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Hedman LD, Gill-Body KM, Plummer L, Quinn L, Riley N, Tyrell CM. On "Concerns on the Science and Practice of a Movement System." Joyce CT, Beneciuk JM, George SZ. Phys Ther. 2023;103:pzad087. https://doi.org/10.1093/ptj/pzad087. Phys Ther 2024; 104:pzae022. [PMID: 38381621 DOI: 10.1093/ptj/pzae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Affiliation(s)
- Lois D Hedman
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kathleen M Gill-Body
- Department of Rehabilitation Services, Newton-Wellesley Hospital, Newton, Massachusetts, USA
| | - Laura Plummer
- Department of Physical Therapy, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College Columbia University, New York, New York, USA
| | - Nora Riley
- Department of Physical Therapy, St. Ambrose University, Davenport, Iowa, USA
| | - Christine M Tyrell
- Department of Physical Therapy, Jefferson College of Rehabilitation Sciences, Philadelphia, Pennsylvania, USA
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Metelski N, Gu Y, Quinn L, Friel KM, Gordon AM. Safety and efficacy of non-invasive brain stimulation for the upper extremities in children with cerebral palsy: A systematic review. Dev Med Child Neurol 2024; 66:573-597. [PMID: 37528530 DOI: 10.1111/dmcn.15720] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 08/03/2023]
Abstract
AIM To evaluate available evidence examining safety and efficacy of non-invasive brain stimulation (NIBS) on upper extremity outcomes in children with cerebral palsy (CP). METHOD We electronically searched 12 sources up to May 2023 using JBI and Cochrane guidelines. Two reviewers selected articles with predetermined eligibility criteria, conducted data extraction, and assessed risk of bias using the Cochrane Risk of Bias criteria. RESULTS Nineteen studies were included: eight using repetitive transcranial magnetic stimulation (rTMS) and 11 using transcranial direct current stimulation (tDCS). Moderate certainty evidence supports the safety of rTMS and tDCS for children with CP. Very low to moderate certainty evidence suggests that rTMS and tDCS result in little to no difference in upper extremity outcomes. INTERPRETATION Evidence indicates that NIBS is a safe and feasible intervention to target upper extremity outcomes in children with CP, although it also indicates little to no significant impact on upper extremity outcomes. These findings are discussed in relation to the heterogeneous participants' characteristics and stimulation parameters. Larger studies of high methodological quality are required to inform future research and protocols for NIBS.
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Affiliation(s)
- Nicole Metelski
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Yu Gu
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Kathleen M Friel
- Burke Neurological Institute, White Plains, New York, and Weill Cornell Medicine, New York, New York, USA
| | - Andrew M Gordon
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
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Borders JC, Lowell ER, Huber JE, Quinn L, Michelle S Troche. A Preliminary Study of Voluntary Cough Motor Performance and Learning With Skill Training and Biofeedback. J Speech Lang Hear Res 2024:1-25. [PMID: 38557139 DOI: 10.1044/2024_jslhr-23-00516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
PURPOSE Sensorimotor cough skill training (CST) has been shown to improve cough strength, as well as facilitate changes during training (i.e., motor performance) and generalization to untrained tasks (i.e., motor learning). However, there is a gap in our understanding of the effects of voluntary CST (without sensory stimuli) on motor performance and learning. Furthermore, the contribution of physiologic factors, such as lung volume, a driver of cough strength in healthy adults, and treatment-specific factors, such as biofeedback, remains unexamined. METHOD Twenty individuals with Parkinson's disease (PD) completed pre- and post-CST single voluntary, sequential voluntary, and reflex cough testing. Participants were randomized to biofeedback or no biofeedback groups. They completed one CST session involving 25 trials of voluntary coughs, with the treatment target set 25% above baseline peak flow. Participants were instructed to "cough hard" to exceed the target. In the biofeedback group, participants received direct visualization of the target line in real time. RESULTS Cough peak flow showed positive improvements in motor performance (β = .02; 95% credible interval [CI]: 0.01, 0.03) and learning (β = .26; 95% CI: 0.03, 0.47). Changes in lung volume from pre- to post-CST did not predict treatment response. No differences in treatment response were detected between the biofeedback groups. CONCLUSIONS A single session of voluntary CST improved voluntary cough motor performance and learning. Although lung volume increased during CST, changes to lung volume did not predict treatment response. These findings demonstrate the potential of voluntary CST to improve motor performance and motor learning among individuals with PD and cough dysfunction. SUPPLEMENTAL MATERIAL AND OPEN SCIENCE FORM https://doi.org/10.23641/asha.25447444.
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Affiliation(s)
- James C Borders
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Emilie R Lowell
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Jessica E Huber
- Motor Speech Laboratory, Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
| | - Lori Quinn
- Neurorehabilitation Research Laboratory, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Michelle S Troche
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
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Desai R, Martelli D, Alomar JA, Agrawal S, Quinn L, Bishop L. Validity and reliability of inertial measurement units for gait assessment within a post stroke population. Top Stroke Rehabil 2024; 31:235-243. [PMID: 37545107 DOI: 10.1080/10749357.2023.2240584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/15/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND The ability to objectively measure spatiotemporal metrics within individuals post-stroke is integral to plan appropriate intervention, track recovery, and ultimately improve efficacy of rehabilitation programs. Inertial measurement units (IMUs) provide a means to systematically collect gait-specific metrics that could not otherwise be obtained from clinical outcomes. However, the use of IMUs to measure spatiotemporal parameters in stroke survivors has yet to be validated. The purpose of this study is to determine the validity and reliability of IMU-recorded spatiotemporal gait metrics as compared to a motion capture camera system (MCCS) in individuals post-stroke. METHODS Participants (n = 23, M/F = 12/11, mean (SD) age = 50.2(11.1) spatiotemporal data were collected simultaneously from a MCCS and APDM Opal IMUs during a five-minute treadmill walking task at a self-selected speed. Criterion validity and test-retest reliability were assessed using Lin's concordance correlation coefficients (CCCs) and intraclass correlation coefficients (ICCs), respectively. Spatiotemporal values from MCCS and IMU were used to calculate gait asymmetry, and a t-test was used to assess the difference between asymmetry values. RESULTS There were fair-to-excellent agreement between IMU and MCCS of temporal parameters (CCC 0.56-0.98), excellent agreement of spatial parameters (CCC >0.90), and excellent test-retest reliability for all parameters (ICC >0.90). CONCLUSIONS Compared to motion capture, the APDM Opal IMUs produced accurate and reliable measures of spatiotemporal parameters. Findings support the use of IMUs to assess spatiotemporal parameters in individual's post-stroke.
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Affiliation(s)
- Radhika Desai
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Dario Martelli
- Department of Mechanical Engineering, School of Engineering and Applied Science, Columbia University, New York, NY, USA
| | - Jehan A Alomar
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Sunil Agrawal
- Department of Mechanical Engineering, School of Engineering and Applied Science, Columbia University, New York, NY, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Lauri Bishop
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
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Kipnis D, Leung S, Schreier AR, Kwei K, Shah H, Quinn L. An Individualized Yoga Intervention for People with Functional Neurological Disorder: Case Series. Int J Yoga Therap 2024; 34:Article 3. [PMID: 38519849 DOI: 10.17761/2024-d-23-00165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
Functional neurological disorder (FND) is a heterogeneous condition of neurological symptoms that cannot be linked to a specific neurological cause. Yoga combines movement, breathing, and meditation and has established mind-body effects for people who are managing both psychological and neurological conditions. This case series describes key components of a yoga program for people with FND, evaluating feasibility, acceptability, and efficacy via self-report surveys, clinical assessments, and postintervention interview. Four individuals with FND participated in 45-minute, one-to-one virtual yoga sessions, two times a week for 8 weeks. We measured outcomes in four domains (healthcare utilization, FND symptoms, quality of life and self-efficacy, and function and mobility) at baseline, week 4, and week 8. Assessments included the Psychogenic Movement Disorders Rating Scale, timed up-and-go test, Patient Health Questionnaire-15, Brief Illness Perceptions Questionnaire, 36-Item Short Form Health Survey, and University of Washington Self-Efficacy Scale. Four participants completed at least 8 sessions, and two completed the full intervention (16 sessions). There were no adverse events. Two participants reported positive changes after yoga and improved on all clinical assessments (timed up-and-go test and Psychogenic Movement Disorders Rating Scale). Postintervention interview analysis revealed three themes: negative diagnosis experience, perceived health effects of yoga, and session format preferences. This was an exploratory case series describing a yoga intervention that was associated with some benefits for people with FND (decreased FND symptom severity and increased function, perceived health, quality of life, and self-efficacy). A larger case series is warranted to understand how to best select individuals who would benefit from the program.
