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Avila C, Sarter M. Cortico-striatal action control inherent of opponent cognitive-motivational styles. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.12.584623. [PMID: 38559086 PMCID: PMC10979997 DOI: 10.1101/2024.03.12.584623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Turning on cue or stopping at a red light requires the detection of such cues to select action sequences, or suppress action, in accordance with cue-associated action rules. Cortico-striatal projections are an essential part of the brain's attention-motor interface. Glutamate-sensing microelectrode arrays were used to measure glutamate transients in the dorsomedial striatum (DMS) of male and female rats walking a treadmill and executing cued turns and stops. Prelimbic-DMS projections were chemogenetically inhibited to determine their behavioral necessity and the cortico-striatal origin of cue-evoked glutamate transients. Furthermore, we investigated rats exhibiting preferably goal-directed (goal trackers, GTs) versus cue-driven attention (sign trackers, STs), to determine the impact of such cognitive-motivational biases on cortico-striatal control. GTs executed more cued turns and initiated such turns more slowly than STs. During turns, but not missed turns or cued stops, cue-evoked glutamate concentrations were higher in GTs than in STs. In conjunction with turn cue-evoked glutamate spike levels, the presence of a single spike rendered GTs to be almost twice as likely to turn than STs. In contrast, multiple glutamate spikes predicted GTs to be less likely to turn than STs. In GTs, but not STs, inhibition of prelimbic-DMS projections attenuated turn rates, turn cue-evoked glutamate peaks, and increased the number of spikes. These findings suggest that turn cue-evoked glutamate release in GTs is tightly controlled by cortico-striatal neuronal activity. In contrast, in STs, glutamate release from DMS glutamatergic terminals may be regulated by other striatal circuitry, preferably mediating cued suppression of action and reward tracking.
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Affiliation(s)
- Cassandra Avila
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Martin Sarter
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Department of Psychology & Neuroscience Program, University of Michigan, Ann Arbor, MI, USA
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Netukova S, Horakova L, Szabo Z, Krupicka R. Beyond timing and step counting in 360° turning-in-place assessment: a scoping review. Biomed Eng Online 2024; 23:13. [PMID: 38297359 PMCID: PMC10832107 DOI: 10.1186/s12938-024-01208-0] [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: 10/20/2023] [Accepted: 01/22/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Turning in place is a challenging motor task and is used as a brief assessment test of lower limb function and dynamic balance. This review aims to examine how research of instrumented analysis of turning in place is implemented. In addition to reporting the studied population, we covered acquisition systems, turn detection methods, quantitative parameters, and how these parameters are computed. METHODS Following the development of a rigorous search strategy, the Web of Science and Scopus were systematically searched for studies involving the use of turning-in-place. From the selected articles, the study population, types of instruments used, turn detection method, and how the turning-in-place characteristics were calculated. RESULTS Twenty-one papers met the inclusion criteria. The subject groups involved in the reviewed studies included young, middle-aged, and older adults, stroke, multiple sclerosis and Parkinson's disease patients. Inertial measurement units (16 studies) and motion camera systems (5 studies) were employed for gathering measurement data, force platforms were rarely used (2 studies). Two studies used commercial software for turn detection, six studies referenced previously published algorithms, two studies developed a custom detector, and eight studies did not provide any details about the turn detection method. The most frequently used parameters were mean angular velocity (14 cases, 7 studies), turn duration (13 cases, 13 studies), peak angular velocity (8 cases, 8 studies), jerkiness (6 cases, 5 studies) and freezing-of-gait ratios (5 cases, 5 studies). Angular velocities were derived from sensors placed on the lower back (7 cases, 4 studies), trunk (4 cases, 2 studies), and shank (2 cases, 1 study). The rest (9 cases, 8 studies) did not report sensor placement. Calculation of the freezing-of-gait ratio was based on the acceleration of the lower limbs in all cases. Jerkiness computation employed acceleration in the medio-lateral (4 cases) and antero-posterior (1 case) direction. One study did not reported any details about jerkiness computation. CONCLUSION This review identified the capabilities of turning-in-place assessment in identifying movement differences between the various subject groups. The results, based on data acquired by inertial measurement units across studies, are comparable. A more in-depth analysis of tests developed for gait, which has been adopted in turning-in-place, is needed to examine their validity and accuracy.
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Affiliation(s)
- Slavka Netukova
- Faculty of Biomedical Engineering, Department of Biomedical Informatics, Czech Technical University, Nam Sitna 3105, Prague, Czech Republic.
| | - Lucie Horakova
- Faculty of Biomedical Engineering, Department of Biomedical Informatics, Czech Technical University, Nam Sitna 3105, Prague, Czech Republic
| | - Zoltan Szabo
- Faculty of Biomedical Engineering, Department of Biomedical Informatics, Czech Technical University, Nam Sitna 3105, Prague, Czech Republic
| | - Radim Krupicka
- Faculty of Biomedical Engineering, Department of Biomedical Informatics, Czech Technical University, Nam Sitna 3105, Prague, Czech Republic
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Hulzinga F, Seuthe J, D'Cruz N, Ginis P, Nieuwboer A, Schlenstedt C. Split-Belt Treadmill Training to Improve Gait Adaptation in Parkinson's Disease. Mov Disord 2023; 38:92-103. [PMID: 36239376 DOI: 10.1002/mds.29238] [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: 07/07/2022] [Revised: 09/04/2022] [Accepted: 09/14/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Gait deficits in people with Parkinson's disease (PD) are triggered by circumstances requiring gait adaptation. The effects of gait adaptation training on a split-belt treadmill (SBT) are unknown in PD. OBJECTIVE We investigated the effects of repeated SBT versus tied-belt treadmill (TBT) training on retention and automaticity of gait adaptation and its transfer to over-ground walking and turning. METHODS We recruited 52 individuals with PD, of whom 22 were freezers, in a multi-center randomized single-blind controlled study. Training consisted of 4 weeks of supervised treadmill training delivered three times per week. Tests were conducted pre- and post-training and at 4-weeks follow-up. Turning (primary outcome) and gait were assessed over-ground and during a gait adaptation protocol on the treadmill. All tasks were performed with and without a cognitive task. RESULTS We found that SBT-training improved gait adaptation with moderate to large effects sizes (P < 0.02) compared to TBT, effects that were sustained at follow-up and during dual tasking. However, better gait adaptation did not transfer to over-ground turning speed. In both SBT- and TBT-arms, over-ground walking and Movement Disorder Society-Unified Parkinson's Disease Rating Scale III (MDS-UPDRS-III scores were improved, the latter of which reached clinically meaningful effects in the SBT-group only. No impact was found on freezing of gait. CONCLUSION People with PD are able to learn and retain the ability to overcome asymmetric gait-speed perturbations on a treadmill remarkably well, but seem unable to generalize these skills to asymmetric gait off-treadmill. Future study is warranted into gait adaptation training to boost the transfer of complex walking skills. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Femke Hulzinga
- Department of Rehabilitation Sciences, Neurorehabilitation Research Group, KU Leuven, Leuven, Belgium
| | - Jana Seuthe
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany.,Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Nicholas D'Cruz
- Department of Rehabilitation Sciences, Neurorehabilitation Research Group, KU Leuven, Leuven, Belgium
| | - Pieter Ginis
- Department of Rehabilitation Sciences, Neurorehabilitation Research Group, KU Leuven, Leuven, Belgium
| | - Alice Nieuwboer
- Department of Rehabilitation Sciences, Neurorehabilitation Research Group, KU Leuven, Leuven, Belgium
| | - Christian Schlenstedt
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany.,Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Soke F, Erkoc Ataoglu NE, Ozcan Gulsen E, Yilmaz O, Gulsen C, Kocer B, Kirteke F, Basturk S, Comoglu SS, Tokcaer AB. The psychometric properties of the figure-of-eight walk test in people with Parkinson's disease. Disabil Rehabil 2023; 45:301-309. [PMID: 35191344 DOI: 10.1080/09638288.2022.2028020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To investigate: (1) the interrater, and test-retest reliability of the figure-of-eight walk test (F8WT) in people with Parkinson's disease (PwPD); (2) the minimum detectable change in the F8WT times; (3) the concurrent and known-groups validity of the F8WT times; and (4) the cut-off times that best discriminate PwPD from healthy people and fallers from non-fallers with PD. METHODS This was a cross-sectional study. Forty-three PwPD and 34 healthy people were recruited. The F8WT was performed along with the timed up and go test, 10 m walk test, Berg Balance Scale, Activities-Specific Balance Confidence Scale, Unified Parkinson's disease Rating Scale, and Hoehn and Yahr Scale. RESULTS The F8WT showed good interrater and test-retest reliability (ICC = 0.964-0.978 and ICC = 0.905-0.920, respectively). The MDC was 2.77 s. The F8WT was correlated with other outcome measures. Significant differences in the F8WT times were found between PwPD and healthy people and between fallers and non-fallers with PD (p < 0.001 and p < 0.001, respectively). The cut-off times of 8.43 s best discriminated PwPD from healthy people, while 11.19 s best discriminated fallers from non-fallers with PD. CONCLUSIONS The F8WT is a reliable, valid, and easy-to-administer tool in assessing the walking skill of PwPD.Implications for rehabilitationThe figure-of-eight walk test (F8WT) is a reliable, valid, and clinically available tool for assessing walking skill in Parkinson's disease (PD).The minimal detectable change of the F8WT is 2.77 s, which may help to determine any real change in walking skill after any intervention.The F8WT correlated with functional mobility, gait speed, balance, balance confidence, and severity and stage of PD.The F8WT times may detect impaired walking skill between people with PD and healthy people, and between fallers and non-fallers with PD.
