHODS Experienced nurses used the TUG times and functional observations recorded hourly throughout the waking day to optimize the LCAS hourly dose and the Duodopa flow rate over several days. When patients were stabilized on each of the interventions, the TUG measures were then recorded to compare the outcomes of the interventions. RESULTS Twenty-six participants had TUG times recorded while on one or more of the formulations: 19 had TUG times recorded on tablets, 23 on LCAS and 10 on Duodopa. TUG times on LCAS and Duodopa were significantly faster compared to tablets (p < 0.0001, p = 0.001 respectively). Severity of dyskinesia was not significantly different between formulations (p = 0.35). Daily dose for the three formulations and the hourly doses for LCAS and Duodopa did not differ significantly (p = 0.37, p = 0.19 respectively). CONCLUSION This report demonstrated the efficacy of LCAS for improving motor complications and its equivalency with Duodopa jejunal infusion.
Collapse
Affiliation(s)
- Chee Boon Sung
- Clinical Research Centre for Movement Disorders and Gait, Parkinson's Foundation Center of Excellence, Monash Health, Kingston Centre, Melbourne, Australia
| | - Mary Danoudis
- Clinical Research Centre for Movement Disorders and Gait, Parkinson's Foundation Center of Excellence, Monash Health, Kingston Centre, Melbourne, Australia
- Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Eldho Paul
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Monash Medical Centre, Clayton, Australia
| | - Robert Iansek
- Clinical Research Centre for Movement Disorders and Gait, Parkinson's Foundation Center of Excellence, Monash Health, Kingston Centre, Melbourne, Australia
- Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences, Monash University, Clayton, Australia
| |
Collapse
|
12
|
Ortega-Bastidas P, Gómez B, Aqueveque P, Luarte-Martínez S, Cano-de-la-Cuerda R. Instrumented Timed Up and Go Test (iTUG)-More Than Assessing Time to Predict Falls: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:3426. [PMID: 37050485 PMCID: PMC10098780 DOI: 10.3390/s23073426] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
The Timed Up and Go (TUG) test is a widely used tool for assessing the risk of falls in older adults. However, to increase the test's predictive value, the instrumented Timed Up and Go (iTUG) test has been developed, incorporating different technological approaches. This systematic review aims to explore the evidence of the technological proposal for the segmentation and analysis of iTUG in elderlies with or without pathologies. A search was conducted in five major databases, following PRISMA guidelines. The review included 40 studies that met the eligibility criteria. The most used technology was inertial sensors (75% of the studies), with healthy elderlies (35%) and elderlies with Parkinson's disease (32.5%) being the most analyzed participants. In total, 97.5% of the studies applied automatic segmentation using rule-based algorithms. The iTUG test offers an economical and accessible alternative to increase the predictive value of TUG, identifying different variables, and can be used in clinical, community, and home settings.
Collapse
Affiliation(s)
- Paulina Ortega-Bastidas
- Health Sciences PhD Programme, International Doctoral School, Universidad Rey Juan Carlos, 28922 Madrid, Spain
- Kinesiology Department, Faculty of Medicine, Universidad de Concepción, Concepción, 151 Janequeo St., Concepcion 4030000, Chile
| | - Britam Gómez
- Biomedical Engineering, Faculty of Engineering, Universidad de Santiago de Chile, Libertador Bernardo O’Higgins Av., Santiago 9170022, Chile
| | - Pablo Aqueveque
- Department of Electrical Engineering, Faculty of Engineering, Universidad de Concepción, 219 Edmundo Larenas St., Concepción 4030000, Chile
| | - Soledad Luarte-Martínez
- Kinesiology Department, Faculty of Medicine, Universidad de Concepción, Concepción, 151 Janequeo St., Concepcion 4030000, Chile
| | - Roberto Cano-de-la-Cuerda
- Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Universidad Rey Juan Carlos, 28922 Madrid, Spain
| |
Collapse
|
13
|