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Affiliation(s)
| | - Sally Leung
- Teachers College, Columbia University, New York, N.Y
| | | | - Kimberly Kwei
- Department of Neurology, Columbia University Irving Medical Center, New York, N.Y
| | - Hiral Shah
- Department of Neurology, Columbia University Irving Medical Center, New York, N.Y
| | - Lori Quinn
- Teachers College, Columbia University, New York, N.Y
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Kipnis D, Pacheco A, Delfing D, Toomer-Mensah N, Macpherson CE, Rieger J, Parker A, Coley RB, Coley D, Shah H, Quinn L. Community-based participatory research approach to address healthcare disparities confronting members of the Black Diaspora with Parkinson's disease. Parkinsonism Relat Disord 2024; 119:105936. [PMID: 38145610 DOI: 10.1016/j.parkreldis.2023.105936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 12/27/2023]
Affiliation(s)
- Danielle Kipnis
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th St., New York, NY, 10027, United States
| | - Alissa Pacheco
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th St., New York, NY, 10027, United States
| | - Dalina Delfing
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th St., New York, NY, 10027, United States
| | - Nia Toomer-Mensah
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th St., New York, NY, 10027, United States; Mount Neboh Baptist Church, 1883 Adam Clayton Powell Jr Blvd, New York, NY, 10026, United States; Long Island University, Brooklyn, NY, United States
| | - Chelsea E Macpherson
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th St., New York, NY, 10027, United States
| | - Jamie Rieger
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th St., New York, NY, 10027, United States
| | - Anita Parker
- St. Luke's AME Church, 1872 Amsterdam Ave, New York, NY, 10031, United States
| | - R Bernard Coley
- Special Interest Group (SIG) Black Diaspora, Morgan Hill, CA, United States
| | - Denise Coley
- Special Interest Group (SIG) Black Diaspora, Morgan Hill, CA, United States
| | - Hiral Shah
- Department of Neurology, Columbia University Irving Medical Center, 710 W 168th St, New York, NY, 10033, United States
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th St., New York, NY, 10027, United States; Department of Rehabilitation and Regenerative Medicine (Physical Therapy), Columbia University Irving Medical Center, Harkness Pavilion Suite 199, 180 Fort Washington Ave, New York, NY, 10032, United States.
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Li H, Desai R, Quiles N, Quinn L, Friel C. Characterizing Heart Rate Variability Response to Maximal Exercise Testing in People with Huntington's Disease. J Huntingtons Dis 2024; 13:67-76. [PMID: 38489192 DOI: 10.3233/jhd-230593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Background Huntington's disease (HD) is an autosomal dominant, neurodegenerative disease that involves dysfunction in the autonomic nervous system (ANS). Heart rate variability (HRV) is a valid and noninvasive measure for ANS dysfunction, yet no study has characterized HRV response to exercise in people with HD. Objective Characterize HRV response to exercise in individuals with HD and explore its implications for exercise prescription and cardiac dysautonomia mechanisms. Methods 19 participants with HD were recruited as part of a cohort of individuals enrolled in the Physical Activity and Exercise Outcomes in Huntington's Disease (PACE-HD) study at Teachers College, Columbia University (TC). 13 non-HD age- and gender-matched control participants were also recruited from TC. HRV was recorded with a Polar H10 heart rate (HR) monitor before, during, and after a ramp cycle-ergometer exercise test. Results Participants with HD showed reduced HR peak (p < 0.01) and HR reserve (p < 0.001) compared with controls. Participants with HD demonstrated reduced root mean square of successive differences between normal-to-normal intervals (RMSSD) and successive differences of normal-to-normal intervals (SDSD) at rest (p < 0.001). Participants with HD also showed differences for low frequency (LF) power (p < 0.01), high frequency (HF) normalized units (nu) (p < 0.05), LF (nu) (p < 0.001), and HF/LF ratio (p < 0.05) compared with controls. Conclusions We found reduced aerobic exercise capacity and sympathovagal dysautonomia both at rest and during post-exercise recovery in people with HD, suggesting modified exercise prescription may be required for people with HD. Further investigations focusing on cardiac dysautonomia and underlying mechanisms of sympathovagal dysautonomia in people with HD are warranted.
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Affiliation(s)
- Haoyu Li
- Programs in Physical Therapy, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Radhika Desai
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Norberto Quiles
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, New York, NY, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Ciarán Friel
- Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
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Šimková I, Aiglová R, Koubek F, Přeček J, Látal J, Buriánková E, Quinn L, Henzlová L, Táborský M, Švébišová H, Tučková L, Melichar B. Carcinoid syndrome with right-sided valve involvement - a case report and review of the literature. Klin Onkol 2024; 38:139-145. [PMID: 38697823 DOI: 10.48095/ccko2024139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
BACKGROUND The survival of patients with neuroendocrine tumors has substantially improved with modern treatment options. Although the associated carcinoid syndrome can be diagnosed early and controlled effectively, cardiologists still encounter patients with cardiac manifestations, particularly among individuals with persistently high levels of vasoactive mediators. Treatment options have been limited to surgical valve replacement in fully manifested disease. Since surgery is not always feasible, transcatheter valve implantation is becoming an interesting alternative. CASE A case of a 50-year-old woman with carcinoid syndrome and right-sided valvular heart disease is presented. Moderate pulmonary valve stenosis and severe tricuspid valve regurgitation were diagnosed during the evaluation and treatment of neuroendocrine tumor. The possibility of rare valve involvement and the need for interdisciplinary cooperation in the diagnosis, monitoring and treatment of patients with neuroendocrine tumors producing vasoactive substances must be emphasized. CONCLUSION The patient had a typically presenting carcinoid syndrome with a rare cardiac manifestation. Although monitoring and treatment were carried out in accordance with recommendations and appropriate to the clinical condition, rapid progression of the metastatic disease ultimately precluded invasive cardiac intervention.
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Macpherson CE, Fineman J, Chandrana A, Quinn L. Development of a Physical Therapy Telehealth Examination Battery for People with Parkinson Disease. Int J Telerehabil 2023; 15:e6592. [PMID: 38162943 PMCID: PMC10754248 DOI: 10.5195/ijt.2023.6592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Scope The rapid transition to telehealth following the COVID-19 pandemic raised challenges for remote delivery of physical therapy. One challenge was identifying outcome measures for people with Parkinson Disease (PwP) that could safely be conducted via telehealth. This paper evaluates the feasibility of a telehealth physical therapy examination battery for PwP in early to middle stage of disease progression. Methodology We reviewed recommended outcome measures from the American Physical Therapy Association's Academy of Neurologic Physical Therapy (ANPT) Parkinson Evidence Database to Guide Effectiveness (EDGE) document and evaluated their appropriateness for remote administration. A clinical decision tree was created to streamline the examination process, incorporating elements of the ANPT movement analysis of tasks as a movement screen. The examination battery was then conducted on three PwP and evaluated for safety and feasibility. Conclusion This physical therapy telehealth examination battery provides physical therapists with a method to conduct safe and efficient remote assessments for PwP.