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Affiliation(s)
- Fatih Soke
- Department of Physiotherapy and Rehabilitation, Gulhane Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | | | - Elvan Ozcan Gulsen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Yuksek Ihtisas University, Ankara, Turkey
| | - Oznur Yilmaz
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cagri Gulsen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Bilge Kocer
- Department of Neurology, Diskapi Yildirim Beyazit Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Fatos Kirteke
- Department of Ergotherapy, Faculty of Health Sciences, Fenerbahce University, Istanbul, Turkey
| | - Sultan Basturk
- Kanalboyu Physical Therapy and Rehabilitation Medical Center, Malatya, Turkey
| | - Selim Selcuk Comoglu
- Department of Neurology, Diskapi Yildirim Beyazit Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ayse Bora Tokcaer
- Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Alberts JL, Kaya RD, Scelina K, Scelina L, Zimmerman EM, Walter BL, Rosenfeldt AB. Digitizing a Therapeutic: Development of an Augmented Reality Dual-Task Training Platform for Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2022; 22:8756. [PMID: 36433353 PMCID: PMC9694181 DOI: 10.3390/s22228756] [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: 09/21/2022] [Revised: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Augmented reality (AR) may be a useful tool for the delivery of dual-task training. This manuscript details the development of the Dual-task Augmented Reality Treatment (DART) platform for individuals with Parkinson's disease (PD) and reports initial feasibility, usability, and efficacy of the DART platform in provoking dual-task interference in individuals with PD. The DART platform utilizes the head-mounted Microsoft HoloLens2 AR device to deliver concurrent motor and cognitive tasks. Biomechanical metrics of gait and cognitive responses are automatically computed and provided to the supervising clinician. To assess feasibility, individuals with PD (N = 48) completed a bout of single-task and dual-task walking using the DART platform. Usability was assessed by the System Usability Scale (SUS). Dual-task interference was assessed by comparing single-task walking and walking during an obstacle course while performing a cognitive task. Average gait velocity decreased from 1.06 to 0.82 m/s from single- to dual-task conditions. Mean SUS scores were 81.3 (11.3), which placed the DART in the "good" to "excellent" category. To our knowledge, the DART platform is the first to use a head-mounted AR system to deliver a dual-task paradigm and simultaneously provide biomechanical data that characterize cognitive and motor performance. Individuals with PD were able to successfully use the DART platform with satisfaction, and dual-task interference was provoked. The DART platform should be investigated as a platform to treat dual-task declines associated with PD.
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Affiliation(s)
- Jay L. Alberts
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA
| | - Ryan D. Kaya
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA
| | - Kathryn Scelina
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA
| | - Logan Scelina
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA
| | - Eric M. Zimmerman
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA
| | - Benjamin L. Walter
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA
| | - Anson B. Rosenfeldt
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA
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Soke F, Demirkaya S, Gulsen C, Yavuz N, Karakoc S, Ozcan Gulsen E, Yilmaz O, Kocer B, Kurtulus Aydin F, Yucesan C. The figure-of-eight walk test is a reliable and valid test for assessing walking skill in people with multiple sclerosis. Mult Scler Relat Disord 2022; 67:104099. [PMID: 35969935 DOI: 10.1016/j.msard.2022.104099] [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: 03/02/2022] [Revised: 07/30/2022] [Accepted: 08/08/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND The ability to turn while walking is essential for people's activities of daily living. Difficulties in turning while walking are commonly shown in people with multiple sclerosis (PwMS). The figure-of-eight walk test (F8W) is a clinical test assessing walking skill in a curved pathway; however, its reliability and validity have not been systematically examined for PwMS. PURPOSES The study is aimed to investigate: (1) the test-retest reliability of the F8W in PwMS; (2) the standard error of measurement and minimum detectable change in the F8W times; (3) the concurrent and known-groups validity of the F8W times; and (4) the cut-off times that best discriminate fallers from non-fallers with MS. METHOD This cross-sectional study included 41 PwMS and 33 healthy people. The F8W was performed along with the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), Activities-specific Balance Confidence Scale (ABC), and Expanded Disability Status Scale (EDSS). To determine the test-retest reliability, the F8W was conducted twice, 7-10 days apart. The reliability was assessed using the intraclass correlation coefficient (ICC), Bland-Altman plots, standard error of measurement (SEM), and minimal detectable change (MDC). To examine validity, the correlations between the F8W and the TUG, BBS, ABC, and EDSS were assessed using correlation coefficients, and the completion times of the F8W were compared between PwMS and healthy people, and between fallers and non-fallers with MS. The receiver operating characteristic curve was constructed to determine the optimal F8W cut-off time discriminating fallers from non-fallers with MS. RESULTS The F8W had excellent test-retest reliability with an ICC of 0.916. Bland-Altman plots showed high agreement between sessions. The SEM and MDC were found to be 0.45 and 1.25, respectively. The F8W indicated a moderate to strong correlation with other outcome measures (correlation coefficients ranged from -0.596 to 0.839, p<0.05). On the F8W, PwMS had a longer time than healthy people while fallers had a longer time than non-fallers with MS (p<0.001, and p<0.001, respectively). The cut-off time of 8.52 s best discriminated the fallers from non-fallers with MS. CONCLUSIONS The F8W is a reliable and clinically available measurement tool for walking skill in PwMS.
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Affiliation(s)
- Fatih Soke
- University of Health Sciences, Gulhane Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Emrah Neighborhood, Etlik/Kecioren, Ankara 06018, Turkey.
| | - Seref Demirkaya
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Neurology, Ankara, Turkey
| | - Cagri Gulsen
- Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Numan Yavuz
- University of Health Sciences, Gulhane Institute of Health Sciences, Ankara, Turkey
| | - Selda Karakoc
- University of Health Sciences, Gulhane Institute of Health Sciences, Ankara, Turkey
| | - Elvan Ozcan Gulsen
- Anadolu University, Vocational School of Health Services, Elderly Care Program, Eskisehir, Turkey
| | - Oznur Yilmaz
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Bilge Kocer
- University of Health Sciences, Diskapi Yildirim Beyazit Teaching and Research Hospital, Department of Neurology, Ankara, Turkey
| | - Fatma Kurtulus Aydin
- University of Health Sciences, Diskapi Yildirim Beyazit Teaching and Research Hospital, Department of Neurology, Ankara, Turkey
| | - Canan Yucesan
- Ankara University, Faculty of Medicine, Department of Neurology, Ankara, Turkey
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Chen PH, Yang YY, Liao YY, Cheng SJ, Wang PN, Cheng FY. Factors Associated with Fear of Falling in Individuals with Different Types of Mild Cognitive Impairment. Brain Sci 2022; 12:brainsci12080990. [PMID: 35892431 PMCID: PMC9332262 DOI: 10.3390/brainsci12080990] [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: 07/05/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 12/10/2022] Open
Abstract
Mild cognitive impairment (MCI) is considered an intermediate state between normal aging and early dementia. Fear of falling (FOF) could be considered a risk indicator for falls and quality of life in individuals with MCI. Our objective was to explore factors associated with FOF in those with MCI due to Alzheimer’s disease (AD-MCI) and mild cognitive impairment in Parkinson’s disease (PD-MCI). Seventy-one participants were separated into two groups, AD-MCI (n = 37) and PD-MCI (n = 34), based on the disease diagnosis. FOF was assessed using the Activities-specific Balance Confidence scale. The neuropsychological assessment and gait assessment were also measured. FOF was significantly correlated with global cognitive function, attention and working memory, executive function, Tinetti assessment scale scores, gait speed, and stride length in the AD-MCI group. Moreover, attention and working memory were the most important factors contributing to FOF. In the PD-MCI group, FOF was significantly correlated with gait speed, and time up and go subtask performance. Furthermore, turn-to-walk was the most important factor contributing to FOF. We noted that FOF in different types of MCI was determined by different factors. Therapies that aim to lower FOF in AD-MCI and PD-MCI populations may address attention and working memory and turn-to-walk, respectively.
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Affiliation(s)
- Pei-Hao Chen
- Department of Neurology, MacKay Memorial Hospital, Taipei 104, Taiwan; (P.-H.C.); (S.-J.C.)
- Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan
- Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei 106, Taiwan
| | - Ya-Yuan Yang
- Institute of Long-Term Care, MacKay Medical College, New Taipei City 252, Taiwan;
- Kaifeng Minquan Day Care Center, Taipei 104, Taiwan
| | - Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
| | - Shih-Jung Cheng
- Department of Neurology, MacKay Memorial Hospital, Taipei 104, Taiwan; (P.-H.C.); (S.-J.C.)
- Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Pei-Ning Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Department of Neurology, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Fang-Yu Cheng
- Institute of Long-Term Care, MacKay Medical College, New Taipei City 252, Taiwan;
- Correspondence: ; Tel.: +886-226-360-303
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The Microsoft HoloLens 2 Provides Accurate Measures of Gait, Turning, and Functional Mobility in Healthy Adults. SENSORS 2022; 22:s22052009. [PMID: 35271156 PMCID: PMC8914774 DOI: 10.3390/s22052009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 01/27/2023]
Abstract
Augmented-reality (AR) headsets, such as the Microsoft HoloLens 2 (HL2), have the potential to be the next generation of wearable technology as they provide interactive digital stimuli in the context of ecologically-valid daily activities while containing inertial measurement units (IMUs) to objectively quantify the movements of the user. A necessary precursor to the widespread utilization of the HL2 in the fields of movement science and rehabilitation is the rigorous validation of its capacity to generate biomechanical outcomes comparable to gold standard outcomes. This project sought to determine equivalency of kinematic outcomes characterizing lower-extremity function derived from the HL2 and three-dimensional (3D) motion capture systems (MoCap). Sixty-six healthy adults completed two lower-extremity tasks while kinematic data were collected from the HL2 and MoCap: (1) continuous walking and (2) timed up-and-go (TUG). For all the continuous walking metrics (cumulative distance, time, number of steps, step and stride length, and velocity), equivalence testing indicated that the HL2 and MoCap were statistically equivalent (error ≤ 5%). The TUG metrics, including turn duration and turn velocity, were also statistically equivalent between the two systems. The accurate quantification of gait and turning using a wearable such as the HL2 provides initial evidence for its use as a platform for the development and delivery of gait and mobility assessments, including the in-person and remote delivery of highly salient digital movement assessments and rehabilitation protocols.
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Hsu YC, Wang H, Zhao Y, Chen F, Tsui KL. Automatic Recognition and Analysis of Balance Activity in Community-Dwelling Older Adults: Algorithm Validation. J Med Internet Res 2021; 23:e30135. [PMID: 34932008 PMCID: PMC8726020 DOI: 10.2196/30135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/23/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Clinical mobility and balance assessments identify older adults who have a high risk of falls in clinics. In the past two decades, sensors have been a popular supplement to mobility and balance assessment to provide quantitative information and a cost-effective solution in the community environment. Nonetheless, the current sensor-based balance assessment relies on manual observation or motion-specific features to identify motions of research interest. OBJECTIVE The objective of this study was to develop an automatic motion data analytics framework using signal data collected from an inertial sensor for balance activity analysis in community-dwelling older adults. METHODS In total, 59 community-dwelling older adults (19 males and 40 females; mean age = 81.86 years, SD 6.95 years) were recruited in this study. Data were collected using a body-worn inertial measurement unit (including an accelerometer and a gyroscope) at the L4 vertebra of each individual. After data preprocessing and motion detection via a convolutional long short-term memory (LSTM) neural network, a one-class support vector machine (SVM), linear discriminant analysis (LDA), and k-nearest neighborhood (k-NN) were adopted to classify high-risk individuals. RESULTS The framework developed in this study yielded mean accuracies of 87%, 86%, and 89% in detecting sit-to-stand, turning 360°, and stand-to-sit motions, respectively. The balance assessment classification showed accuracies of 90%, 92%, and 86% in classifying abnormal sit-to-stand, turning 360°, and stand-to-sit motions, respectively, using Tinetti Performance Oriented Mobility Assessment-Balance (POMA-B) criteria by the one-class SVM and k-NN. CONCLUSIONS The sensor-based approach presented in this study provided a time-effective manner with less human efforts to identify and preprocess the inertial signal and thus enabled an efficient balance assessment tool for medical professionals. In the long run, the approach may offer a flexible solution to relieve the community's burden of continuous health monitoring.
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Affiliation(s)
- Yu-Cheng Hsu
- School of Data Science, City University of Hong Kong, Kowloon, Hong Kong
| | - Hailiang Wang
- School of Design, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Yang Zhao
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, China
| | - Frank Chen
- Department of Management Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Kwok-Leung Tsui
- School of Data Science, City University of Hong Kong, Kowloon, Hong Kong.,Grado Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
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Sarter M, Avila C, Kucinski A, Donovan E. Make a Left Turn: Cortico-Striatal Circuitry Mediating the Attentional Control of Complex Movements. Mov Disord 2021; 36:535-546. [PMID: 33615556 DOI: 10.1002/mds.28532] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND In movement disorders such as Parkinson's disease (PD), cholinergic signaling is disrupted by the loss of basal forebrain cholinergic neurons, as well as aberrant activity in striatal cholinergic interneurons (ChIs). Several lines of evidence suggest that gait imbalance, a key disabling symptom of PD, may be driven by alterations in high-level frontal cortical and cortico-striatal processing more typically associated with cognitive dysfunction. METHODS Here we describe the corticostriatal circuitry that mediates the cognitive-motor interactions underlying such complex movement control. The ability to navigate dynamic, obstacle-rich environments requires the continuous integration of information about the environment with movement selection and sequencing. The cortical-attentional processing of extero- and interoceptive cues requires modulation by cholinergic activity to guide striatal movement control. Cue-derived information is "transferred" to striatal circuitry primarily via fronto-striatal glutamatergic projections. RESULT Evidence from parkinsonian fallers and from a rodent model reproducing the dual cholinergic-dopaminergic losses observed in these patients supports the main hypotheses derived from this neuronal circuitry-guided conceptualization of parkinsonian falls. Furthermore, in the striatum, ChIs constitute a particularly critical node for the integration of cortical with midbrain dopaminergic afferents and thus for cues to control movements. CONCLUSION Procholinergic treatments that enhance or rescue cortical and striatal mechanisms may improve complex movement control in parkinsonian fallers and perhaps also in older persons suffering from gait disorders and a propensity for falls. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Martin Sarter
- Department of Psychology & Neuroscience Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Cassandra Avila
- Department of Psychology & Neuroscience Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Aaron Kucinski
- Department of Psychology & Neuroscience Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Eryn Donovan
- Department of Psychology & Neuroscience Program, University of Michigan, Ann Arbor, Michigan, USA
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11
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Reduction of falls in a rat model of PD falls by the M1 PAM TAK-071. Psychopharmacology (Berl) 2021; 238:1953-1964. [PMID: 33735392 PMCID: PMC7969347 DOI: 10.1007/s00213-021-05822-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/08/2021] [Indexed: 01/03/2023]
Abstract
RATIONALE In addition to the disease-defining motor symptoms, patients with Parkinson's disease (PD) exhibit gait dysfunction, postural instability, and a propensity for falls. These dopamine (DA) replacement-resistant symptoms in part have been attributed to loss of basal forebrain (BF) cholinergic neurons and, in interaction with striatal dopamine (DA) loss, to the resulting disruption of the attentional control of balance and complex movements. Rats with dual cholinergic-DA losses ("DL rats") were previously demonstrated to model PD falls and associated impairments of gait and balance. OBJECTIVES We previously found that the muscarinic M1-positive allosteric modulator (PAM) TAK-071 improved the attentional performance of rats with BF cholinergic losses. Here, we tested the hypotheses that TAK-071 reduces fall rates in DL rats. RESULTS Prior to DL surgery, female rats were trained to traverse a rotating straight rod as well as a rod with two zigzag segments. DL rats were refamiliarized with such traversals post-surgery and tested over 7 days on increasingly demanding testing conditions. TAK-071 (0.1, 0.3 mg/kg, p.o.) was administered prior to daily test sessions over this 7-day period. As before, DL rats fell more frequently than sham-operated control rats. Treatment of DL rats with TAK-071 reduced falls from the rotating rod and the rotating zigzag rod, specifically when the angled part of the zigzag segment, upon entering, was at a steep, near vertical angle. CONCLUSIONS TAK-071 may benefit complex movement control, specifically in situations which disrupt the patterning of forward movement and require the interplay between cognitive and motor functions to modify movement based on information about the state of dynamic surfaces, balance, and gait.
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Effects of whole-body vibration on motor function in patients with Parkinson’s disease: a systematic review and meta-analysis. BRAIN IMPAIR 2020. [DOI: 10.1017/brimp.2020.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To review the effects of whole body vibration for patients with Parkinson’s disease.Design:Randomized clinical trials comparing whole body vibration with no vibration or conventional physical therapy for patients with Parkinson’s disease were searched up to July 31, 2019.Results:Seven studies with 196 patients were included for quantitative analysis. No significant difference was found between groups in motor score of unified Parkinson’s disease rating scale (UPDRS-III) (WMD [weighted mean difference] = −1.75, 95% CI, −5.40 to 1.90, I2 = 45.8%), functional reach test (SMD [standardized mean difference] = 0.21, 95% CI, −0.29 to 0.71; I2 = 0%), and other balance tests (including Berg balance test and Tinetti score) (SMD = 0.39, 95% CI, −0.01 to 0.80; I2 = 0%). No statistical difference was detected in walking velocity as well (WMD = −0.05, 95% CI, −0.17 to 0.06; I2 = 0%). In contrast, the pooled analysis from four studies on the Time Up and Go test showed favorable results for whole body vibration (WMD = −1.59, 95% CI, −2.90 to −0.28, I2 = 0%).Conclusion:Whole body vibration may not be beneficial over placebo or conventional physical therapy in overall motor function, balance, and walking velocity in patients with Parkinson’s disease. However, it might have positive effects on sit to stand transitions or turning.