Yoo TK, Lee S, Park SJ, Lee JY. Arterial stiffness expressed as brachial-ankle pulse wave velocity and gait assessment independent of lower extremity strength: a cross-sectional study in the older men population. J Geriatr Cardiol 2023; 20:91-99. [PMID: 36910247 PMCID: PMC9992948 DOI: 10.26599/1671-5411.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Older men are more vulnerable to fatal falls than women, and gait disturbances contribute to the risk of falls. Studies have assessed the association between arterial stiffness and gait dysfunction, but the results have been inconclusive. This study aimed to conduct a cross-sectional analysis to evaluate the association between brachial-ankle pulse wave velocity (baPWV) and gait assessment in older men. METHODS Data from the 2014-2015 Korea Institute of Sport Science Fitness Standards project were used for the analysis. The inclusion criteria were men aged > 65 years with gait assessment [the 30-s chair stand test (30s-CST), the timed up and go (TUG) test, the figure-of-8 walk (F8W) test, the 2-min step test (2MST), and the 6-min walk test (6MWT)] and baPWV measurement data. Generalized linear regression analysis was conducted with multiple confounding factor adjustments, including lower extremity isometric strength. RESULTS A total of 291 participants were included in the analysis. The mean age was 71.38 ± 4.40 years. The mean values were as follows: (1) 30s-CST, 17.48 ± 5.00; (2) TUG test, 6.01 ± 1.10 s; (3) F8W test, 25.65 ± 4.71 s; (4) 2MST, 102.40 ± 18.83 per 2 min; and (5) 6MWT, 500.02 ± 85.65 m. After multivariable adjustment, baPWV was associated with the 6MWT (β = -0.037, 95% CI: -0.072--0.002), TUG test (β = 0, 95% CI: 0.000-0.001), and F8W test (β = 0.002, 95% CI: 0.000-0.004). baPWV was not associated with the 30s-CST and 2MST. CONCLUSIONS The current study showed a statistically significant association between gait assessments and arterial stiffness, independent of lower extremity strength. However, this association was modest. Future prospective studies are needed to elucidate the complex relationship between arterial stiffness and gait dysfunction.
Collapse
Affiliation(s)
- Tae Kyung Yoo
- Department of Medicine, MetroWest Medical Center, Framingham, USA
| | - Seunghee Lee
- Department of Physical Education, Korea University, Seoul, South Korea
| | - Sae-Jong Park
- Division of Sports Science, Korea Institute of Sport Science, Seoul, South Korea
| | - Jong-Young Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| |
Collapse
|
14
|
Lee H, Ko B. Effects of Music-Based Interventions on Motor and Non-Motor Symptoms in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1046. [PMID: 36673802 PMCID: PMC9859027 DOI: 10.3390/ijerph20021046] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
This systematic review and meta-analysis examined previous studies on music-based interventions for individuals with Parkinson’s disease (PD). The effectiveness of the interventions on various motor and non-motor outcomes was evaluated. This review was conducted by searching PubMed, CINAHL, PsycINFO, and Cochrane Library CENTRAL prior to June 2022 for randomized controlled trial (RCT) and controlled clinical trial (CCT) studies published in English. Data were expressed as weighted/standardized mean difference (MD/SMD) with 95% confidence intervals (CI). I2 index was used for heterogeneity. The initial search identified 745 studies, and 13 studies involving 417 participants with PD which met the inclusion criteria included in this review. The results of the meta-analysis revealed that music-based interventions can significantly improve walking velocity (MD = 0.12, 95% CI = 0.07~0.16, p < 0.00001), stride length (MD = 0.04, 95% CI = 0.02~0.07, p = 0.002), and mobility (MD = −1.05, 95% CI = −1.53~−0.57, p < 0.0001). However, the results did not support significant effects for music-based interventions on cadence (MD = 3.21, 95% CI = −4.15~10.57, p = 0.39), cognitive flexibility (MD = 20.91, 95% CI = −10.62~52.44, p = 0.19), inhibition (SMD = 0.07, 95% CI = −0.40~0.55, p = 0.76), and quality of life (SMD = −0.68, 95% CI= −1.68~0.32, p = 0.18). The findings suggest that music-based interventions are effective for the improvement of some motor symptoms, but evidence for non-motor symptoms is limited. Further high-quality studies with a larger sample size are required to obtain the robust effects of music-based interventions on various outcomes among patients with PD.
