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Uhlig M, Prell T. Gait Characteristics Associated with Fear of Falling in Hospitalized People with Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2023; 23:1111. [PMID: 36772149 PMCID: PMC9919788 DOI: 10.3390/s23031111] [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: 11/11/2022] [Revised: 12/26/2022] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Fear of falling (FOF) is common in Parkinson's disease (PD) and associated with distinct gait changes. Here, we aimed to answer, how quantitative gait assessment can improve our understanding of FOF-related gait in hospitalized geriatric patients with PD. METHODS In this cross-sectional study of 79 patients with advanced PD, FOF was assessed with the Falls Efficacy Scale International (FES-I), and spatiotemporal gait parameters were recorded with a mobile gait analysis system with inertial measurement units at each foot while normal walking. In addition, demographic parameters, disease-specific motor (MDS-revised version of the Unified Parkinson's Disease Rating Scale, Hoehn & Yahr), and non-motor (Non-motor Symptoms Questionnaire, Montreal Cognitive Assessment) scores were assessed. RESULTS According to the FES-I, 22.5% reported low, 28.7% moderate, and 47.5% high concerns about falling. Most concerns were reported when walking on a slippery surface, on an uneven surface, or up or down a slope. In the final regression model, previous falls, more depressive symptoms, use of walking aids, presence of freezing of gait, and lower walking speed explained 42% of the FES-I variance. CONCLUSION Our study suggests that FOF is closely related to gait changes in hospitalized PD patients. Therefore, FOF needs special attention in the rehabilitation of these patients, and targeting distinct gait parameters under varying walking conditions might be a promising part of a multimodal treatment program in PD patients with FOF. The effect of these targeted interventions should be investigated in future trials.
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Affiliation(s)
- Manuela Uhlig
- Department of Neurology, Jena University Hospital, 07743 Jena, Germany
| | - Tino Prell
- Department of Neurology, Jena University Hospital, 07743 Jena, Germany
- Department of Geriatrics, Halle University Hospital, 06120 Halle, Germany
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2
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Leal-Nascimento AH, da Silva ES, Zanardi APJ, Ivaniski-Mello A, Passos-Monteiro E, Martinez FG, Rodrigo de Carvalho A, Baptista RR, Peyré-Tartaruga LA. Biomechanical responses of Nordic walking in people with Parkinson's disease. Scand J Med Sci Sports 2021; 32:290-297. [PMID: 34780079 DOI: 10.1111/sms.14095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/28/2021] [Accepted: 11/08/2021] [Indexed: 11/27/2022]
Abstract
In healthy adults, Nordic walking (NW) is known to increase the external mechanical energy fluctuations, though the external work is unaltered due to an improved pendulum-like recovery in comparison with free walking (FW). We aimed to compare mechanical, pendulum-like, and spatiotemporal parameters of gait at different speeds with and without NW poles in people with Parkinson's disease and healthy controls. The study included 11 people (aged 65.6 ± 7.0 years) with idiopathic Parkinson's disease, scoring between 1 and 1.5 on the Hoehn and Yahr scale (H&Y), and nine healthy controls (aged 70.0 ± 5.6 years). All the people were experienced Nordic walkers. Walking tests were performed at 1.8 km h-1 and 4.7 km h-1 , on eight 3D force platforms on a walkway. We found greater pendulum-like energy recovery (p < 0.05) in the Parkinson group during NW than in FW, while external mechanical work remained similar (p > 0.05). People with Parkinson's disease showed a major increase in vertical and forward energy fluctuations using poles than in healthy controls. In addition, the Parkinson group showed increased stride frequency and reduced stride length compared to controls in the NW and FW conditions. Our findings partly justify the lower walking economy in Parkinson's disease due to reduced pendulum-like mechanism at commonly used speeds. NW alters gait mechanics similarly in Parkinson group and healthy control, increasing the total mechanical work. Therefore, NW can be a compelling strategy for rehabilitation because of its potential for improving functional mobility, increasing pendulum-like mechanism in Parkinson's disease.