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Affiliation(s)
- Chelsea E. Macpherson
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Julie Fineman
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
- Doctor of Physical Therapy Program, Marist College, Poughkeepsie, NY, USA
| | - Anuja Chandrana
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
- Department of Rehabilitation and Regenerative Medicine (Physical Therapy), Columbia University Irving Medical Center, New York, NY, USA
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Kipnis D, Kruusamäe H, King M, Schreier AR, Quinn L, Shih HJS. Dance interventions for individuals post-stroke - a scoping review. Top Stroke Rehabil 2023; 30:768-785. [PMID: 35968809 DOI: 10.1080/10749357.2022.2107469] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 07/24/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND There is a growing body of literature assessing the potential benefits of dance for individuals post-stroke. OBJECTIVES We conducted a scoping review mapping the state of the literature on feasibility, intervention procedures, and efficacy of dance to improve health-related outcomes for individuals post-stroke. ELIGIBILITY CRITERIA Included studies were original research that described the use of a dance intervention for individuals post-stroke, included any health-related outcome, and were written in English. SOURCES OF EVIDENCE Databases selected were Pubmed, Scopus, Google Scholar, Proquest, MedRxiv, and CINHAL. CHARTING METHODS Two reviewers extracted relevant data and results were organized into themes and categories determined by all authors through discussion. RESULTS We searched electronic databases were in February 2021. We included 18 publications from 14 studies. Ten were quantitative, five were qualitative, one was mixed-methods, and two were community project descriptions. Twelve publications evaluated in-person dance classes and six evaluated dance exergaming. Based on the limited studies included, evidence suggests dance is a feasible and potentially effective intervention for individuals post-stroke. Studies demonstrate dance may facilitate changes in balance and fall risk, encourage confidence, promote comfort with the changed body, increase rehabilitation motivation, and facilitate community reintegration. Evidence is limited by number of studies, design (lack of control groups and blinded assessments), intervention descriptions, and outcomes reporting. CONCLUSIONS There is growing interest in dance for stroke interventions. Further research should focus on rigorous study design, optimal intervention timing, consistency of reporting outcomes, key elements of dance classes, and the impact of cultural dance styles.
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Affiliation(s)
- Danielle Kipnis
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York City, NY, USA
| | - Helena Kruusamäe
- Institute of Sport Sciences and Physiotherapy, University of Tartu
- Estonian Military Academy
| | - Miriam King
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York City, NY, USA
| | - Abigail R Schreier
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York City, NY, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York City, NY, USA
- Department of Rehabilitation and Regenerative Medicine (Physical Therapy), Columbia University Irving Medical Center
| | - Hai-Jung Steffi Shih
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York City, NY, USA
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Németh AH, Antoniades CA, Dukart J, Minnerop M, Rentz C, Schuman BJ, van de Warrenburg B, Willemse I, Bertini E, Gupta AS, de Mello Monteiro CB, Almoajil H, Quinn L, Perlman SB, Horak F, Ilg W, Traschütz A, Vogel AP, Dawes H. Using Smartphone Sensors for Ataxia Trials: Consensus Guidance by the Ataxia Global Initiative Working Group on Digital-Motor Biomarkers. Cerebellum 2023:10.1007/s12311-023-01608-3. [PMID: 38015365 DOI: 10.1007/s12311-023-01608-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 11/29/2023]
Abstract
Smartphone sensors are used increasingly in the assessment of ataxias. To date, there is no specific consensus guidance regarding a priority set of smartphone sensor measurements, or standard assessment criteria that are appropriate for clinical trials. As part of the Ataxia Global Initiative Digital-Motor Biomarkers Working Group (AGI WG4), aimed at evaluating key ataxia clinical domains (gait/posture, upper limb, speech and oculomotor assessments), we provide consensus guidance for use of internal smartphone sensors to assess key domains. Guidance was developed by means of a literature review and a two stage Delphi study conducted by an Expert panel, which surveyed members of AGI WG4, representing clinical, research, industry and patient-led experts, and consensus meetings by the Expert panel to agree on standard criteria and map current literature to these criteria. Seven publications were identified that investigated ataxias using internal smartphone sensors. The Delphi 1 survey ascertained current practice, and systems in use or under development. Wide variations in smartphones sensor use for assessing ataxia were identified. The Delphi 2 survey identified seven measures that were strongly endorsed as priorities in assessing 3/4 domains, namely gait/posture, upper limb, and speech performance. The Expert panel recommended 15 standard criteria to be fulfilled in studies. Evaluation of current literature revealed that none of the studies met all criteria, with most being early-phase validation studies. Our guidance highlights the importance of consensus, identifies priority measures and standard criteria, and will encourage further research into the use of internal smartphone sensors to measure ataxia digital-motor biomarkers.
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Affiliation(s)
- Andrea H Németh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Chrystalina A Antoniades
- Neurometrology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Martina Minnerop
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine, (INM-1), Research Centre Jülich, Jülich, Germany
| | - Clara Rentz
- Institute of Neuroscience and Medicine, (INM-1), Research Centre Jülich, Jülich, Germany
| | | | - Bart van de Warrenburg
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, 6525, Nijmegen, Netherlands
| | - Ilse Willemse
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders, Dept Neurosciences, Bambino Gesu' Children's Research Hospital, IRCCS, Rome, Italy
| | - Anoopum S Gupta
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Carlos Bandeira de Mello Monteiro
- Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
- School of Arts, Science and Humanities, University of São Paulo, São Paulo, SP, Brazil
| | - Hajar Almoajil
- Physical Therapy Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Damman, Saudi Arabia
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | | | - Fay Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- APDM Precision Motion, Clario, Portland, OR, USA
| | - Winfried Ilg
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, Tübingen, Germany
- Centre for Integrative Neuroscience (CIN), Tübingen, Germany
| | - Andreas Traschütz
- Research Division "Translational Genomics of Neurodegenerative Diseases", Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Adam P Vogel
- Centre for Neuroscience of Speech, The University of Melbourne, Melbourne, Australia
- Division of Translational Genomics of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Center for Neurology, University Hospital Tübingen, Tübingen, Germany
- Redenlab Inc, Melbourne, Australia
| | - Helen Dawes
- NIHR Exeter Biomedical Research Centre, Medical School, Faculty of Health and Life Sciences, College of Medicine and Health, St Lukes Campus, University of Exeter, Heavitree Road, Exeter, UK.
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Barbuto S, Lee S, Stein J, Kuo SH, Quinn L, Spinner M, Derovanessian T, Stern Y. Physical Activity and Fitness Levels of Individuals With Ataxia: A Cross-Sectional Study. Arch Phys Med Rehabil 2023; 104:1669-1675. [PMID: 37380120 PMCID: PMC10543624 DOI: 10.1016/j.apmr.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/06/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE To investigate physical activity levels of individuals with ataxia and correlate fitness to ataxia severity. DESIGN An observational study SETTING: An outpatient ataxia clinic in a large, tertiary, urban hospital in the US. PARTICIPANTS Individuals with cerebellar ataxia (N=42). INTERVENTION Not applicable. MAIN OUTCOME MEASURE Participants were classified as sedentary or physically active using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Maximal oxygen consumption (V̇o2max) as an indicator of fitness level was measured, and ataxia severity was determined by the Scale for the Assessment and Rating of Ataxia (SARA). Mixed effect models were used to correlate ataxia severity to fitness levels. RESULTS Most participants (28 out of 42) lived sedentary lifestyles, and these individuals had poor fitness levels (only 67.3% of their predicted measure). The main barriers to physical activity included lack of energy, lack of time, and fear of falling. There were no differences in age, sex, disease type, disease duration, ataxia severity, fatigue level, and medication use between sedentary and active groups. Measures of V̇o2max, maximal work, maximal heart rate, and anerobic threshold demonstrated statistically significant differences between groups whereas maximal respiratory rate and expired ventilation/carbon dioxide production were similar between groups. When adjusting for age, sex, functional mobility status, and disease duration, ataxia severity was inversely correlated with fitness level in the sedentary group. There was no relationship between ataxia severity and fitness level in the 14 individuals who were physically active. CONCLUSIONS Lower fitness levels were associated with more ataxia symptoms in the sedentary group. This relationship was not seen in individuals who were more active. Given the poor health outcomes associated with low fitness, physical activity should be encouraged in this population.
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Affiliation(s)
- Scott Barbuto
- Department of Physical Medicine and Rehabilitation, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY.
| | - Seonjoo Lee
- Department of Biostatistics, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY
| | - Joel Stein
- Department of Physical Medicine and Rehabilitation, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY; Department of Physical Medicine and Rehabilitation, Weill Cornell Medical College, New York, NY
| | - Sheng-Han Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Michael Spinner
- Department of Neurology, Psychiatry, Sergievsky Center and Taub Institute, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY
| | - Therese Derovanessian
- Department of Physical Medicine and Rehabilitation, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY
| | - Yaakov Stern
- Department of Neurology, Psychiatry, Sergievsky Center and Taub Institute, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY
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13
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Shih HJS, Quinn L, Morgan-Jones P, Long K, Schreier AR, Friel CP. Wearable activity monitors to support physical activity interventions in neurodegenerative disease: a feasibility study. Neurodegener Dis Manag 2023. [PMID: 37317956 DOI: 10.2217/nmt-2022-0028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Aim: To evaluate the feasibility of using activity monitors in a physical activity (PA) intervention in people with Parkinson's (PD) and Huntington's disease (HD). Materials & methods: People with early-stage PD (n = 13) and HD (n = 14) enrolled in a 4-month coaching program, wore a Fitbit, and were guided through a behavioral intervention to facilitate PA uptake. Wear time, wear habits and activity metrics (e.g., steps) were analyzed. Results: Retention rate was 85% and participants had an average 92.3% (±9.2) valid wear days. Daily wear time was 18.4 (±4.5) h. Day & night Fitbit wearers showed improvements in steps (d = 1.02) and MET×min/week (d = 0.69) compared with day-only wearers. Conclusion: Implementing wearables in a coaching intervention was feasible and provided insights into PA behavior.