Collapse
Affiliation(s)
- Hyunjung Lee
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Bumsuk Ko
- Department of Music, Graduate School, Hansei University, Gunpo 15852, Republic of Korea
| |
Collapse
|
15
|
Feng H, Jiang Y, Lin J, Qin W, Jin L, Shen X. Cortical activation and functional connectivity during locomotion tasks in Parkinson's disease with freezing of gait. Front Aging Neurosci 2023; 15:1068943. [PMID: 36967824 PMCID: PMC10032375 DOI: 10.3389/fnagi.2023.1068943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/14/2023] [Indexed: 03/29/2023] Open
Abstract
Background Freezing of gait (FoG) is a severely disabling symptom in Parkinson's disease (PD). The cortical mechanisms underlying FoG during locomotion tasks have rarely been investigated. Objectives We aimed to compare the cerebral haemodynamic response during FoG-prone locomotion tasks in patients with PD and FoG (PD-FoG), patients with PD but without FoG (PD-nFoG), and healthy controls (HCs). Methods Twelve PD-FoG patients, 10 PD-nFoG patients, and 12 HCs were included in the study. Locomotion tasks included normal stepping, normal turning and fast turning ranked as three difficulty levels based on kinematic requirements and probability of provoking FoG. During each task, we used functional near-infrared spectroscopy to capture concentration changes of oxygenated haemoglobin (ΔHBO2) and deoxygenated haemoglobin (ΔHHB) that reflected cortical activation, and recorded task performance time. The cortical regions of interest (ROIs) were prefrontal cortex (PFC), supplementary motor area (SMA), premotor cortex (PMC), and sensorimotor cortex (SMC). Intra-cortical functional connectivity during each task was estimated based on correlation of ΔHBO2 between ROIs. Two-way multivariate ANOVA with task performance time as a covariate was conducted to investigate task and group effects on cerebral haemodynamic responses of ROIs. Z statistics of z-scored connectivity between ROIs were used to determine task and group effects on functional connectivity. Results PD-FoG patients spent a nearly significant longer time completing locomotion tasks than PD-nFoG patients. Compared with PD-nFoG patients, they showed weaker activation (less ΔHBO2) in the PFC and PMC. Compared with HCs, they had comparable ΔHBO2 in all ROIs but more negative ΔHHB in the SMC, whereas PD-nFoG showed SMA and PMC hyperactivity but more negative ΔHHB in the SMC. With increased task difficulty, ΔHBO2 increased in each ROI except in the PFC. Regarding functional connectivity during normal stepping, PD-FoG patients showed positive and strong PFC-PMC connectivity, in contrast to the negative PFC-PMC connectivity observed in HCs. They also had greater PFC-SMC connectivity than the other groups. However, they exhibited decreased SMA-SMC connectivity when task difficulty increased and had lower SMA-PMC connectivity than HCs during fast turning. Conclusion Insufficient compensatory cortical activation and depletion of functional connectivity during complex locomotion in PD-FoG patients could be potential mechanisms underlying FoG. Clinical trial registration Chinese clinical trial registry (URL: http://www.chictr.org.cn, registration number: ChiCTR2100042813).
Collapse
Affiliation(s)
- HongSheng Feng
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - YanNa Jiang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - JinPeng Lin
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - WenTing Qin
- Department of Neurology and Neurological Rehabilitation, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - LingJing Jin
- Department of Neurology and Neurological Rehabilitation, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Xia Shen
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Rehabilitation Medicine Research Center, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Xia Shen,
| |
Collapse
|
16
|
Balance Ability and Occupational Performance in Patients With Parkinson’s Disease and On-Medication-State Freezing of Gait. Rehabil Nurs 2022; 47:138-146. [DOI: 10.1097/rnj.0000000000000365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
Relevance of Sociodemographics and Clinical Tests in Single- and Dual-Task Conditions as Gait Speed Predictors of Parkinson’s Disease. J Clin Med 2022; 11:jcm11030757. [PMID: 35160208 PMCID: PMC8837099 DOI: 10.3390/jcm11030757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/15/2022] [Accepted: 01/27/2022] [Indexed: 02/01/2023] Open
Abstract
This cross-sectional study aimed to identify the patient characteristics and clinical test results that predict the functional gait speed of people with Parkinson’s disease (PD). The impact of dual tasks on gait in Parkinson’s disease (PD) reveals a lack of automaticity and increased cognitive demands. We explored which characteristics explained walking speed with and without dual-task interference and if they reflected the cognitive demands of the task. The preferred gait speed, stride length, and cadence were measured in individuals with PD through five conditions: single-task (ST) and visual, verbal, auditory, and motor dual-tasks (DTs). Sociodemographic and disease characteristics and the results from clinical tests such as the Dynamic Parkinson’s Disease Gait Scale (DYPAGS), Frontal Assessment Battery (FAB), and Parkinson’s Disease Questionnaire-39 (PDQ-39), among others, were also recorded. Two models of multiple regression analysis were used to explore the predictive value of outcomes concerning speed. In Model I, clinical results were included, and in Model II, spatiotemporal variables were added to the significant predictors of Model I. Forty PD patients (aged 66.72 (7.5) years) completed the assessments. All the models generated were significant (p < 0.01). Models I and II accounted for 47% and 93% of the variance, respectively, in the single-task condition. A patient’s gender, prescribed medication (drugs), academic level, and Hoehn and Yahr (H&Y) stage, along with the FAB, DYPAGS, and PDQ-39 scores, were significant predictors of gait speed in Model I for the ST and DT conditions. In Model II, the H&Y stage and prescribed medication (drugs), along with the FAB and DYPAGS scores, remained significant predictors. This research found that sociodemographics, the patient’s stage disease, and their clinical test results contribute to their walking speed, highlighting the multifactorial nature of gait in demanding environments.