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Affiliation(s)
- Antonio Henrique Leal-Nascimento
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Federal Institute of Education, Science and Technology of Pará, Abaetetuba, Brazil
| | - Edson Soares da Silva
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - André Ivaniski-Mello
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Elren Passos-Monteiro
- Postgraduate in Human Movement Sciences, Faculty of Physical Education, Universidade Federal do Pará, Castanhal, Brazil
| | - Flávia Gomes Martinez
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rafael Reimann Baptista
- Physical Activity Research Laboratory, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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3
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Huang YH, Fang IY, Kuo YL. The Influence of Nordic Walking on Spinal Posture, Physical Function, and Back Pain in Community-Dwelling Older Adults: A Pilot Study. Healthcare (Basel) 2021; 9:healthcare9101303. [PMID: 34682988 PMCID: PMC8544539 DOI: 10.3390/healthcare9101303] [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: 08/13/2021] [Revised: 09/25/2021] [Accepted: 09/26/2021] [Indexed: 11/21/2022] Open
Abstract
Nordic walking is an increasingly popular form of exercise among the elderly. Using poles is thought to facilitate a more upright posture; however, previous studies primarily investigated the effects of Nordic walking on respiratory function and physical fitness. The aims of this study were to investigate the influence of Nordic walking on spinal posture, physical functions, and back pain in community-dwelling older adults. Thirty-one community-dwelling older adults aged ≥ 60 years participated in a twice weekly Nordic walking training program for 12 weeks. The outcome measures, including spinal posture, physical functions, back pain, and the strength and endurance of back extensor muscles were assessed before and after a 12-week program. After training, spinal posture, back pain, and the strength and endurance of back extensor muscles did not show any statistically significant changes. Among the seven clinical tests of physical function, only the 30 s arm curl test, the 30 s chair stand test, and the single leg stance test showed significant improvements. Nordic walking has limited influence on age-related hyperkyphosis and back pain, but may be effective for physical function. The results of this study can provide useful information for people involved in the prevention and treatment of physical dysfunction in community-dwelling older adults.
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Affiliation(s)
- Yi-Hung Huang
- Department of Orthopedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan;
- Department of Orthopedics, National Cheng Kung University Hospital, Tainan City 704, Taiwan
| | - I-Yao Fang
- Physical Education Center, Southern Taiwan University of Science and Technology, Tainan City 710, Taiwan;
| | - Yi-Liang Kuo
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City 701, Taiwan
- Correspondence: ; Tel.: +886-06-2353535 (ext. 6251)
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Podsiadło S, Skiba A, Kałuża A, Ptaszek B, Stożek J, Skiba A, Marchewka A. Influence of Nordic Walking Training on Vitamin D Level in the Blood and Quality of Life among Women Aged 65-74. Healthcare (Basel) 2021; 9:healthcare9091146. [PMID: 34574920 PMCID: PMC8471811 DOI: 10.3390/healthcare9091146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction. Demographic forecasts indicate the progressive aging process of societies in all countries worldwide. The extension of life span may be accompanied by deterioration of its quality resulting from a decrease in physical activity, mental or even social performance, and a deficit in certain chemical compounds responsible for proper functioning of the body. Aim. The aim of the study was to evaluate the influence of a 12-week Nordic walking (NW) training intervention on the level of vitamin D in the blood and quality of life among women aged 65–74 years. Materials and methods. The study comprised 37 women aged 65–74 (x = 68.08, SD = 4.2). The subjects were randomly assigned to 2 groups: experimental group (NW), which consisted of 20 women who underwent an intervention in the form of Nordic walking training for 12 weeks, and the control group (C), including 17 women who underwent observation. In the experimental group, training sessions were held 3 times a week for 1 h. At that time, the C group was not subject to any intervention. The SF−36 questionnaire was used to measure quality of life. Vitamin D was assessed based on the results of biochemical blood tests. The analysed parameters were assessed twice-before and after the completed intervention or observation. Results. Comparison of the results regarding trials 1 and 2 allowed to note statistically significant improvement in quality of life for all health components and factors in the NW group. Analysis of vitamin D levels demonstrated a statistically significant increase in the NW group. In group C, no significant changes in the analysed parameters were observed. Conclusions. Regularly undertaking Nordic walking training significantly influences the improvement of self-evaluation regarding the components of physical and mental health, as well as the concentration of vitamin D in women aged 65–74 years.