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Affiliation(s)
- Hai-Jung Steffi Shih
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY 10027, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY 10027, USA
- Department of Rehabilitation & Regenerative Medicine (Physical Therapy), Columbia University Irving Medical Center, NY, USA
| | - Philippa Morgan-Jones
- School of Engineering, Cardiff University, CF24 3AA, UK
- Centre for Trials Research, Cardiff University, CF14 4YS, UK
| | - Katrina Long
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY 10027, USA
- Department of Occupational Therapy, San Jose State University, San Jose, CA, USA
| | - Abigail R Schreier
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY 10027, USA
| | - Ciaran P Friel
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, NY 10022, USA
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14
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Fritz NE, Kegelmeyer DA, Rao AK, Quinn L, Kloos AD. Clinical Decision Trees to Guide Physical Therapy Management of Persons with Huntington's Disease. J Huntingtons Dis 2022; 11:435-453. [PMID: 36155527 PMCID: PMC9837690 DOI: 10.3233/jhd-220549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND In 2020, our group published physical therapy clinical practice guidelines (CPG) for people with Huntington's disease (HD). The guideline recommendations were categorized according to six primary movement impairment classifications. OBJECTIVE To facilitate implementation of this CPG, we have developed guideline-based algorithms for physical therapy assessments and interventions and recommendations for therapists to overcome barriers to CPG implementation for people with HD. METHODS We conducted a literature review of papers that evaluated physical therapy interventions in individuals with HD (n = 26) to identify assessments for each of the primary movement impairment classifications, and then searched for papers (n = 28) that reported their clinometric/psychometric properties in HD. Assessments were evaluated using modified Movement Disorder Society Committee on Rating Scales criteria and other relevant criteria. RESULTS We identified a "core set" of physical therapy assessments for persons with HD, including the Six Minute Walk Test, Timed Up and Go Test, Berg Balance Scale, and the Medical Outcomes Study Short Form 36 (SF-36). We then developed guideline-based decision trees to assist in decision making and implementation of the CPG into practice for persons with HD across the continuum of care. Finally, we developed strategies for overcoming barriers to implementation, such as seeking specialized training in HD, engaging caretakers or family members to help the person with HD to exercise, and establishing clinical pathways that support early physical therapy referrals. CONCLUSION Knowledge translation documents such as this are essential to promoting implementation of the physical therapy CPGs into clinical practice.
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Affiliation(s)
- Nora E. Fritz
- Departments of Health Care Sciences and Neurology, Wayne State University, Detroit, MI, USA,Correspondence to: Nora Fritz, PhD, PT, DPT, NCS, Wayne State University, Departments of Health Care Sciences and Neurology, 259 Mack Avenue #2324, Detroit, MI 48201, USA. Tel.: +1 313 577 1096; E-mail:
| | - Deb A. Kegelmeyer
- Physical Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Ashwini K. Rao
- Program in Physical Therapy, Department of Rehabilitative and Regenerative Medicine, G.H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Anne D. Kloos
- Physical Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
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15
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Geller D, Nilsen DM, Quinn L, Van Lew S, Bayona C, Gillen G. Home mirror therapy: a randomized controlled pilot study comparing unimanual and bimanual mirror therapy for improved arm and hand function post-stroke. Disabil Rehabil 2022; 44:6766-6774. [PMID: 34538193 DOI: 10.1080/09638288.2021.1973121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To compare home-based unimanual mirror therapy (UMT) and bimanual mirror therapy (BMT) for upper limb recovery in subacute/chronic stroke individuals with moderate-to-severe arm impairment. METHOD Twenty-two participants were randomized into 1 of 3 groups: UMT, BMT or traditional occupational therapy (TOT) home-based programs. The intervention was 6-weeks and consisted of OT 2 days a week, weekly sessions with the research OT, and 30-minutes of the home-based program 5 days a week, according to group allocation. The Action Research Arm Test (ARAT), ABILHAND, Fugl-Meyer Assessment (FMA), grip strength, and Stroke Impact Scale (SIS) were used for outcome measures. RESULTS All groups significantly improved over time on all outcome measures and adhered to the prescribed dosage regardless of group (p<0.05). While there were no between-group differences, effect size and 95% confidence interval data suggest a clinical significance in favor of UMT as compared to the other groups. CONCLUSIONS All participants, regardless of home-based program, adhered to the prescribed dosage and significantly improved over time. Despite no between-group differences, effect size and 95% confidence interval data suggest that UMT may be more beneficial for individuals with moderate-to-severe arm impairment as compared to BMT or TOT. ClinicalTrials.gov: #NCT02780440Implications for RehabilitationHome-based unimanual mirror therapy (UMT), bimanual mirror therapy (BMT), and traditional occupational therapy (TOT), when administered in conjunction with outpatient OT, are helpful for improving upper limb recovery post-stroke.Home-based UMT may be more beneficial than BMT or TOT for improvement in upper limb motor function and activities of daily living of patients with moderate to severe arm impairment post-stroke.
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Affiliation(s)
- Daniel Geller
- Department of Occupational Therapy, New York University Langone Health, Rusk Rehabilitation, New York, NY, USA.,Department of Rehabilitation and Regenerative Medicine (Occupational Therapy), Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Dawn M Nilsen
- Department of Rehabilitation and Regenerative Medicine (Occupational Therapy), Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Lori Quinn
- Department of Behavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Stephen Van Lew
- Department of Occupational Therapy, New York University Langone Health, Rusk Rehabilitation, New York, NY, USA
| | - Claribell Bayona
- Department of Occupational Therapy, New York University Langone Health, Rusk Rehabilitation, New York, NY, USA
| | - Glen Gillen
- Department of Rehabilitation and Regenerative Medicine (Occupational Therapy), Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
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16
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Fritz NE, Kegelmeyer D, Rao AK, Quinn L, Nance MA, Kloos A. Coordination of Care Among Physical Therapists and Neurologists in Huntington Disease. Neurol Clin Pract 2022; 12:377-381. [DOI: 10.1212/cpj.0000000000200073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 07/18/2022] [Indexed: 11/15/2022]
Abstract
AbstractThis paper presents a framework for physical therapy through the course of Huntington’s disease (HD) which includes coordinated care plans with neurologists. HD is an inherited neurodegenerative disorder that leads to impaired strength and coordination and ultimately progressive loss of function. Interdisciplinary HD care teams provide patient-centered, comprehensive evaluations and make recommendations for pharmacological, healthcare and lifestyle interventions based on best available evidence. Physical therapists work to improve movement and mobility using specific therapeutic interventions and individualized exercise programs. The proposed framework recommends that neurologists refer persons with HD to physical therapy at all disease stages, ideally beginning in premanifest and early stages, and that they regularly communicate with physical therapists to ensure implementation of a coordinated care plan. Resources are provided for neurologists to facilitate appropriate referral for individuals with HD to physical therapy based on clinical practice guidelines, including a referral decision guide.