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13
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Rehman RZU, Klocke P, Hryniv S, Galna B, Rochester L, Del Din S, Alcock L. Turning Detection During Gait: Algorithm Validation and Influence of Sensor Location and Turning Characteristics in the Classification of Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5377. [PMID: 32961799 PMCID: PMC7570702 DOI: 10.3390/s20185377] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/11/2020] [Accepted: 09/16/2020] [Indexed: 12/24/2022]
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder resulting in a range of mobility deficits affecting gait, balance and turning. In this paper, we present: (i) the development and validation of an algorithm to detect turns during gait; (ii) a method to extract turn characteristics; and (iii) the classification of PD using turn characteristics. Thirty-seven people with PD and 56 controls performed 180-degree turns during an intermittent walking task. Inertial measurement units were attached to the head, neck, lower back and ankles. A turning detection algorithm was developed and validated by two raters using video data. Spatiotemporal and signal-based characteristics were extracted and used for PD classification. There was excellent absolute agreement between the rater and the algorithm for identifying turn start and end (ICC ≥ 0.99). Classification modeling (partial least square discriminant analysis (PLS-DA)) gave the best accuracy of 97.85% when trained on upper body and ankle data. Balanced sensitivity (97%) and specificity (96.43%) were achieved using turning characteristics from the neck, lower back and ankles. Turning characteristics, in particular angular velocity, duration, number of steps, jerk and root mean square distinguished mild-moderate PD from controls accurately and warrant future examination as a marker of mobility impairment and fall risk in PD.
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Affiliation(s)
- Rana Zia Ur Rehman
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; (R.Z.U.R.); (B.G.); (L.R.); (S.D.D.)
- Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (P.K.); (S.H.)
| | - Philipp Klocke
- Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (P.K.); (S.H.)
- Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Sofia Hryniv
- Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (P.K.); (S.H.)
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
| | - Brook Galna
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; (R.Z.U.R.); (B.G.); (L.R.); (S.D.D.)
- Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (P.K.); (S.H.)
- School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Lynn Rochester
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; (R.Z.U.R.); (B.G.); (L.R.); (S.D.D.)
- Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (P.K.); (S.H.)
- The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne NE1 1AA, UK
| | - Silvia Del Din
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; (R.Z.U.R.); (B.G.); (L.R.); (S.D.D.)
- Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (P.K.); (S.H.)
| | - Lisa Alcock
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; (R.Z.U.R.); (B.G.); (L.R.); (S.D.D.)
- Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (P.K.); (S.H.)
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Complex Movement Control in a Rat Model of Parkinsonian Falls: Bidirectional Control by Striatal Cholinergic Interneurons. J Neurosci 2020; 40:6049-6067. [PMID: 32554512 DOI: 10.1523/jneurosci.0220-20.2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 01/18/2023] Open
Abstract
Older persons and, more severely, persons with Parkinson's disease (PD) exhibit gait dysfunction, postural instability and a propensity for falls. These dopamine (DA) replacement-resistant symptoms are associated with losses of basal forebrain and striatal cholinergic neurons, suggesting that falls reflect disruption of the corticostriatal transfer of movement-related cues and their striatal integration with movement sequencing. To advance a rodent model of the complex movement deficits of Parkinsonian fallers, here we first demonstrated that male and female rats with dual cortical cholinergic and striatal DA losses (DL rats) exhibit cued turning deficits, modeling the turning deficits seen in these patients. As striatal cholinergic interneurons (ChIs) are positioned to integrate movement cues with gait, and as ChI loss has been associated with falls in PD, we next used this task, as well as a previously established task used to reveal heightened fall rates in DL rats, to broadly test the role of ChIs. Chemogenetic inhibition of ChIs in otherwise intact male and female rats caused cued turning deficits and elevated fall rates. Spontaneous turning was unaffected. Furthermore, chemogenetic stimulation of ChIs in DL rats reduced fall rates and restored cued turning performance. Stimulation of ChIs was relatively more effective in rats with viral transfection spaces situated lateral to the DA depletion areas in the dorsomedial striatum. These results indicate that striatal ChIs are essential for the control of complex movements, and they suggest a therapeutic potential of stimulation of ChIs to restore gait and balance, and to prevent falls in PD.SIGNIFICANCE STATEMENT In persons with Parkinson's disease, gait dysfunction and the associated risk for falls do not benefit from dopamine replacement therapy and often result in long-term hospitalization and nursing home placement. Here, we first validated a new task to demonstrate impairments in cued turning behavior in rodents modeling the cholinergic-dopaminergic losses observed in Parkinsonian fallers. We then demonstrated the essential role of striatal cholinergic interneurons for turning behavior as well as for traversing dynamic surfaces and avoiding falls. Stimulation of these interneurons in the rat model rescued turning performance and reduced fall rates. Our findings indicate the feasibility of investigating the neuronal circuitry underling complex movement control in rodents, and that striatal cholinergic interneurons are an essential node of such circuitry.
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15
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Zou TE, Liang PJ, Lee SC. Turning duration and steps predict future falls in poststroke hemiplegic individuals: A preliminary cohort study. Top Stroke Rehabil 2020; 28:33-41. [PMID: 32397952 DOI: 10.1080/10749357.2020.1760644] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: Turning was reported as one of the activities that most frequently leads to falling among stroke patients. This study investigated whether the duration and steps of a 180° turn while walking can distinguish retrospective fallers from non-fallers and predict future falls in a 1-year period in patients with poststroke hemiplegia. Methods: Thirty stroke patients were recruited. They were instructed to get up from a chair, walk straight 3 m, turn around, and return to seated position to assess the 180° walking-turn task. Turning performance was measured by two inertial sensor units of Physilog. Turn duration and steps were recorded for analysis. The numbers of retrospective and prospective falls were also obtained. Results: No significant difference was observed between retrospective stroke fallers and non-fallers in turn duration and steps. Turn duration and steps were significantly greater in prospective stroke fallers than in non-fallers. The cutoff turn duration of 4 s (area under the curve 0.75, 95% CI: 0.56-0.93, sensitivity 67%, specificity 80%, p =.04) and turn step of 7 steps (area under the curve 0.73, 95% CI: 0.51-0.94, sensitivity 56%, specificity 85%, p =.05) were found to most accurately predict prospective stroke fallers from non-fallers. Conclusions: Turn duration and steps were unable to discriminate between retrospective fallers and non-fallers but could predict prospective falls in patients with stroke. More than 4 s or 7 steps to complete a 180° turn while walking can be a predictor for patients with stroke at an increased risk of falling.
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Affiliation(s)
- Tian-En Zou
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation , New Taipei City, Taiwan
| | - Pei-Jung Liang
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation , New Taipei City, Taiwan
| | - Shu-Chun Lee
- School of Gerontology Health Management, College of Nursing, Taipei Medical University , Taipei City, Taiwan
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16
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Criminger C, Swank C. Impact of dual-tasking on mobility tasks in Parkinson's disease as described through 2D kinematic analysis. Aging Clin Exp Res 2020; 32:835-840. [PMID: 31270689 DOI: 10.1007/s40520-019-01256-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/22/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Walking for people with Parkinson's disease (PD) degrades during motor-cognitive interplay (i.e., dual task conditions). Declining gait mechanics and turning ability result in more frequent falls and an interruption of daily activities in persons with PD. AIMS To determine the impact of dual-tasking on key mobility elements during a walking task in people with PD with 2D motion analysis. METHODS Participants performed Timed Up and Go (TUG) single, dual task conditions (TUGalone, TUGmotor, and TUGcognitive). 2D motion analysis application was used to quantify seven key mobility elements including: sit-to-walk (STW) (s), walking turn time (WTT) (s), number of turn steps, turn-to-sit (TTS) (s), total number of TUG steps, total TUG time and turn strategy (on-the-spot or u-shaped). RESULTS Thirty-one participants with PD completed this study [age M= 69 ± 8.19, UPDRSm M= 23.21 ± 10.03, HY MED= 2 (range 1-4)]. All key elements were significantly different between TUG conditions with the exception of sit-to-walk and turn strategy. Turn strategy was consistent across TUG tasks despite added cognitive loading. Repeated-measures MANOVA differences were observed in WTT (p = 0.01), number of turn steps (p = 0.03), TTS (p < 0.001), total number of TUG steps (p = 0.01), and total TUG time (p = 0.01). No significant relationships were found between disease severity (HY/UPDRSm) and turn strategy. DISCUSSION/CONCLUSION Key mobility elements were significantly affected across dual task walking conditions in persons with PD. The use of 2D motion analysis assisted with identification of key mobility elements impacted during the single and dual task conditions.
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Affiliation(s)
- Christina Criminger
- Department of Physical Therapy, Winston-Salem State University, 346 FL Atkins Bldg., 601 Martin Luther King Drive, Winston-Salem, NC, 27110, USA.
| | - Chad Swank
- Baylor Scott and White Institute for Rehabilitation, 909 N. Washington Ave, Dallas, TX, 75246, USA
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17
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Reliability and validity of the timed 360° turn test in people with Parkinson’s disease. Eur Geriatr Med 2020; 11:417-426. [DOI: 10.1007/s41999-019-00285-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
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18
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Franzén E, Johansson H, Freidle M, Ekman U, Wallén MB, Schalling E, Lebedev A, Lövdén M, Holmin S, Svenningsson P, Hagströmer M. The EXPANd trial: effects of exercise and exploring neuroplastic changes in people with Parkinson's disease: a study protocol for a double-blinded randomized controlled trial. BMC Neurol 2019; 19:280. [PMID: 31718583 PMCID: PMC6849188 DOI: 10.1186/s12883-019-1520-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) affects many physiological systems essential for balance control. Recent studies suggest that intensive and cognitively demanding physical exercise programs are capable of inducing plastic brain changes in PD. We have developed a highly challenging balance training (the HiBalance) program that emphasizes critical aspects of balance control through progressively introducing more challenging exercises which incorporates dual-tasking. Earlier studies have shown it to be effective in improving balance, gait and dual-tasking. The study design has thereafter been adjusted to link intervention-induced behavioral changes to brain morphology and function. Specifically, in this randomized controlled trial, we will determine the effects of the HiBalance program on balance, gait and cognition and relate this to task-evoked functional MRI (fMRI), as well as brain-derived neurotrophic factor (BDNF) in participants with mild-moderate PD. METHODS One hundred participants with idiopathic PD, Hoehn & Yahr stage 2 or 3, ≥ 60 years of age, ≥ 21 on Montreal Cognitive Assessment will be recruited in successive waves and randomized into either the HiBalance program or to an active control group (the HiCommunication program, targeting speech and communication). Both interventions will be performed in small groups, twice a week with 1 h sessions for 10 weeks. In addition, a 1 h, once a week, home exercise program will also be performed. A double-blinded design will be used. At the pre- and post-assessments, participants will be assessed on balance (main outcome), gait, cognitive functions, physical activity, voice/speech function, BDNF in serum and fMRI (3 T Philips) during performance of motor-cognitive tasks. DISCUSSION Since there is currently no cure for PD, findings of neuroplastic brain changes in response to exercise would revolutionize the way we treat PD, and, in turn, provide new hope to patients for a life with better health, greater independence and improved quality of life. TRIAL REGISTRATION ClincalTrials.gov: NCT03213873, first posted July 11, 2017.