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Affiliation(s)
- Szymon Podsiadło
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
- Correspondence:
| | - Agnieszka Skiba
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Anna Kałuża
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Bartłomiej Ptaszek
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Kraków, Poland;
| | - Joanna Stożek
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Amadeusz Skiba
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Anna Marchewka
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
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5
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Fino PC, Mancini M. Phase-Dependent Effects of Closed-Loop Tactile Feedback on Gait Stability in Parkinson's Disease. IEEE Trans Neural Syst Rehabil Eng 2021; 28:1636-1641. [PMID: 32634100 DOI: 10.1109/tnsre.2020.2997283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Gait disturbances in people with Parkinson's disease (PD) are a major cause for functional dependence and have recently been shown to be the largest risk factor for falls, institutionalization and death in PD. The use of external cues has been successful at improving gait in people with PD, but the effect of external cues on gait stability is unclear. We examined whether different forms of cueing, open-loop and closed-loop, influenced the local dynamic stability of three critical phases of gait. Forty-three adults with PD completed six, two-minute long walking trials in the following cued conditions: no cue (B), open-loop cueing, fixed auditory cue (OL), closed-loop cueing, tactile feedback delivered to wrist when the ipsilateral foot contacted with the ground (CL). Conditions were performed with and without a cognitive task. Kinematic data were recorded with inertial sensors. Only CL cueing was associated with changes in trunk stability, and these changes were only evident during the weight transfer phase of gait. Both OL and CL caused reductions in overall gait speed, stride length, and an increase in stride time. While CL cueing significantly influenced local dynamic stability during weight transfer, it remains unknown whether these changes are associated with more or less global stability. Future research will explore the clinical implications.
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6
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Guseva OV, Zhukova NG. [Nordic walking in winter as the multitask training in patients with Parkinson's disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:38-42. [PMID: 33580759 DOI: 10.17116/jnevro202112101138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate an influence of 8-week course of winter nordic walking as the multitask on the spatial-temporal characteristics of walking and motor disturbances in patients with Parkinson's disease (PD). MATERIAL AND METHODS Eleven patients (3 men and 8 women, mean age 66.82±3.97 years) with Hoehn and Yahr stage 1 to 2 PD were included in the study. Preliminary medical examination, including the anthropometric profile with the calculation of the body mass index (BMI), the grip strength on the right and left sides, spirometry, functional tests with the physical load (orthostatic test with the determination of systolic and diastolic blood pressure (SBP and DPB) and type of reaction (normal, hypertonic, hypotonic), the 6 Minute Walk Test, timed Up and Go test), was performed to evaluate the physical state. The evaluation of motor function was performed using the unified Parkinson's disease rating scale of the Movement Disorder Society (MDS UPDRS), part III. A 8-week course of nordic walking training was carried out at the certified track on the stadium localized outside of the city, in the wood and parks area in the winter. RESULTS Compared to the first training, gait velocity increased at the 3rd session, the step length at the 6th. The improvement of the spatial-temporal characteristics of walking was accompanied by the improvement of the motor function as measured by MDS UPDRS, part III. CONCLUSION Winter nordic walking as multitask is the effective measure of exercise treatment in patients with PD, because it improves the spatial-temporal characteristics of walking and the motor function.