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17
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Macpherson CE, Shih HJS, Pacheco A, Magill R, Quinn L. On "Updates in Motor Learning: Implications for Physical Therapist Practice and Education." Leech KA, Roemmich RT, Gordon J, Reisman DS, Cherry-Allen KM. Phys Ther. 2022;102:pzab250. https://doi.org/10.1093/ptj/pzab250. Phys Ther 2022; 102:6609698. [PMID: 35713522 DOI: 10.1093/ptj/pzac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/22/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Chelsea E Macpherson
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Hai-Jung Steffi Shih
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Alissa Pacheco
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Richard Magill
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA.,Department of Rehabilitation and Regenerative Medicine (Physical Therapy), Columbia University Irving Medical Center, New York, New York, USA
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18
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Quinn L, Playle R, Drew CJG, Taiyari K, Williams-Thomas R, Muratori LM, Hamana K, Griffin BA, Kelson M, Schubert R, Friel C, Morgan-Jones P, Rosser A, Busse M. Physical activity and exercise outcomes in Huntington's disease (PACE-HD): results of a 12-month trial-within-cohort feasibility study of a physical activity intervention in people with Huntington's disease. Parkinsonism Relat Disord 2022; 101:75-89. [PMID: 35809488 DOI: 10.1016/j.parkreldis.2022.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/02/2022] [Accepted: 06/19/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION While physical activity (PA) is recognized as important in Huntington's disease (HD) disease management, there has been no long-term evaluation undertaken. We aimed to evaluate the feasibility of a nested (within cohort) randomized controlled trial (RCT) of a physical therapist-led PA intervention. METHODS Participants were recruited from six HD specialist centers participating in the Enroll-HD cohort study in Germany, Spain and U.S. Assessments were completed at baseline and 12 months and linked to Enroll-HD cohort data. Participants at three sites (cohort) received no contact between baseline and 12 month assessments. Participants at three additional sites (RCT) were randomized to PA intervention or control group. The intervention consisted of 18 sessions delivered over 12 months; control group participants received no intervention, however both groups completed monthly exercise/falls diaries and 6-month assessments. RESULTS 274 participants were screened, 204 met inclusion criteria and 116 were enrolled (59 in cohort; 57 in RCT). Retention rates at 12-months were 84.7% (cohort) and 79.0% (RCT). Data completeness at baseline ranged from 42.3 to 100% and at 12-months 19.2-85.2%. In the RCT, there was 80.5% adherence, high intervention fidelity, and similar adverse events between groups. There were differences in fitness, walking endurance and self-reported PA at 12 months favoring the intervention group, with data completeness >60%. Participants in the cohort had motor and functional decline at rates comparable to previous studies. CONCLUSION Predefined progression criteria indicating feasibility were met. PACE-HD lays the groundwork for a future, fully-powered within cohort trial, but approaches to ensure data completeness must be considered. CLINICALTRIALS GOV: NCT03344601.
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Affiliation(s)
- Lori Quinn
- Dept of Biobehavioral Sciences, Teachers College, Columbia University, NY, NY, USA; Centre for Trials Research, Cardiff University, UK
| | | | | | | | | | - Lisa M Muratori
- George-Huntington-Institute and Institute for Clinical Radiology, University of Münster, Münster, Germany; Stony Brook University, Stony Brook, NY, USA
| | - Katy Hamana
- School of Healthcare Sciences, Cardiff University, UK
| | | | - Mark Kelson
- Department of Mathematics, Exeter University, Exeter, UK
| | - Robin Schubert
- George-Huntington-Institute and Institute for Clinical Radiology, University of Münster, Münster, Germany
| | - Ciaran Friel
- Feinstein Institutes for Medical Research, Northwell Health, NY, NY, UK
| | - Philippa Morgan-Jones
- Centre for Trials Research, Cardiff University, UK; School of Engineering, Cardiff University, Cardiff, UK
| | - Anne Rosser
- Schools of Medicine and Biosciences, Cardiff University, Cardiff, UK
| | - Monica Busse
- Centre for Trials Research, Cardiff University, UK.
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19
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Fritz NE, Busse M, Muratori LM, Rao AK, Kloos A, Kegelmeyer D, Quinn L. An MDS Evidence-Based Review on Treatments for Huntington's Disease. Mov Disord 2022; 37:1566-1567. [PMID: 35856726 DOI: 10.1002/mds.29059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/06/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Nora E Fritz
- Program in Physical Therapy and Department of Neurology, Wayne State University, Detroit, Michigan, USA
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Lisa M Muratori
- Department of Physical Therapy, Stony Brook University, Stony Brook, New York, USA
| | - Ashwini K Rao
- Department of Rehabilitation & Regenerative Medicine (Program in Physical Therapy), GH Sergievsky Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Anne Kloos
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, Ohio State University, Columbus, Ohio, USA
| | - Deborah Kegelmeyer
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, Ohio State University, Columbus, Ohio, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
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20
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Desai R, Blacutt M, Youdan G, Fritz NE, Muratori LM, Hausdorff JM, Busse M, Quinn L. Postural control and gait measures derived from wearable inertial measurement unit devices in Huntington's disease: Recommendations for clinical outcomes. Clin Biomech (Bristol, Avon) 2022; 96:105658. [PMID: 35588586 DOI: 10.1016/j.clinbiomech.2022.105658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 04/13/2022] [Accepted: 04/22/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Postural control impairments begin early in Huntington's disease yet measures most sensitive to progression have not been identified. The aims of this study were to: 1) evaluate postural control and gait in people with and without Huntington's disease using wearable sensors; and 2) identify measures related to diagnosis and clinical severity. METHODS 43 individuals with Huntington's disease and 15 age-matched peers performed standing with feet together and feet apart, sitting, and walking with wearable inertial sensors. One-way analysis of variance determined differences in measures of postural control and gait between early and mid-disease stage, and non-Huntington's disease peers. A random forest analysis identified feature importance for Huntington's disease diagnosis. Stepwise and ordinal regressions were used to determine predictors of clinical chorea and tandem walking scores respectively. FINDINGS There was a significant main effect for all postural control and gait measures comparing early stage, mid stage and non-Huntington's disease peers, except for gait cycle duration and step duration. Total sway, root mean square and mean velocity during sitting, as well as gait speed had the greatest importance in classifying disease status. Stepwise regression showed that root mean square during standing with feet apart significantly predicted clinical measure of chorea, and ordinal regression model showed that root mean square and total sway standing feet together significantly predicted clinical measure of tandem walking. INTERPRETATIONS Root mean square measures obtained in sitting and standing using wearable sensors have the potential to serve as biomarkers of postural control impairments in Huntington's disease.
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Affiliation(s)
- Radhika Desai
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA.
| | - Miguel Blacutt
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA.
| | - Gregory Youdan
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA.
| | - Nora E Fritz
- Wayne State University, Departments of Health Care Sciences and Neurology, Detroit, MI, USA.
| | - Lisa M Muratori
- Department Physical Therapy, Stony Brook University, New York, USA.
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Physical Therapy, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, UK.
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA; Centre for Trials Research, Cardiff University, Cardiff, UK.
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21
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Duff SV, Miller A, Quinn L, Youdan G, Bishop L, Ruthrauff H, Wade E. Quantifying intra- and interlimb use during unimanual and bimanual tasks in persons with hemiparesis post-stroke. J Neuroeng Rehabil 2022; 19:44. [PMID: 35525970 PMCID: PMC9077965 DOI: 10.1186/s12984-022-01020-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 04/13/2022] [Indexed: 11/30/2022] Open
Abstract
Background Individuals with hemiparesis post-stroke often have difficulty with tasks requiring upper extremity (UE) intra- and interlimb use, yet methods to quantify both are limited. Objective To develop a quantitative yet sensitive method to identify distinct features of UE intra- and interlimb use during task performance. Methods Twenty adults post-stroke and 20 controls wore five inertial sensors (wrists, upper arms, sternum) during 12 seated UE tasks. Three sensor modalities (acceleration, angular rate of change, orientation) were examined for three metrics (peak to peak amplitude, time, and frequency). To allow for comparison between sensor data, the resultant values were combined into one motion parameter, per sensor pair, using a novel algorithm. This motion parameter was compared in a group-by-task analysis of variance as a similarity score (0–1) between key sensor pairs: sternum to wrist, wrist to wrist, and wrist to upper arm. A use ratio (paretic/non-paretic arm) was calculated in persons post-stroke from wrist sensor data for each modality and compared to scores from the Adult Assisting Hand Assessment (Ad-AHA Stroke) and UE Fugl-Meyer (UEFM). Results A significant group × task interaction in the similarity score was found for all key sensor pairs. Post-hoc tests between task type revealed significant differences in similarity for sensor pairs in 8/9 comparisons for controls and 3/9 comparisons for persons post stroke. The use ratio was significantly predictive of the Ad-AHA Stroke and UEFM scores for each modality. Conclusions Our algorithm and sensor data analyses distinguished task type within and between groups and were predictive of clinical scores. Future work will assess reliability and validity of this novel metric to allow development of an easy-to-use app for clinicians.