Collapse
|
18
|
Dsouza ZL, Rebello SR, Dsilva C. Correlation between community balance and mobility scale (CB&M) with a battery of outcome measures to assess balance in Parkinson's disease - a cross-sectional study. Arch Physiother 2021; 11:25. [PMID: 34749815 PMCID: PMC8576918 DOI: 10.1186/s40945-021-00117-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 09/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evaluating balance in a functional context that integrates challenging tasks frequently performed in the community is essential to identify community-dwelling individuals who are at risk of falls in early Parkinson Disease (PD) than a simple balance measure. Community Balance and Mobility (CB&M) scale is one such measure that evaluates severe deficits in gait, balance, and mobility. The risk of falling and fear of fall is common among PD individuals and this affects the day to day functioning as well as the quality of life. Early identification of individuals who may be at risk to fall will lead to intervention strategies that can help to with balance issues. The aim of this study was to correlate between Community Balance and Mobility with a battery of outcome measures commonly used to assess balance in Parkinson's disease. METHODS A cross sectional study design; with individuals referred to Outpatient physiotherapy department, diagnosed with idiopathic Parkinson's disease, independently mobile and on a stable drug regimen referred by the neurologist; were screened and recruited by convenience sampling. With written informed consent, demographic data gathered and scales such as Berg Balance scale, Community balance & mobility scale, Functional Reach test and Timed up and go test were administered with an ample amount of rest. RESULTS The results obtained were documented and analysed using Karl Pearson's correlation coefficient. Significant correlation between CB&M and BBS (r = 0.795) was found, CB&M and TUG (r = - 0.755), CB&M and FRT (r = 0.772). CONCLUSION CB&M is a useful measure which integrates items that challenge balance in the community context. It has been used to assess high functioning community dwelling individuals and hence may be apt for individuals with early Parkinson's, since the tasks to be performed in CB&M are challenging and these simulate community level activities where the risk of falls is higher. It may well be a good tool to assess early Parkinson's; their level of balance, community level activity and without need for sophisticated & expensive equipment.
Collapse
Affiliation(s)
- Ziona Lionel Dsouza
- Department of Physiotherapy, Ramaiah Medical College Hospital, M S Ramaiah nagar, MSRIT Post, Bangalore, 560054, India
| | - Sydney Roshan Rebello
- Department of Physiotherapy, Father Muller College of Allied Health Sciences, Mangalore, 575002, India.
| | - Cherishma Dsilva
- Department of Physiotherapy, Father Muller College of Allied Health Sciences, Mangalore, 575002, India
| |
Collapse
|
19
|
Pol F, Salehinejad MA, Baharlouei H, Nitsche MA. The effects of transcranial direct current stimulation on gait in patients with Parkinson's disease: a systematic review. Transl Neurodegener 2021; 10:22. [PMID: 34183062 PMCID: PMC8240267 DOI: 10.1186/s40035-021-00245-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/07/2021] [Indexed: 12/01/2022] Open
Abstract
Background Gait problems are an important symptom in Parkinson’s disease (PD), a progressive neurodegenerative disease. Transcranial direct current stimulation (tDCS) is a neuromodulatory intervention that can modulate cortical excitability of the gait-related regions. Despite an increasing number of gait-related tDCS studies in PD, the efficacy of this technique for improving gait has not been systematically investigated yet. Here, we aimed to systematically explore the effects of tDCS on gait in PD, based on available experimental studies. Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, PubMed, Web of Science, Scopus, and PEDro databases were searched for randomized clinical trials assessing the effect of tDCS on gait in patients with PD. Results Eighteen studies were included in this systematic review. Overall, tDCS targeting the motor cortex and supplementary motor area bilaterally seems to be promising for gait rehabilitation in PD. Studies of tDCS targeting the dorosolateral prefrontal cortex or cerebellum showed more heterogeneous results. More studies are needed to systematically compare the efficacy of different tDCS protocols, including protocols applying tDCS alone and/or in combination with conventional gait rehabilitation treatment in PD. Conclusions tDCS is a promising intervention approach to improving gait in PD. Anodal tDCS over the motor areas has shown a positive effect on gait, but stimulation of other areas is less promising. However, the heterogeneities of methods and results have made it difficult to draw firm conclusions. Therefore, systematic explorations of tDCS protocols are required to optimize the efficacy.