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Affiliation(s)
- O V Guseva
- Siberian State Medical University, Tomsk, Russia
| | - N G Zhukova
- Siberian State Medical University, Tomsk, Russia
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7
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Zanardi APJ, da Silva ES, Costa RR, Passos-Monteiro E, Dos Santos IO, Kruel LFM, Peyré-Tartaruga LA. Gait parameters of Parkinson's disease compared with healthy controls: a systematic review and meta-analysis. Sci Rep 2021; 11:752. [PMID: 33436993 PMCID: PMC7804291 DOI: 10.1038/s41598-020-80768-2] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 12/28/2020] [Indexed: 12/15/2022] Open
Abstract
We systematically reviewed observational and clinical trials (baseline) studies examining differences in gait parameters between Parkinson’s disease (PD) in on-medication state and healthy control. Four electronic databases were searched (November-2018 and updated in October-2020). Independent researchers identified studies that evaluated gait parameters measured quantitatively during self-selected walking speed. Risk of bias was assessed using an instrument proposed by Downs and Black (1998). Pooled effects were reported as standardized mean differences and 95% confidence intervals using a random-effects model. A total of 72 studies involving 3027 participants (1510 with PD and 1517 health control) met the inclusion criteria. The self-selected walking speed, stride length, swing time and hip excursion were reduced in people with PD compared with healthy control. Additionally, PD subjects presented higher cadence and double support time. Although with a smaller difference for treadmill, walking speed is reduced both on treadmill (.13 m s−1) and on overground (.17 m s−1) in PD. The self-select walking speed, stride length, cadence, double support, swing time and sagittal hip angle were altered in people with PD compared with healthy control. The precise determination of these modifications will be beneficial in determining which intervention elements are most critical in bringing about positive, clinically meaningful changes in individuals with PD (PROSPERO protocol CRD42018113042).
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Affiliation(s)
- Ana Paula Janner Zanardi
- Exercise Research Laboratory, Universidade Federal Do Rio Grande Do Sul, 750 Felizardo St, Porto Alegre, RS, 90690-200, Brazil.,Univel University Center, Cascavel, Brazil
| | - Edson Soares da Silva
- Exercise Research Laboratory, Universidade Federal Do Rio Grande Do Sul, 750 Felizardo St, Porto Alegre, RS, 90690-200, Brazil
| | - Rochelle Rocha Costa
- Exercise Research Laboratory, Universidade Federal Do Rio Grande Do Sul, 750 Felizardo St, Porto Alegre, RS, 90690-200, Brazil
| | - Elren Passos-Monteiro
- Exercise Research Laboratory, Universidade Federal Do Rio Grande Do Sul, 750 Felizardo St, Porto Alegre, RS, 90690-200, Brazil.,Laboratory of PhysioMechanics of Locomotion, Universidade Federal Do Pará, Castanhal, Brazil
| | - Ivan Oliveira Dos Santos
- Exercise Research Laboratory, Universidade Federal Do Rio Grande Do Sul, 750 Felizardo St, Porto Alegre, RS, 90690-200, Brazil
| | - Luiz Fernando Martins Kruel
- Exercise Research Laboratory, Universidade Federal Do Rio Grande Do Sul, 750 Felizardo St, Porto Alegre, RS, 90690-200, Brazil
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8
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Spatiotemporal characteristics of locomotor adaptation of walking with two handheld poles. Exp Brain Res 2020; 238:2973-2982. [PMID: 33074403 DOI: 10.1007/s00221-020-05954-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/10/2020] [Indexed: 02/04/2023]
Abstract
Pole walking (PW) has received attention not only as a whole-body exercise that can be adapted for elderly people with poor physical fitness but also as a possible intervention for the restoration of gait function in normal walking without the use of poles (i.e., conventional walking CW). However, the characteristics of PW, especially how and why PW training affects CW, remain unclear. The purpose of this study was to examine the characteristics of locomotor adaptation in PW from the perspective of kinematic variables. For this purpose, we compared the locomotor adaptation in PW and CW to that when walking on a split-belt treadmill in terms of spatial and temporal coordination. The result showed that adaptations to the split-belt treadmill in PW and CW were found only in interlimb parameters (step length and double support time ratios (fast/slow limb)), not in intralimb parameters (stride length and stance time ratios). In these interlimb parameters, the movement patterns acquired through split-belt locomotor adaptations (i.e., the aftereffects) were transferred between CW and PW regardless of whether the novel movement patterns were learned in CW or PW. The aftereffects of double support time and step length learned in CW were completely washed out by the subsequent execution in PW. On the other hand, the aftereffect of double support time learned in PW was not completely washed out by the subsequent execution in CW, whereas the aftereffect of step length learned in PW was completely washed out by the subsequent execution in CW. These results suggest that the neural mechanisms related to controlling interlimb parameters are shared between CW and PW, and it is possible that, in interlimb coordination, temporal coordination is preferentially stored in adaptation during PW.