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Affiliation(s)
- Susan V Duff
- Department of Physical Therapy, Crean College of Health and Behavioral Sciences, Chapman University, 9401 Jeronimo Rd, Irvine, CA, 92618, USA.
| | - Aaron Miller
- Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, TN, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Gregory Youdan
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Lauri Bishop
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Heather Ruthrauff
- Department of Occupational Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Eric Wade
- Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, TN, USA
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22
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Atkins KJ, Friel CP, Andrews SC, Chong TTJ, Stout JC, Quinn L. A qualitative examination of apathy and physical activity in Huntington's and Parkinson's disease. Neurodegener Dis Manag 2022; 12:129-139. [PMID: 35412856 DOI: 10.2217/nmt-2021-0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Aim: In Huntington's disease (HD) and Parkinson's disease (PD), apathy is a frequently cited barrier to participation in physical activity. Current diagnostic criteria emphasize dissociable variants of apathy that differentially affect goal-directed behavior. How these dimensions present and affect physical activity in HD and PD is unknown. Methods: Using a qualitative approach, we examined the experience of apathy and its impact on physical activity in 20 people with early-manifest HD or idiopathic PD. Results: Two major themes emerged: the multidimensionality of apathy, including initiation or goal-identification difficulties, and the interplay of apathy and fatigue; and facilitators of physical activity, including routines, safe environments and education. Conclusion: Physical activity interventions tailored to apathy phenotypes may maximize participant engagement.
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Affiliation(s)
- Kelly J Atkins
- School of Psychological Sciences, Turner Institute for Brain & Mental Health, Monash University, Melbourne, VIC, 3800, Australia
| | - Ciarán P Friel
- Center for Personalized Health, Feinstein Institutes for Medical Research, Northwell Health, New York, NY, 11030, USA
| | - Sophie C Andrews
- School of Psychological Sciences, Turner Institute for Brain & Mental Health, Monash University, Melbourne, VIC, 3800, Australia.,Neuroscience Research Australia, Sydney, NSW, 2031, Australia.,School of Psychology, University of New South Wales, Sydney, NSW, 2033, Australia
| | - Trevor T-J Chong
- School of Psychological Sciences, Turner Institute for Brain & Mental Health, Monash University, Melbourne, VIC, 3800, Australia.,Department of Neurology, Alfred Health, Melbourne, VIC, 3004, Australia.,Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Julie C Stout
- School of Psychological Sciences, Turner Institute for Brain & Mental Health, Monash University, Melbourne, VIC, 3800, Australia
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teacher's College, Columbia University, New York City, NY, 10027, USA.,Centre for Trials Research, Cardiff University, Cardiff, Wales, CF14 4YS, UK
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23
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Hedman LD, Gill-Body KM, Quinn L, Hanke T, Judd DL, Plummer L, Quiben M, Riley N, Scheets PL, Tyrell CM, Wolf L. On "Reflections on the Wisdom of Profession-Specific Diagnostic Labels." Jette AM. Phys Ther. 2021; 101:pzab139. https://doi.org/10.1093/ptj/pzab139. Phys Ther 2022; 102:6395188. [PMID: 34718806 DOI: 10.1093/ptj/pzab237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/28/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Lois D Hedman
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | | | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Timothy Hanke
- Physical Therapy Program, College of Health Sciences, Midwestern University, Downers Grove, Illinois, USA
| | - Dana L Judd
- Department of Physical Medicine & Rehabilitation, University of Colorado Physical Therapy Program, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Laura Plummer
- Department of Physical Therapy, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Myla Quiben
- Department of Physical Therapy, University of Texas Health Science Center, University of North Texas, Fort Worth, Texas, USA
| | - Nora Riley
- Department of Physical Therapy, St. Ambrose University, Davenport, Iowa, USA
| | - Patricia L Scheets
- Infinity Rehab, Quality and Clinical Outcomes, Infinity HealthCare, Wilsonville, Oregon, USA
| | - Christine M Tyrell
- Department of Physical Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Leslie Wolf
- Rehabilitation Services, OhioHealth, Columbus, Ohio, USA
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Keane A, Regan SO, Quinn L, Murphy D, Kelly BO, Lynam A, Lyons F, Devitt E. Evaluation of the impact of human immunodeficiency virus pre-exposure prophylaxis on new human immunodeficiency virus diagnoses during the COVID-19 pandemic. Int J STD AIDS 2021; 33:99-102. [PMID: 34852685 DOI: 10.1177/09564624211054587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS The national PrEP programme launched in Ireland in November 2019 with tenofovir/emtricitabine free to those meeting eligibility criteria. We assessed the impact of the first year of the PrEP programme on new HIV diagnoses in the largest sexual health and HIV service in Ireland. METHODS A free PrEP service was established in November 2019. We reviewed the number of new diagnoses of HIV between November 2018-2019, before the introduction of the national PrEP programme and compared this with the number of new HIV diagnosis between November 2019-2020. RESULTS There were 95 new HIV diagnoses (63.3% MSM) between November 2018 and 2019 and 73 new HIV diagnoses (65.7% MSM) between November 2019 and 2020. There was a statistically significant decline in new HIV diagnoses between the 2 years (P = 0.0003). 546 patients were prescribed PrEP as of December 2020.106 patients (19.4%) changed their PrEP dosing regimen due to lockdown. 178 individuals (32.6%) had a rectal infection diagnosed. CONCLUSION There has been a reduction in new HIV diagnoses in our cohort (although this has occurred during a global pandemic). It is too early to say if PrEP reduces late presentations of HIV based on our findings. A significant number of rectal infections were identified in the PrEP clinic suggesting ongoing risk despite pandemic restrictions. Further research into sexual practices during COVID-19 is needed to assess if this had an impact on the lower rates of HIV acquisition.
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Affiliation(s)
- A Keane
- Department of Genitourinary Medicine and Infectious Diseases, 58024GUIDE Clinic, St James Hospital, Dublin, Ireland
| | - S O Regan
- Department of Genitourinary Medicine and Infectious Diseases, 58024GUIDE Clinic, St James Hospital, Dublin, Ireland
| | - L Quinn
- Department of Genitourinary Medicine and Infectious Diseases, 58024GUIDE Clinic, St James Hospital, Dublin, Ireland
| | - D Murphy
- Department of Genitourinary Medicine and Infectious Diseases, 58024GUIDE Clinic, St James Hospital, Dublin, Ireland
| | - B O Kelly
- Department of Genitourinary Medicine and Infectious Diseases, 58024GUIDE Clinic, St James Hospital, Dublin, Ireland
| | - A Lynam
- Department of Genitourinary Medicine and Infectious Diseases, 58024GUIDE Clinic, St James Hospital, Dublin, Ireland
| | - F Lyons
- Department of Genitourinary Medicine and Infectious Diseases, 58024GUIDE Clinic, St James Hospital, Dublin, Ireland
| | - E Devitt
- Department of Genitourinary Medicine and Infectious Diseases, 58024GUIDE Clinic, St James Hospital, Dublin, Ireland
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Karhan P, Ptáček J, Quinn L. Decision and detection thresholds for quantitative evaluation of the labeled leukocytes scan. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00437-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Lynch A, Quinn L, Briggs R, Tan T, Thorpe O, Romero-Ortuno R, Byrne T, Cunningham C, Lavin A. 161 THE ROLE OF THE GERIATRIC DAY HOSPITAL DURING THE COVID 19 PANDEMIC. Age Ageing 2021. [PMCID: PMC8690085 DOI: 10.1093/ageing/afab219.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- A Lynch
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland,Age Related Health Department, Tallaght University Hospital, Dublin, Ireland
| | - L Quinn
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
| | - R Briggs
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland,Discipline of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - T Tan
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
| | - O Thorpe
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
| | - R Romero-Ortuno
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland,Discipline of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - T Byrne
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
| | - C Cunningham
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland,Discipline of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - A Lavin
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland,Discipline of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
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Lynch A, Quinn L, Briggs R, Tan T, Thorpe O, Romero-Ortuno R, Byrne T, Cunningham C, Lavin A. 163 EVALUATING THE ROLE OF THE GERIATRIC DAY HOSPITAL IN MEDICATION OPTIMISATION. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
The geriatric day hospital (GDH) provides outpatient geriatric medical, nursing and rehabilitation care to older adults. The aim of this study was to assess whether medication optimisation occurs in this setting. We believe the GDH would be an ideal location for mediation optimisation due to the stable community dwelling patients and close follow up by specialised physicians.