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Affiliation(s)
- Erika Franzén
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden. .,Karolinska University Hospital, Allied Health Professionals Function, Function Area Occupational Therapy & Physiotherapy, Stockholm, Sweden. .,Stockholms Sjukhem, R&D unit, Stockholm, Sweden.
| | - Hanna Johansson
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Allied Health Professionals Function, Function Area Occupational Therapy & Physiotherapy, Stockholm, Sweden
| | - Malin Freidle
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Urban Ekman
- Stockholms Sjukhem, R&D unit, Stockholm, Sweden.,Department of Neurobiology, Care sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Allied Health Professionals Function, Function Area Medical Psychology, Stockholm, Sweden
| | - Martin Benka Wallén
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Ellika Schalling
- Department of Clinical Science, Intervention and Technology, CLINTEC, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Allied Health Professionals Function, Function Area Speech and Language Pathology, Stockholm, Sweden
| | - Alexander Lebedev
- Department of Neurobiology, Care sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet, Stockholm, Sweden
| | - Martin Lövdén
- Department of Neurobiology, Care sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Staffan Holmin
- Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet, Stockholm, Sweden
| | - Per Svenningsson
- Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet, Stockholm, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Allied Health Professionals Function, Function Area Occupational Therapy & Physiotherapy, Stockholm, Sweden.,Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
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19
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Soke F, Guclu-Gunduz A, Ozkul C, Cekim K, Irkec C, Gonenli Kocer B. Reliability and validity of the timed 360° turn test in people with multiple sclerosis. Physiother Theory Pract 2019; 37:736-747. [PMID: 31319754 DOI: 10.1080/09593985.2019.1641867] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: To investigate (1) the intrarater, interrater, and test-retest reliability of the timed 360° turn test in people with Multiple Sclerosis (MS); (2) the minimum detectable change in the timed 360° turn test times; (3) the concurrent and discriminant validity of the timed 360° turn test times; and (4) the cut-off times that best discriminate people with MS from healthy people and fallers from non-fallers with MS.Method: Sixty-one people with MS (Expanded Disability Status Scale, EDSS, 0-6.5) and 34 healthy people were recruited in this cross-sectional study. The timed 360° turn test was administered along with the Timed Up and Go Test, Berg Balance Scale, Four Square Step Test, and EDSS by two independent raters.Results: The timed 360° turn test showed good intrarater, interrater, and test-retest reliability. Minimal detectable changes were 1.49 s and 1.53 s for the dominant and non-dominant sides, respectively. The timed 360° turn test was strongly correlated with other outcome measures. Significant differences in 360° turn times were found between people with MS and healthy people and between fallers and non-fallers with MS (p < .001 and p < .001, respectively). The cut-off times of 2.65 s on the dominant side and 2.42 s on the non-dominant best discriminated people with MS from healthy people, while 3.65 s on the dominant side and 3.75 s on the non-dominant best discriminated fallers from non-fallers with MS.Conclusions: The timed 360° turn test is a simple and reliable tool for assessing turning ability in MS.
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Affiliation(s)
- Fatih Soke
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Arzu Guclu-Gunduz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Cagla Ozkul
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Kader Cekim
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Ceyla Irkec
- Faculty of Medicine, Department of Neurology, Gazi University, Ankara, Turkey
| | - Bilge Gonenli Kocer
- Department of Neurology, Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey
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Kucinski A, Lustig C, Sarter M. Addiction vulnerability trait impacts complex movement control: Evidence from sign-trackers. Behav Brain Res 2018; 350:139-148. [PMID: 29705686 PMCID: PMC6506847 DOI: 10.1016/j.bbr.2018.04.045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 11/15/2022]
Abstract
Cognitive-motivational vulnerability traits are associated with increased risk for substance addiction and relapse. Sign-tracking (ST) behavior in rats is associated with poor attentional control, mediated by an unresponsive basal forebrain cholinergic system, and an increased risk for substance addiction/relapse. A separate literature links poor attentional control and cholinergic losses to increased fall risk in Parkinson's disease. Here we tested the hypothesis that the relatively inferior attentional control of STs extends to complex movement control and a propensity for falls. STs were found to fall more often than goal-trackers (GTs) while traversing a straight rotating rod and, similar to human fallers, when taxed by a secondary task. Furthermore, STs fell more often while traversing a rotating zig-zag rod. GTs exhibited fewer falls from this rod by avoiding entry to the rotating zig-zag sections when in, or rotating toward, a difficult traversal state. Goal-tracking rats approached risky movement situations using strategies indicative of superior top-down control. These results suggest that the impact of opponent cognitive-cholinergic traits extends to complex movement control, and that impairments in the cognitive-motor interface are likely to be comorbid with addiction vulnerability. Sign-tracking indexes an endophenotype that may increase the risk for a wide range of neurobehavioral disorders.
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Affiliation(s)
- Aaron Kucinski
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - Cindy Lustig
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - Martin Sarter
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA.
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21
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Pham MH, Warmerdam E, Elshehabi M, Schlenstedt C, Bergeest LM, Heller M, Haertner L, Ferreira JJ, Berg D, Schmidt G, Hansen C, Maetzler W. Validation of a Lower Back "Wearable"-Based Sit-to-Stand and Stand-to-Sit Algorithm for Patients With Parkinson's Disease and Older Adults in a Home-Like Environment. Front Neurol 2018; 9:652. [PMID: 30158894 PMCID: PMC6104484 DOI: 10.3389/fneur.2018.00652] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 07/20/2018] [Indexed: 01/17/2023] Open
Abstract
Introduction: Impaired sit-to-stand and stand-to-sit movements (postural transitions, PTs) in patients with Parkinson's disease (PD) and older adults (OA) are associated with risk of falling and reduced quality of life. Inertial measurement units (IMUs, also called "wearables") are powerful tools to monitor PT kinematics. The purpose of this study was to develop and validate an algorithm, based on a single IMU positioned at the lower back, for PT detection and description in the above-mentioned groups in a home-like environment. Methods: Four PD patients (two with dyskinesia) and one OA served as algorithm training group, and 21 PD patients (16 without and 5 with dyskinesia) and 11 OA served as test group. All wore an IMU on the lower back and were videotaped while performing everyday activities for 90-180 min in a non-standardized home-like environment. Accelerometer and gyroscope signals were analyzed using discrete wavelet transformation (DWT), a six degrees-of-freedom (DOF) fusion algorithm and vertical displacement estimation. Results: From the test group, 1,001 PTs, defined by video reference, were analyzed. The accuracy of the algorithm for the detection of PTs against video observation was 82% for PD patients without dyskinesia, 47% for PD patients with dyskinesia and 85% for OA. The overall accuracy of the PT direction detection was comparable across groups and yielded 98%. Mean PT duration values were 1.96 s for PD patients and 1.74 s for OA based on the algorithm (p < 0.001) and 1.77 s for PD patients and 1.51 s for OA based on clinical observation (p < 0.001). Conclusion: Validation of the PT detection algorithm in a home-like environment shows acceptable accuracy against the video reference in PD patients without dyskinesia and controls. Current limitations are the PT detection in PD patients with dyskinesia and the use of video observation as the video reference. Potential reasons are discussed.