Collapse
Affiliation(s)
- Fateme Pol
- Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Hamzeh Baharlouei
- Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| |
Collapse
|
20
|
de Oliveira MPB, Lobato DFM, Smaili SM, Carvalho C, Borges JBC. Effect of aerobic exercise on functional capacity and quality of life in individuals with Parkinson's disease: A systematic review of randomized controlled trials. Arch Gerontol Geriatr 2021; 95:104422. [PMID: 33932826 DOI: 10.1016/j.archger.2021.104422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/08/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the effect of aerobic exercise (AE) on functional capacity and quality of life in individuals with Parkinson's disease (PD) in the mild to moderate stages. DATA SOURCES Medline, Embase, Web of Science, The Cochrane Library, Lilacs and PEDro were searched from inception until January 2021 using the MeSH terms. STUDY SELECTION Studies conducted in individuals with PD involving AE compared to a control group were included. DATA EXTRACTION Characteristics of the studies were independently extracted by two reviewers. The PEDro scale was used to assess the methodological quality, and the level of evidence was analyzed and synthesized using the GRADE approach. DATA SYNTHESIS Of the ten studies, 411 individuals with PD were included. The level of synthesized evidence for cardiorespiratory function was low and without effect, and very low and without effect. For gait was very low and with effect for speed and stride length and without effect for cadence. For mobility was very low and with effect. For muscle strength was very low and with effect for the lower limbs as well as without effect for the upper limbs. For postural balance was very low and without effect. For quality of life was low and without effect. CONCLUSION Aerobic exercise was capable of promoting improvements in gait (walking speed and stride length), mobility, and lower limb muscle strength in individuals with PD in the mild to moderate stages. No significant improvement in quality of life was found due to the practice of AE.
Collapse
Affiliation(s)
- Marcos Paulo Braz de Oliveira
- Federal University of São Carlos, Physical Therapy Department, Healthy Aging Research Laboratory, São Carlos/SP, Brazil.
| | - Daniel Ferreira Moreira Lobato
- Federal University of Mineiro Triangle, Applied Physical Therapy Department, Human Movement Analysis Laboratory, Uberaba/MG, Brazil
| | - Suhaila Mahmoud Smaili
- State University of Londrina, Physical Therapy Department, Neurofunctional Physical Therapy Research Group, Londrina/PR, Brazil
| | - Cristiano Carvalho
- Federal University of São Carlos, Physical Therapy Department, Rheumatology and Hand Rehabilitation Research Laboratory, São Carlos/SP, Brazil
| | | |
Collapse
|
21
|
Niswander W, Wang W, Kontson K. Optimization of IMU Sensor Placement for the Measurement of Lower Limb Joint Kinematics. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5993. [PMID: 33105876 PMCID: PMC7660215 DOI: 10.3390/s20215993] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/25/2020] [Accepted: 10/15/2020] [Indexed: 12/24/2022]
Abstract
There is an increased interest in using wearable inertial measurement units (IMUs) in clinical contexts for the diagnosis and rehabilitation of gait pathologies. Despite this interest, there is a lack of research regarding optimal sensor placement when measuring joint kinematics and few studies which examine functionally relevant motions other than straight level walking. The goal of this clinical measurement research study was to investigate how the location of IMU sensors on the lower body impact the accuracy of IMU-based hip, knee, and ankle angular kinematics. IMUs were placed on 11 different locations on the body to measure lower limb joint angles in seven participants performing the timed-up-and-go (TUG) test. Angles were determined using different combinations of IMUs and the TUG was segmented into different functional movements. Mean bias and root mean square error values were computed using generalized estimating equations comparing IMU-derived angles to a reference optical motion capture system. Bias and RMSE values vary with the sensor position. This effect is partially dependent on the functional movement analyzed and the joint angle measured. However, certain combinations of sensors produce lower bias and RMSE more often than others. The data presented here can inform clinicians and researchers of placement of IMUs on the body that will produce lower error when measuring joint kinematics for multiple functionally relevant motions. Optimization of IMU-based kinematic measurements is important because of increased interest in the use of IMUs to inform diagnose and rehabilitation in clinical settings and at home.
Collapse
Affiliation(s)
- Wesley Niswander
- Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA;
| | - Wei Wang
- Division of Clinical Evidence and Analysis 2, Office of Clinical Evidence and Analysis, Office of Product Evaluation and Quality, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA;
| | - Kimberly Kontson
- Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA;
| |
Collapse
|