Methods
Electronic patient records of the new patients ≥65 years seen in the GDH over a 3-month period were reviewed. Potentially inappropriate prescriptions (PIPs) and potentially prescribing omissions (PPOs) were identified using the STOPP/START prescribing tool on admission to the GDH and again at discharge from the GDH.
Results
One-hundred and sixty-seven patient records were reviewed; mean age 80.8 (SD6.5) years, 62.9% female, median clinical frailty scale score 6 (IQR5–6), mean number of conditions 5.79 (SD3), mean number of medications 7.57 (SD3.7). Patients had a median of 4 (IQR2–7) consultations. The number of patients prescribed at least 1 STOPP-PIP reduced by 10% (42.4% vs 38%; p < 0.001). Vasodilator drugs in patients with orthostatic hypotension were deprescribed most frequently (6.5% vs 3%; p < 0.001). PPOs were reduced by 36% (47.5% vs 30.6%;p < 0.001). The largest improvement was identified in the prescription of vitamin D in patients experiencing falls (17.4% vs 13.8%;p < 0.001). Logistic regression was performed to ascertain the influence of age, gender, falls, dementia, co-morbidity number and medication number on the likelihood of a patient experiencing a PIP or PPO. For every medication prescribed, the odds of experiencing a PIP increased by 11.8% (OR1.187, 95%CI 1.052–1.339). Being female increased the odds of experiencing a PPO by 21.7% (OR2.17, 95%CI 10.53–4.468).
Conclusion
Medication optimisation is key in avoiding side effects from potentially inappropriate medications. The frequency of patient attendances coupled with geriatricians’ expertise makes the GDH an ideal setting for medication optimisation in multi-morbid frail community-dwelling older adults.
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Affiliation(s)
- A Lynch
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
- Age Related Health Care Department, Tallaght University Hospital , Dublin, Ireland
| | - L Quinn
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
| | - R Briggs
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
- Discipline of Medical Gerontology, Trinity College Dublin , Dublin, Ireland
| | - T Tan
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
| | - O Thorpe
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
| | - R Romero-Ortuno
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
- Discipline of Medical Gerontology, Trinity College Dublin , Dublin, Ireland
| | - T Byrne
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
| | - C Cunningham
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
- Discipline of Medical Gerontology, Trinity College Dublin , Dublin, Ireland
| | - A Lavin
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
- Discipline of Medical Gerontology, Trinity College Dublin , Dublin, Ireland
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Keren K, Busse M, Fritz NE, Muratori LM, Gazit E, Hillel I, Scheinowitz M, Gurevich T, Inbar N, Omer N, Hausdorff JM, Quinn L. Quantification of Daily-Living Gait Quantity and Quality Using a Wrist-Worn Accelerometer in Huntington's Disease. Front Neurol 2021; 12:719442. [PMID: 34777196 PMCID: PMC8579964 DOI: 10.3389/fneur.2021.719442] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Huntington's disease (HD) leads to altered gait patterns and reduced daily-living physical activity. Accurate measurement of daily-living walking that takes into account involuntary movements (e.g. chorea) is needed. Objective: To evaluate daily-living gait quantity and quality in HD, taking into account irregular movements. Methods: Forty-two individuals with HD and fourteen age-matched non-HD peers completed clinic-based assessments and a standardized laboratory-based circuit of functional activities, wearing inertial measurement units on the wrists, legs, and trunk. These activities were used to train and test an algorithm for the automated detection of walking. Subsequently, 29 HD participants and 22 age-matched non-HD peers wore a tri-axial accelerometer on their non-dominant wrist for 7 days. Measures included gait quantity (e.g., steps per day), gait quality (e.g., regularity) metrics, and percentage of walking bouts with irregular movements. Results: Measures of daily-living gait quantity including step counts, walking time and bouts per day were similar in HD participants and non-HD peers (p > 0.05). HD participants with higher clinician-rated upper body chorea had a greater percentage of walking bouts with irregular movements compared to those with lower chorea (p = 0.060) and non-HD peers (p < 0.001). Even after accounting for irregular movements, within-bout walking consistency was lower in HD participants compared to non-HD peers (p < 0.001), while across-bout variability of these measures was higher (p < 0.001). Many of the daily-living measures were associated with disease-specific measures of motor function. Conclusions: Results suggest that a wrist-worn accelerometer can be used to evaluate the quantity and quality of daily-living gait in people with HD, while accounting for the influence of irregular (choreic-like) movements, and that gait features related to within- and across-bout consistency markedly differ in individuals with HD and non-HD peers.
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Affiliation(s)
- Karin Keren
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Biomedical Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Nora E. Fritz
- Departments of Health Care Sciences and Neurology, Wayne State University, Detroit, MI, United States
| | - Lisa M. Muratori
- Department of Physical Therapy, School of Health Technology and Management, Stony Brook University, Stony Brook, NY, United States
- George Huntington's Institute, Muenster, Germany
| | - Eran Gazit
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Inbar Hillel
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Micky Scheinowitz
- Department of Biomedical Engineering, Tel Aviv University, Tel Aviv, Israel
- School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Tanya Gurevich
- Movement Disorders Unit, Tel Aviv Medical Center, Tel Aviv, Israel
- Sackler School of Medicine and Sagol, School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Noit Inbar
- Movement Disorders Unit, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Nurit Omer
- Movement Disorders Unit, Tel Aviv Medical Center, Tel Aviv, Israel
- Sackler School of Medicine and Sagol, School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M. Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine and Sagol, School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Lori Quinn
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
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Bouwman H, Pieters R, Polder A, Quinn L. Ten Bird Species, Six Guilds, Three Habitats, and 59 Chlorinated and Brominated POPs: What do 64 Eggs from the Largest Economic Hub of Southern Africa tell us? Arch Environ Contam Toxicol 2021; 81:347-366. [PMID: 34480207 DOI: 10.1007/s00244-021-00882-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/21/2021] [Indexed: 06/13/2023]
Abstract
There is little information on how POPs in eggs of different terrestrial, wetland, and aquatic birds share a large urban and rural landscape relate. We collected and analysed 64 eggs belonging to ten species of six feeding guilds, and compared organic chlorinated pesticide (OCP), polychlorinated biphenyl (PCB), and brominated flame retardants (BFR) residue concentrations and compositions. The eggs were collected in the Gauteng and the northern part of the Free Sate provinces of South Africa, one of the largest economic hubs in Africa. White-breasted Cormorant and African Darter eggs (at the highest trophic level as large aquatic predators) had the highest ΣOCP and ΣPCB concentrations, and Cape Sparrow and Southern Masked Weaver (granivores) eggs had the lowest concentrations, corresponding to the lowest trophic level in our collection. The highest percentage p,p'-DDT were in eggs of the terrestrial insectivore Crowned Lapwing (24%) and the scavenging African Sacred Ibis (17%), and the lowest in African Darter (1.0%) and White-breasted Cormorant (0.9%) eggs, suggesting that recency of DDT releases in a region cannot be gauged by this metric. African Sacred Ibis and Southern Masked Weaver eggs had the highest ΣBFR concentrations, with Crowned Lapwing, Cattle Egret, and White-breasted Cormorant eggs the least. Based on feeding guilds, the mean ΣPOP concentrations increased from granivore, aquatic omnivore, scavenger, terrestrial insectivore, small aquatic predator, to large aquatic predator. Mean ΣPOP concentrations in eggs increased from terrestrial, to wetland, to aquatic habitat birds. Interesting patterns were observed with multivariate analyses. There were no significant regressions between egg size and any summed POP classes. ΣBFR concentrations were not correlated with ΣOCPs or ΣPCBs. Eggshell thinning of African Darter eggs was associated with p,p'-DDE and ΣPCB suggesting risk. Other metrics also suggest risk. Therefore, different species of terrestrial and aquatic birds from the same area acquire and deposit POPs in different proportions and quantities in their eggs. Trophic levels and habitat explain the overall patterns, but detailed differences were found, some of which we are unable to explain. Based on POPs residues in terrestrial, wetland, and aquatic bird eggs, different POPs classes behave differently in a shared large inland industrial area, complicating deductions about POPs and associated risks based on one or few species.