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Affiliation(s)
- Minh H Pham
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany.,Digital Signal Processing and System Theory, Faculty of Engineering, Kiel University, Kiel, Germany
| | - Elke Warmerdam
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany.,Digital Signal Processing and System Theory, Faculty of Engineering, Kiel University, Kiel, Germany
| | - Morad Elshehabi
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany.,Department of Neurodegeneration, Center for Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Christian Schlenstedt
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Lu-Marie Bergeest
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Maren Heller
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Linda Haertner
- Department of Neurodegeneration, Center for Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Joaquim J Ferreira
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Daniela Berg
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany.,Department of Neurodegeneration, Center for Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Gerhard Schmidt
- Digital Signal Processing and System Theory, Faculty of Engineering, Kiel University, Kiel, Germany
| | - Clint Hansen
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany.,Department of Neurodegeneration, Center for Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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22
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Proessl F, Swanson CW, Rudroff T, Fling BW, Tracy BL. Good agreement between smart device and inertial sensor-based gait parameters during a 6-min walk. Gait Posture 2018; 64:63-67. [PMID: 29859414 DOI: 10.1016/j.gaitpost.2018.05.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/07/2018] [Accepted: 05/27/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Traditional laboratory-based kinetic and kinematic gait analyses are expensive, time-intensive, and impractical for clinical settings. Inertial sensors have gained popularity in gait analysis research and more recently smart devices have been employed to provide quantification of gait. However, no study to date has investigated the agreement between smart device and inertial sensor-based gait parameters during prolonged walking. RESEARCH QUESTION Compare spatiotemporal gait metrics measured with a smart device versus previously validated inertial sensors. METHODS Twenty neurologically healthy young adults (7 women; age: 25.0 ± 3.7 years; BMI: 23.4 ± 2.9 kg/m2) performed a 6-min walk test (6MWT) wearing inertial sensors and smart devices to record stride duration, stride length, cadence, and gait speed. Pearson correlations were used to assess associations between spatiotemporal measures from the two devices and agreement between the two methods was assessed with Bland-Altman plots and limits of agreement. RESULTS All spatiotemporal gait metrics (stride duration, cadence, stride length and gait speed) showed strong (r>0.9) associations and good agreement between the two devices. SIGNIFICANCE Smart devices are capable of accurately reflecting many of the spatiotemporal gait metrics of inertial sensors. As the smart devices also accurately reflected individual leg output, future studies may apply this analytical strategy to clinical populations, to identify hallmarks of disability status and disease progression in a more ecologically valid environment.
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Affiliation(s)
- F Proessl
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - C W Swanson
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - T Rudroff
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA; Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA.
| | - B W Fling
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA; Molecular, Cellular, and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO, USA
| | - B L Tracy
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
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23
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Turcato AM, Godi M, Giardini M, Arcolin I, Nardone A, Giordano A, Schieppati M. Abnormal gait pattern emerges during curved trajectories in high-functioning Parkinsonian patients walking in line at normal speed. PLoS One 2018; 13:e0197264. [PMID: 29750815 PMCID: PMC5947908 DOI: 10.1371/journal.pone.0197264] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 04/30/2018] [Indexed: 12/22/2022] Open
Abstract
Background Several patients with Parkinson´s disease (PD) can walk normally along straight trajectories, and impairment in their stride length and cadence may not be easily discernible. Do obvious abnormalities occur in these high-functioning patients when more challenging trajectories are travelled, such as circular paths, which normally implicate a graded modulation in the duration of the interlimb gait cycle phases? Methods We compared a cohort of well-treated mildly to moderately affected PD patients to a group of age-matched healthy subjects (HS), by deliberately including HS spontaneously walking at the same speed of the patients with PD. All participants performed, in random order: linear and circular walking (clockwise and counter-clockwise) at self-selected speed. By means of pressure-sensitive insoles, we recorded walking speed, cadence, duration of single support, double support, swing phase, and stride time. Stride length-cadence relationships were built for linear and curved walking. Stride-to-stride variability of temporal gait parameters was also estimated. Results Walking speed, cadence or stride length were not different between PD and HS during linear walking. Speed, cadence and stride length diminished during curved walking in both groups, stride length more in PD than HS. In PD compared to HS, the stride length-cadence relationship was altered during curved walking. Duration of the double-support phase was also increased during curved walking, as was variability of the single support, swing phase and double support phase. Conclusion The spatio-temporal gait pattern and variability are significantly modified in well-treated, high-functioning patients with PD walking along circular trajectories, even when they exhibit no changes in speed in straight-line walking. The increased variability of the gait phases during curved walking is an identifying characteristic of PD. We discuss our findings in term of interplay between control of balance and of locomotor progression: the former is challenged by curved trajectories even in high-functioning patients, while the latter may not be critically affected.
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Affiliation(s)
- Anna Maria Turcato
- Division of Physical Medicine and Rehabilitation, ICS Maugeri SPA SB, Institute of Veruno, IRCCS, Veruno, Novara, Italy
| | - Marco Godi
- Division of Physical Medicine and Rehabilitation, ICS Maugeri SPA SB, Institute of Veruno, IRCCS, Veruno, Novara, Italy
- * E-mail:
| | - Marica Giardini
- Division of Physical Medicine and Rehabilitation, ICS Maugeri SPA SB, Institute of Veruno, IRCCS, Veruno, Novara, Italy
| | - Ilaria Arcolin
- Division of Physical Medicine and Rehabilitation, ICS Maugeri SPA SB, Institute of Veruno, IRCCS, Veruno, Novara, Italy
| | - Antonio Nardone
- Centro Studi Attività Motorie, ICS Maugeri SPA SB, Institute of Pavia, IRCCS, Pavia, Italy
- Neurorehabilitation and Spinal Units, ICS Maugeri SPA SB, Institute of Pavia, IRCCS, Pavia, Italy
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Andrea Giordano
- Unit of Bioengineering, ICS Maugeri SPA SB, Institute of Veruno, IRCCS, Veruno, Novara, Italy
| | - Marco Schieppati
- Department of Exercise & Sports Science, International University of Health, Exercise and Sports, LUNEX University, Differdange, Luxembourg
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24
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Haertner L, Elshehabi M, Zaunbrecher L, Pham MH, Maetzler C, van Uem JMT, Hobert MA, Hucker S, Nussbaum S, Berg D, Liepelt-Scarfone I, Maetzler W. Effect of Fear of Falling on Turning Performance in Parkinson's Disease in the Lab and at Home. Front Aging Neurosci 2018; 10:78. [PMID: 29636676 PMCID: PMC5880950 DOI: 10.3389/fnagi.2018.00078] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/08/2018] [Indexed: 12/26/2022] Open
Abstract
Background: Parkinson’s disease (PD) is a neurodegenerative movement disorder associated with gait and balance problems and a substantially increased risk of falling. Falls occur often during complex movements, such as turns. Both fear of falling (FOF) and previous falls are relevant risk factors for future falls. Based on recent studies indicating that lab-based and home assessment of similar movements show different results, we hypothesized that FOF and a positive fall history would influence the quantitative turning parameters differently in the laboratory and home. Methods: Fifty-five PD patients (43 underwent a standardized lab assessment; 40 were assessed over a mean of 12 days at home with approximately 10,000 turns per participant; and 28 contributed to both assessments) were classified regarding FOF and previous falls as “vigorous” (no FOF, negative fall history), “anxious” (FOF, negative fall history), “stoic” (no FOF, positive fall history) and “aware” (FOF, positive fall history). During the assessments, each participant wore a sensor on the lower back. Results: In the lab assessment, FOF was associated with a longer turning duration and lowered maximum and middle angular velocities of turns. In the home evaluations, a lack of FOF was associated with lowered maximum and average angular velocities of turns. Positive falls history was not significantly associated with turning parameters, neither in the lab nor in the home. Conclusion: FOF but not a positive fall history influences turning metrics in PD patients in both supervised and unsupervised environments, and this association is different between lab and home assessments. Our findings underline the relevance of comprehensive assessments including home-based data collection strategies for fall risk evaluation.
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Affiliation(s)
- Linda Haertner
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Morad Elshehabi
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany.,Department of Neurology, Universitätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Laura Zaunbrecher
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Minh H Pham
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany.,Department of Neurology, Universitätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Corina Maetzler
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany.,Department of Neurology, Universitätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Janet M T van Uem
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Markus A Hobert
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,Department of Neurology, Universitätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Svenja Hucker
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Susanne Nussbaum
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Daniela Berg
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany.,Department of Neurology, Universitätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Inga Liepelt-Scarfone
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Walter Maetzler
- Center for Neurology and Hertie-Institute for Clinical Brain Research, Department of Neurodegeneration, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases, Tübingen, Germany.,Department of Neurology, Universitätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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25
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Caronni A, Sterpi I, Antoniotti P, Aristidou E, Nicolaci F, Picardi M, Pintavalle G, Redaelli V, Achille G, Sciumè L, Corbo M. Criterion validity of the instrumented Timed Up and Go test: A partial least square regression study. Gait Posture 2018; 61:287-293. [PMID: 29413799 DOI: 10.1016/j.gaitpost.2018.01.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 12/18/2017] [Accepted: 01/18/2018] [Indexed: 02/02/2023]
Abstract
The Timed Up and Go (TUG) test is a common mobility measure in rehabilitation. With the instrumental TUG test (ITUG; i.e. the TUG measured by inertial measurement units, IMUs), several movement measures are newly available. However, the clinical meaning of these new measures is not totally clear. Aim of the current work is to evaluate the validity of different ITUG parameters as a measure of balance. Neurological patients (n = 122; 52 females; 89 older than 65 years) completed the TUG test with IMUs secured to their back. IMUs signals were used to split the TUG test in five phases (sit-to-stand, walk1, turn1, walk2 and turn-and-sit) and twelve movement parameters were obtained. Experienced clinicians administered the Mini-BESTest (MB) scale, a sound balance measure. The partial least square regression (PLSR) was used to explore the association between the ITUG variables and the MB measure. A PLSR model with twelve ITUG variables had satisfactory fit parameters (RMSEP: 11%; R2: 0.41, 95% CI: 0.28-0.54; regression line: 1, 95% CI: 0.78-1.22). Three ITUG variables (i.e. turn1 vertical angular velocity, turn1 duration and turn2 vertical angular velocity) were found to be the most important predictors of the MB measure. A PLSR model with the turning variables only had fit parameters comparable to that of the twelve variables model. Turning parameters from the TUG test are good predictors of the MB scale. The mean angular velocity during turning and the duration of the turning phase are thus proposed as a valid, ratio-level measures of balance in neurological patients.