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Roy M, Grattard V, Dinet C, Soares AV, Decavel P, Sagawa YJ. Nordic walking influence on biomechanical parameters: a systematic review. Eur J Phys Rehabil Med 2020; 56:607-615. [PMID: 32397704 DOI: 10.23736/s1973-9087.20.06175-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Nordic walking (NW) as a form of physical activity has been shown to have benefits in various domains, but little is known about the effect of NW on more specific biomechanical parameters. The purpose is to determine the impact of NW on the following parameters: walking speed/distance, muscle activation, spatiotemporal parameters, kinematics and ground reaction force. EVIDENCE ACQUISITION A literature search was carried out in different databases from October 2008 to October 2018. This review was conducted and reported in accordance with the PRISMA statement. Finally, 42 studies with a median PEDro Score of 5.5/10 were included. EVIDENCE SYNTHESIS The included studies reported increased walking distance (+14.8%, P<0.05), walking speed (+25.5%, P<0.05), and stride length (+10.4%, P<0.05), but decreased cadence (-6.2%, P<0.05). NW generally increased: muscle activation and strength for upper limbs; upper and lower limb range of motion, and ground reaction force. CONCLUSIONS NW has beneficial effects on many biomechanical parameters. It appears to be an effective way of doing physical activity and could be used in physical rehabilitation or in daily life.
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Affiliation(s)
- Manon Roy
- Laboratory of Clinical Functional Exploration of Movement, University Hospital of Besançon, Besançon, France - .,Institute of Physical Therapy, University Hospital of Besançon, Besançon, France -
| | - Véronique Grattard
- Institute of Physical Therapy, University Hospital of Besançon, Besançon, France
| | - Christophe Dinet
- Institute of Physical Therapy, University Hospital of Besançon, Besançon, France
| | - Antonio V Soares
- University of Joinville Region and Ielusc College, Joinville, Brazil
| | - Pierre Decavel
- Laboratory of Clinical Functional Exploration of Movement, University Hospital of Besançon, Besançon, France.,Integrative and Clinical Neurosciences EA481, University of Burgundy Franche-Comte, Besançon, France
| | - Yoshimasa J Sagawa
- Laboratory of Clinical Functional Exploration of Movement, University Hospital of Besançon, Besançon, France.,Integrative and Clinical Neurosciences EA481, University of Burgundy Franche-Comte, Besançon, France
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10
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De Santis KK, Kaplan I. The motor and the non-motor outcomes of Nordic Walking in Parkinson's disease: A systematic review. J Bodyw Mov Ther 2020; 24:4-10. [DOI: 10.1016/j.jbmt.2020.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 11/03/2019] [Accepted: 01/27/2020] [Indexed: 01/08/2023]
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The Therapeutic Effect of Nordic Walking on Freezing of Gait in Parkinson's Disease: A Pilot Study. PARKINSONS DISEASE 2019; 2019:3846279. [PMID: 32089815 PMCID: PMC7024088 DOI: 10.1155/2019/3846279] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/27/2019] [Accepted: 12/05/2019] [Indexed: 11/17/2022]
Abstract
Introduction. The effectiveness of the currently utilized therapies for FoG is limited. Several studies demonstrated a beneficial impact of Nordic walking (NW) on several gait parameters in Parkinson's disease, but only one paper reported reduction of freezing. Research Question. In the present study, the question is whether NW is an effective therapeutic intervention in FoG.
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Brognara L, Palumbo P, Grimm B, Palmerini L. Assessing Gait in Parkinson's Disease Using Wearable Motion Sensors: A Systematic Review. Diseases 2019; 7:diseases7010018. [PMID: 30764502 PMCID: PMC6473911 DOI: 10.3390/diseases7010018] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 01/26/2023] Open
Abstract
Abstract: Parkinson’s disease (PD) is a progressive neurodegenerative disorder. Gait impairments are common among people with PD. Wearable sensor systems can be used for gait analysis by providing spatio-temporal parameters useful to investigate the progression of gait problems in Parkinson disease. However, various methods and tools with very high variability have been developed. The aim of this study is to review published articles of the last 10 years (from 2008 to 2018) concerning the application of wearable sensors to assess spatio-temporal parameters of gait in patients with PD. We focus on inertial sensors used for gait analysis in the clinical environment (i.e., we do not cover the use of inertial sensors to monitor walking or general activities at home, in unsupervised environments). Materials and Methods: Relevant articles were searched in the Medline database using Pubmed. Results and Discussion: Two hundred ninety-four articles were initially identified while searching the scientific literature regarding this topic. Thirty-six articles were selected and included in this review. Conclusion: Wearable motion sensors are useful, non-invasive, low-cost, and objective tools that are being extensively used to perform gait analysis on PD patients. Being able to diagnose and monitor the progression of PD patients makes wearable sensors very useful to evaluate clinical efficacy before and after therapeutic interventions. However, there is no uniformity in the use of wearable sensors in terms of: number of sensors, positioning, chosen parameters, and other characteristics. Future research should focus on standardizing the measurement setup and selecting which spatio-temporal parameters are the most informative to analyze gait in PD. These parameters should be provided as standard assessments in all studies to increase replicability and comparability of results.