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Affiliation(s)
- Antonio Caronni
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy.
| | - Irma Sterpi
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy
| | - Paola Antoniotti
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy
| | - Evdoxia Aristidou
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy
| | - Fortunato Nicolaci
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy
| | - Michela Picardi
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy
| | - Giuseppe Pintavalle
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy
| | - Valentina Redaelli
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy
| | - Gianluca Achille
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy
| | - Luciana Sciumè
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Via Dezza 48, 20144, Milano, Italy
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26
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Effects of curved-walking training on curved-walking performance and freezing of gait in individuals with Parkinson's disease: A randomized controlled trial. Parkinsonism Relat Disord 2017; 43:20-26. [DOI: 10.1016/j.parkreldis.2017.06.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/15/2017] [Accepted: 06/27/2017] [Indexed: 11/19/2022]
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27
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Nguyen H, Lebel K, Boissy P, Bogard S, Goubault E, Duval C. Auto detection and segmentation of daily living activities during a Timed Up and Go task in people with Parkinson's disease using multiple inertial sensors. J Neuroeng Rehabil 2017; 14:26. [PMID: 28388939 PMCID: PMC5384139 DOI: 10.1186/s12984-017-0241-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 04/01/2017] [Indexed: 11/17/2022] Open
Abstract
Background Wearable sensors have the potential to provide clinicians with access to motor performance of people with movement disorder as they undergo intervention. However, sensor data often have to be manually classified and segmented before they can be processed into clinical metrics. This process can be time consuming. We recently proposed detection and segmentation algorithms based on peak detection using Inertial Measurement Units (IMUs) to automatically identify and isolate common activities during daily living such as standing up, walking, turning, and sitting down. These algorithms were developed using a homogenous population of healthy older adults. The aim of this study was to investigate the transferability of these algorithms in people with Parkinson’s disease (PD). Methods A modified Timed Up And Go task was used since it is comprised of these activities, all performed in a continuous fashion. Twelve older adults diagnosed with early PD (Hoehn & Yahr ≤ 2) were recruited for the study and performed three trials of a 10 and 5-m TUG during OFF state. They were outfitted with 17 IMUs covering each body segment. Raw data from IMUs were detrended, normalized and filtered to reveal kinematics peaks that corresponded to different activities. Segmentation was accomplished by identifying the first minimum or maximum to the right and the left of these peaks. Segmentation times were compared to results from two examiners who visually segmented the activities. Specificity and sensitivity were used to evaluate the accuracy of the detection algorithms. Results Using the same IMUs and algorithms developed in the previous study, we were able to detect these activities with 97.6% sensitivity and 92.7% specificity (n = 432) in PD population. However, with modifications to the IMUs selection, we were able to detect these activities with 100% accuracy. Similarly, applying the same segmentation to PD population, we were able to isolate these activities within ~500 ms of the visual segmentation. Re-optimizing the filtering frequencies, we were able to reduce this difference to ~400 ms. Conclusions This study demonstrates the agility and transferability of using a system of IMUs to accurately detect and segment activities in daily living in people with movement disorders.
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Affiliation(s)
- Hung Nguyen
- Département des Sciences de l'activité Physique, Université du Québec àMontréal, 141 Avenue du Président -Kennedy, Montréal, Québec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Karina Lebel
- Faculty of Medicine and Health Sciences, Department of Surgery, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Research Center on Aging, Sherbrooke, Québec, Canada.,Interdisciplinary Institute for Technological Innovation (3IT), Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Patrick Boissy
- Faculty of Medicine and Health Sciences, Department of Surgery, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Research Center on Aging, Sherbrooke, Québec, Canada.,Interdisciplinary Institute for Technological Innovation (3IT), Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Sarah Bogard
- Département des Sciences de l'activité Physique, Université du Québec àMontréal, 141 Avenue du Président -Kennedy, Montréal, Québec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Etienne Goubault
- Département des Sciences de l'activité Physique, Université du Québec àMontréal, 141 Avenue du Président -Kennedy, Montréal, Québec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Christian Duval
- Département des Sciences de l'activité Physique, Université du Québec àMontréal, 141 Avenue du Président -Kennedy, Montréal, Québec, Canada. .,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada.
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28
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Godi M, Giardini M, Nardone A, Turcato AM, Caligari M, Pisano F, Schieppati M. Curved Walking Rehabilitation with a Rotating Treadmill in Patients with Parkinson's Disease: A Proof of Concept. Front Neurol 2017; 8:53. [PMID: 28293213 PMCID: PMC5329030 DOI: 10.3389/fneur.2017.00053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/06/2017] [Indexed: 12/20/2022] Open
Abstract
Training subjects to step-in-place eyes open on a rotating platform while maintaining a fixed body orientation in space [podokinetic stimulation (PKS)] produces a posteffect consisting in inadvertent turning around while stepping-in-place eyes closed [podokinetic after-rotation (PKAR)]. Since the rationale for rehabilitation of curved walking in Parkinson's disease is not fully known, we tested the hypothesis that repeated PKS favors the production of curved walking in these patients, who are uneasy with turning, even when straight walking is little affected. Fifteen patients participated in 10 training sessions distributed in 3 weeks. Both counterclockwise and clockwise PKS were randomly administered in each session. PKS velocity and duration were gradually increased over sessions. The velocity and duration of the following PKAR were assessed. All patients showed PKAR, which increased progressively in peak velocity and duration. In addition, before and at the end of the treatment, all patients walked overground along linear and circular trajectories. Post-training, the velocity of walking bouts increased, more so for the circular than the linear trajectory. Cadence was not affected. This study has shown that parkinsonian patients learn to produce turning while stepping when faced with appropriate training and that this capacity translates into improved overground curved walking.
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Affiliation(s)
- Marco Godi
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Division of Physical Medicine and Rehabilitation, Scientific Institute of Veruno , Veruno , Italy
| | - Marica Giardini
- Department of Translational Medicine, University of Eastern Piedmont , Novara , Italy
| | - Antonio Nardone
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy; Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Laboratorio di Comunicazione e Domotica, Division of Physical Medicine and Rehabilitation, Scientific Institute of Veruno, Veruno, Italy
| | - Anna Maria Turcato
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Division of Physical Medicine and Rehabilitation, Scientific Institute of Veruno , Veruno , Italy
| | - Marco Caligari
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Laboratorio di Comunicazione e Domotica, Division of Physical Medicine and Rehabilitation, Scientific Institute of Veruno , Veruno , Italy
| | - Fabrizio Pisano
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Division of Neurological Rehabilitation, Scientific Institute of Veruno , Veruno , Italy
| | - Marco Schieppati
- Istituti Clinici Scientifici Maugeri Spa SB, IRCCS, Centro Studi Attività Motorie, Pavia, Italy; Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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29
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Ciria LF, Muñoz MA, Gea J, Peña N, Miranda JGV, Montoya P, Vila J. Head movement measurement: An alternative method for posturography studies. Gait Posture 2017; 52:100-106. [PMID: 27888694 DOI: 10.1016/j.gaitpost.2016.11.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 07/26/2016] [Accepted: 11/09/2016] [Indexed: 02/02/2023]
Abstract
The present study evaluated the measurement of head movements as a valid method for postural emotional studies using the comparison of simultaneous recording of center of pressure (COP) sway as criterion. Thirty female students viewed a set of 12 pleasant, 12 unpleasant and 12 neutral pictures from the International Affective Picture System, repeated twice, using a block presentation procedure while standing on a force platform (AMTI AccuSway). Head movements were recorded using a webcam (©KPC139E) located in the ceiling in line with the force platform and a light-emitting diode (LED) placed on the top of the head. Open source software (CvMob 3.1) was used to process the data. High indices of correlation and coherence between head and COP sway were observed. In addition, pleasant pictures, compared with unpleasant pictures, elicited greater body sway in the anterior-posterior axis, suggesting an approach response to appetitive stimuli. Thus, the measurement of head movement can be an alternative or complementary method to recording COP for studying human postural changes.
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Affiliation(s)
- L F Ciria
- Human Psychophysiology and Health Group, Mind, Brain and Behavior Research Center-CIMCYC, University of Granada, Spain
| | - M A Muñoz
- Human Psychophysiology and Health Group, Mind, Brain and Behavior Research Center-CIMCYC, University of Granada, Spain.
| | - J Gea
- Research Institute oF Health Sciences (IUNICS), University of Balearic Islands (UIB), Palma, Spain
| | - N Peña
- Department of Physiotherapy, Faculdade de Ciências da Saúde, Federal University of Bahia, Salvador, Brazil
| | - J G V Miranda
- Department of Physics of the Earth and the Environment, Instituto de Fisica Federal University of Bahia, Salvador, Brazil
| | - P Montoya
- Research Institute oF Health Sciences (IUNICS), University of Balearic Islands (UIB), Palma, Spain
| | - J Vila
- Human Psychophysiology and Health Group, Mind, Brain and Behavior Research Center-CIMCYC, University of Granada, Spain
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30
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Cheng FY, Yang YR, Chen LM, Wu YR, Cheng SJ, Wang RY. Positive Effects of Specific Exercise and Novel Turning-based Treadmill Training on Turning Performance in Individuals with Parkinson's disease: A Randomized Controlled Trial. Sci Rep 2016; 6:33242. [PMID: 27628128 PMCID: PMC5023848 DOI: 10.1038/srep33242] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 08/23/2016] [Indexed: 01/23/2023] Open
Abstract
Two different training strategies to improve turning performance in individuals with Parkinson’s disease (PD) were designed and investigated in this study. Subjects were randomly assigned to a specific exercise group, turning-based training group, or control group to receive training that emphasized balance and strengthening, turning-based treadmill training, and general exercise training, respectively. A total of 12 30-min training sessions followed by 10 min of turning training on a level surface were administered over 4 to 6 weeks. The results (n = 12 for each group) showed that both the specific exercise and turning-based training group experienced improved turning performance, the primary outcome, compared with the control group (specific exercise, 33% change, p = 0.016; turning-based training, 35% change, p = 0.021). For the secondary outcomes, the specific exercise group performed better than the control group on the Tinetti balance scale, limit of stability test and lower extremity extensor and abductor strength. The turning-based training groups performed better than the control group in sensory organization and ankle plantar flexor strength. In summary, specific exercise training and turning-based treadmill training were both effective in improving turning performance in participants with PD. However, the improvements in turning performance of these two groups resulted from improving different aspects of impairment in individuals with PD.
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Affiliation(s)
- Fang-Yu Cheng
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, 112, Taiwan
| | - Yea-Ru Yang
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, 112, Taiwan
| | - Li-Mei Chen
- Department of Neurology, Cheng Hsin General Hospital, Taipei, 112, Taiwan
| | - Yih-Ru Wu
- Department of Neuromuscular Disorder, Chang Gung Memorial Hospital, Linkou, 333, Taiwan
| | - Shih-Jung Cheng
- Department of Neurology, Mackay Memorial Hospital, Taipei, 104, Taiwan
| | - Ray-Yau Wang
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, 112, Taiwan
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Van Uem JMT, Walgaard S, Ainsworth E, Hasmann SE, Heger T, Nussbaum S, Hobert MA, Micó-Amigo EM, Van Lummel RC, Berg D, Maetzler W. Quantitative Timed-Up-and-Go Parameters in Relation to Cognitive Parameters and Health-Related Quality of Life in Mild-to-Moderate Parkinson's Disease. PLoS One 2016; 11:e0151997. [PMID: 27055262 PMCID: PMC4824446 DOI: 10.1371/journal.pone.0151997] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/06/2016] [Indexed: 12/11/2022] Open
Abstract
Introduction The instrumented-Timed-Up-and-Go test (iTUG) provides detailed information about the following movement patterns: sit-to-walk (siwa), straight walking, turning and walk-to-sit (wasi). We were interested in the relative contributions of respective iTUG sub-phases to specific clinical deficits most relevant for daily life in Parkinson’s disease (PD). More specifically, we investigated which condition–fast speed (FS) or convenient speed (CS)–differentiates best between mild- to moderate-stage PD patients and controls, which parameters of the iTUG sub-phases are significantly different between PD patients and controls, and how the iTUG parameters associate with cognitive parameters (with particular focus on cognitive flexibility and working memory) and Health-Related-Quality of Life (HRQoL). Methods Twenty-eight PD participants (65.1±7.1 years, H&Y stage 1–3, medication OFF state) and 20 controls (66.1±7.5 years) performed an iTUG (DynaPort®, McRoberts BV, The Netherlands) under CS and FS conditions. The PD Questionnaire 39 (PDQ-39) was employed to assess HRQoL. General cognitive and executive functions were assessed using the Montreal Cognitive Assessment and the Trail Making Test. Results The total iTUG duration and sub-phases durations under FS condition differentiated PD patients slightly better from controls, compared to the CS condition. The following sub-phases were responsible for the observed longer total duration PD patients needed to perform the iTUG: siwa, turn and wasi. None of the iTUG parameters correlated relevantly with general cognitive function. Turning duration and wasi maximum flexion velocity correlated strongest with executive function. Walking back duration correlated strongest with HRQoL. Discussion This study confirms that mild- to moderate-stage PD patients need more time to perform the iTUG than controls, and adds the following aspects to current literature: FS may be more powerful than CS to delineate subtle movement deficits in mild- to moderate-stage PD patients; correlation levels of intra-individual siwa and wasi parameters may be interesting surrogate markers for the level of automaticity of performed movements; and sub-phases and kinematic parameters of the iTUG may have the potential to reflect executive functioning and HRQoL aspects of PD patients.
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Affiliation(s)
- Janet M. T. Van Uem
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
- * E-mail:
| | | | | | - Sandra E. Hasmann
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Tanja Heger
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Susanne Nussbaum
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Markus A. Hobert
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Encarnación M. Micó-Amigo
- McRoberts, The Hague, The Netherlands
- MOVE Research Institute Amsterdam, Department of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | | | - Daniela Berg
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Walter Maetzler
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
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Nguyen HP, Ayachi F, Lavigne-Pelletier C, Blamoutier M, Rahimi F, Boissy P, Jog M, Duval C. Auto detection and segmentation of physical activities during a Timed-Up-and-Go (TUG) task in healthy older adults using multiple inertial sensors. J Neuroeng Rehabil 2015; 12:36. [PMID: 25885438 PMCID: PMC4403848 DOI: 10.1186/s12984-015-0026-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 03/20/2015] [Indexed: 11/30/2022] Open
Abstract
Background Recently, much attention has been given to the use of inertial sensors for remote monitoring of individuals with limited mobility. However, the focus has been mostly on the detection of symptoms, not specific activities. The objective of the present study was to develop an automated recognition and segmentation algorithm based on inertial sensor data to identify common gross motor patterns during activity of daily living. Method A modified Time-Up-And-Go (TUG) task was used since it is comprised of four common daily living activities; Standing, Walking, Turning, and Sitting, all performed in a continuous fashion resulting in six different segments during the task. Sixteen healthy older adults performed two trials of a 5 and 10 meter TUG task. They were outfitted with 17 inertial motion sensors covering each body segment. Data from the 10 meter TUG were used to identify pertinent sensors on the trunk, head, hip, knee, and thigh that provided suitable data for detecting and segmenting activities associated with the TUG. Raw data from sensors were detrended to remove sensor drift, normalized, and band pass filtered with optimal frequencies to reveal kinematic peaks that corresponded to different activities. Segmentation was accomplished by identifying the time stamps of the first minimum or maximum to the right and the left of these peaks. Segmentation time stamps were compared to results from two examiners visually segmenting the activities of the TUG. Results We were able to detect these activities in a TUG with 100% sensitivity and specificity (n = 192) during the 10 meter TUG. The rate of success was subsequently confirmed in the 5 meter TUG (n = 192) without altering the parameters of the algorithm. When applying the segmentation algorithms to the 10 meter TUG, we were able to parse 100% of the transition points (n = 224) between different segments that were as reliable and less variable than visual segmentation performed by two independent examiners. Conclusions The present study lays the foundation for the development of a comprehensive algorithm to detect and segment naturalistic activities using inertial sensors, in hope of evaluating automatically motor performance within the detected tasks.
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Affiliation(s)
- Hung P Nguyen
- Département de Kinanthropologie, Université du Québec à Montréal, C.P. 8888, succursale Centre-Ville, Montréal, H3C 3P8, Québec, Canada.
| | - Fouaz Ayachi
- Département de Kinanthropologie, Université du Québec à Montréal, C.P. 8888, succursale Centre-Ville, Montréal, H3C 3P8, Québec, Canada.
| | - Catherine Lavigne-Pelletier
- Département de Kinanthropologie, Université du Québec à Montréal, C.P. 8888, succursale Centre-Ville, Montréal, H3C 3P8, Québec, Canada.
| | - Margaux Blamoutier
- Faculté des Sciences, Université du Québec à Montréal, Montreal, Canada.
| | - Fariborz Rahimi
- Electrical Engineering Department, University of Bonab, Bonab, East Azerbaijan, Iran.
| | - Patrick Boissy
- Department of Surgery, Orthopaedic Division, Faculty of Medicine and Health Sciences, Université of Sherbrooke, Quebec, Canada.
| | - Mandar Jog
- London Health Sciences Center University Hospital, Ontario, Canada.
| | - Christian Duval
- Département de Kinanthropologie, Université du Québec à Montréal, C.P. 8888, succursale Centre-Ville, Montréal, H3C 3P8, Québec, Canada.
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Early Freezing of Gait: Atypical versus Typical Parkinson Disorders. PARKINSONS DISEASE 2015; 2015:951645. [PMID: 25785228 PMCID: PMC4345077 DOI: 10.1155/2015/951645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 01/22/2015] [Indexed: 11/17/2022]
Abstract
In 18 months, 850 patients were referred to Muhammad Ali Parkinson Center (MAPC). Among them, 810 patients had typical Parkinson disease (PD) and 212 had PD for ≤5 years. Among the 212 patients with early PD, 27 (12.7%) had freezing of gait (FOG). Forty of the 850 had atypical parkinsonism. Among these 40 patients, all of whom had symptoms for ≤5 years, 12 (30.0%) had FOG. FOG improved with levodopa in 21/27 patients with typical PD but did not improve in the 12 patients with atypical parkinsonism. FOG was associated with falls in both groups of patients. We believe that FOG unresponsive to levodopa in typical PD resembles FOG in atypical parkinsonism. We thus compared the 6 typical PD patients with FOG unresponsive to levodopa plus the 12 patients with atypical parkinsonism with the 21 patients with typical PD responsive to levodopa. We compared them by tests of locomotion and postural stability. Among the patients with FOG unresponsive to levodopa, postural stability was more impaired than locomotion. This finding leads us to believe that, in these patients, postural stability, not locomotion, is the principal problem underlying FOG.
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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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