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Affiliation(s)
- Lorenzo Brognara
- Department of Biomedical and Neuromotor Science, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy.
| | - Pierpaolo Palumbo
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy.
| | - Bernd Grimm
- Sylvia Lawry Centre - The Human Motion Institute, 81677 Munich, Germany.
| | - Luca Palmerini
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy.
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Ben Mansour K, Gorce P, Rezzoug N. The impact of Nordic walking training on the gait of the elderly. J Sports Sci 2018; 36:2368-2374. [PMID: 29582714 DOI: 10.1080/02640414.2018.1458396] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The purpose of the current study was to define the impact of regular practice of Nordic walking on the gait of the elderly. Thereby, we aimed to determine whether the gait characteristics of active elderly persons practicing Nordic walking are more similar to healthy adults than that of the sedentary elderly. Comparison was made based on parameters computed from three inertial sensors during walking at a freely chosen velocity. Results showed differences in gait pattern in terms of the amplitude computed from acceleration and angular velocity at the lumbar region (root mean square), the distribution (Skewness) quantified from the vertical and Euclidean norm of the lumbar acceleration, the complexity (Sample Entropy) of the mediolateral component of lumbar angular velocity and the Euclidean norm of the shank acceleration and angular velocity, the regularity of the lower limbs, the spatiotemporal parameters and the variability (standard deviation) of stance and stride durations. These findings reveal that the pattern of active elderly differs significantly from sedentary elderly of the same age while similarity was observed between the active elderly and healthy adults. These results advance that regular physical activity such as Nordic walking may counteract the deterioration of gait quality that occurs with aging.
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Affiliation(s)
| | - Philippe Gorce
- a HandiBio Laboratory, University of Toulon , Toulon Cedex 9 , France
| | - Nasser Rezzoug
- a HandiBio Laboratory, University of Toulon , Toulon Cedex 9 , France
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14
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Metabolic and kinematic parameters during walking with poles in Parkinson's disease. J Neurol 2017; 264:1785-1790. [PMID: 28695362 DOI: 10.1007/s00415-017-8568-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/03/2017] [Accepted: 07/04/2017] [Indexed: 10/19/2022]
Abstract
In healthy people, energy expenditure is generally higher during walking with poles (WP) than during conventional walking (W). In persons with Parkinson's disease (PD), walking is slower and may be associated with greater energy consumption, stride-to-stride variability, and difficulty in regulating stride length. The aim of this study was to determine whether treadmill WP at three different speeds could induce changes in gait kinematics and oxygen consumption in PD patients. The study sample was 20 patients with mild-to-moderate PD and 20 age-matched healthy controls. Subjects underwent 5-min W and WP treadmill tests at three different speeds (2.5, 3.5, and 4.5 km/h). Metabolic and gait parameters (ventilation, gas exchange, stride count and length) were recorded. As compared with the healthy controls, higher energy consumption (P < 0.05) (and other metabolic parameters), shorter stride, and reduced cadence (P < 0.05) were observed for the PD patients, independent of the walking technique. All subjects were noted to take longer strides during WP (P < 0.001), especially at the lowest treadmill speed. However, significantly higher energy consumption was observed only for the healthy controls (P < 0.05). No changes in metabolic parameters during WP were recorded; however, a substantial improvement in gait cycle length was noted for the PD patients.
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