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Affiliation(s)
- Hindrik Bouwman
- Research Unit, Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa.
| | - R Pieters
- Research Unit, Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
| | - A Polder
- Research Unit, Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
- Department of Paraclinical Sciences, Norwegian University of Life Sciences, Ås, Norway
| | - L Quinn
- National Metrology Institute of South Africa, Pretoria, South Africa
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30
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Muratori LM, Quinn L, Li X, Youdan G, Busse M, Fritz NE. Measures of postural control and mobility during dual-tasking as candidate markers of instability in Huntington's disease. Hum Mov Sci 2021; 80:102881. [PMID: 34583142 DOI: 10.1016/j.humov.2021.102881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/08/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Individuals with Huntington's disease (HD) have impairments in performing dual-tasks, however, there is limited information about the effects of changing postural and cognitive demands as well as which measures are best suited as markers of underlying motor-cognitive interference. METHODS Forty-three individuals with HD and 15 healthy controls (HC) completed single tasks of walking (Timed Up & Go (TUG), 7 m walk), standing (feet together, feet apart and foam surface) and seated cognitive performance (Stroop, Symbol Digit Modalities Test (SDMT), Delis-Kaplan Executive Function System (DKEFS) Sorting test) and dual cognitive-motor tasks while standing (+ Stroop) and walking (+ DKEFS, TUG cognitive). APDM Opal sensors recorded measures of postural sway and time to complete motor tasks. RESULTS Individuals with HD had a greater increase in standing postural sway compared to HC from single to dual-tasks and with changes to support surface. Both groups demonstrated a decrease in gait performance during the TUG cognitive, however, this difference was greater in people with HD compared to HC. While those with HD showed a greater dual-task motor cost compared to HC, both groups behaved similarly as condition complexity increased. CONCLUSIONS Standing postural sway is a more sensitive marker of instability than change in standard gait speed, particularly under dual-task conditions. The more complex TUG cognitive is a sensitive measure of walking dual-task performance. The results of this study provide insights about the nature of motor-cognitive impairments in HD and provide support for a distinction between static and dynamic postural control mechanisms during performance of dual-tasks.
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Affiliation(s)
- Lisa M Muratori
- Department of Physical Therapy, Stony Brook University, Stony Brook, NY 11794-8201, United States of America.
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, United States of America.
| | - Xueyao Li
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, United States of America.
| | - Gregory Youdan
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, United States of America.
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, UK.
| | - Nora E Fritz
- Program in Physical Therapy and Department of Neurology, Wayne State University, Detroit, MI, United States of America.
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Quinn L, Riley N, Tyrell CM, Judd DL, Gill-Body KM, Hedman LD, Packel A, Brown DA, Nabar N, Scheets P. A Framework for Movement Analysis of Tasks: Recommendations From the Academy of Neurologic Physical Therapy's Movement System Task Force. Phys Ther 2021; 101:6307338. [PMID: 34160044 DOI: 10.1093/ptj/pzab154] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/11/2021] [Accepted: 05/30/2021] [Indexed: 11/12/2022]
Abstract
The American Physical Therapy Association's Vision Statement of 2013 asserts that physical therapists optimize movement in order to improve the human experience. In accordance with this vision, physical therapists strive to be recognized as experts in movement analysis. However, there continues to be no accepted method to conduct movement analysis, nor an agreement of key terminology to describe movement observations. As a result, the Academy of Neurologic Physical Therapy organized a task force that was charged with advancing the state of practice with respect to these issues, including the development of a proposed method for movement analysis of tasks. This paper presents the work of the Task Force, which includes (1) development of a method for conducting movement analysis within the context of the movement continuum during 6 core tasks (sitting, sit to stand, standing, walking, step up/down, and reach/grasp/manipulate); (2) glossary of movement constructs that can provide a common language for movement analysis across a range of tasks: symmetry, speed, amplitude, alignment, verticality, stability, smoothness, sequencing, timing, accuracy, and symptom provocation; and (3) recommendations for task and environmental variations that can be systematically applied. The expectation is that this systematic framework and accompanying terminology will be easily adapted to additional patient or client-specific tasks, contribute to development of movement system diagnostic labels, and ultimately improve consistency across patient/client examination, evaluation, and intervention for the physical therapy profession. Next steps should include validation of this framework across patient/client groups and settings.
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Affiliation(s)
- Lori Quinn
- Dept of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Nora Riley
- Physical Therapy Department, St. Ambrose University, Davenport, Iowa, USA
| | - Christine M Tyrell
- Department of Physical Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Dana L Judd
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Lois D Hedman
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | | | - David A Brown
- School of Health Professions, University of Texas Medical Branch, Galveston, Texas, USA
| | - Nikita Nabar
- Baylor Scott and White Inpatient Rehabilitation, Lakeway, Texas, USA
| | - Patricia Scheets
- Infinity Rehab, Quality & Clinical Outcomes, Wilsonville, Oregon, USA
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Gill-Body KM, Hedman LD, Plummer L, Wolf L, Hanke T, Quinn L, Riley N, Kaufman R, Verma A, Quiben M, Scheets P. Movement System Diagnoses for Balance Dysfunction: Recommendations From the Academy of Neurologic Physical Therapy's Movement System Task Force. Phys Ther 2021; 101:6307337. [PMID: 34160028 DOI: 10.1093/ptj/pzab153] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/11/2021] [Accepted: 05/30/2021] [Indexed: 11/13/2022]
Abstract
UNLABELLED The movement system was identified as the focus of our expertise as physical therapists in the revised vision statement for the profession adopted by the American Physical Therapy Association in 2013. Attaining success with the profession's vision requires the development of movement system diagnoses that will be useful in clinical practice, research, and education. To date, only a few movement system diagnoses have been identified and described, and none of these specifically address balance dysfunction. Over the past 2 years, a Balance Diagnosis Task Force, a subgroup of the Movement System Task Force of the Academy of Neurologic Physical Therapy, focused on developing diagnostic labels (or diagnoses) for individuals with balance problems. This paper presents the work of the task force that followed a systematic process to review available diagnostic frameworks related to balance, identify 10 distinct movement system diagnoses that reflect balance dysfunction, and develop complete descriptions of examination findings associated with each balance diagnosis. A standardized approach to movement analysis of core tasks, the Framework for Movement Analysis developed by the Academy of Neurologic Physical Therapy Movement Analysis Task Force, was integrated into the examination and diagnostic processes. The aims of this perspective paper are to (1) summarize the process followed by the Balance Diagnosis Task Force to develop an initial set of movement system (balance) diagnoses; (2) report the recommended diagnostic labels and associated descriptions; (3) demonstrate the clinical decision-making process used to determine a balance diagnosis and develop a plan of care; and (4) identify next steps to validate and implement the diagnoses into physical therapist practice, education, and research. IMPACT The development and use of diagnostic labels to classify distinct movement system problems is needed in physical therapy. The 10 balance diagnosis proposed can aid in clinical decision making regarding intervention.
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Affiliation(s)
| | - Lois D Hedman
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Laura Plummer
- Physical Therapy Department, MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Leslie Wolf
- Outpatient Neurologic Rehabilitation, OhioHealth, Columbus, Ohio, USA
| | - Timothy Hanke
- Physical Therapy Program, Midwestern University, Downers Grove, Illinois, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Nora Riley
- Physical Therapy Department, St. Ambrose University, Davenport, Iowa, USA
| | - Regina Kaufman
- Department of Physical Therapy, Springfield College, Springfield, Massachusetts, USA
| | - Akanshka Verma
- Inpatient Rehabilitation Unit & Acute Neurology Service, New York- Presbyterian Hospital, New York, New York, USA
| | - Myla Quiben
- Department of Physical Therapy, School of Health Professions, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Patricia Scheets
- Quality & Clinical Outcomes, Infinity Rehab, Wilsonville, Oregon, USA
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Casertano L, Nathanson R, Bassile CC, Quinn L. Neurological complications in COVID-19: a single case study of rehabilitation treatment. International Journal of Therapy and Rehabilitation 2021. [DOI: 10.12968/ijtr.2020.0140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background/aims: COVID-19 is a global pandemic, which has seen over 198 million cases as of August 2021. This case study highlights the rehabilitation of a young patient with respiratory and neurologic sequalae of COVID-19 across the continuum of care, from the intensive care unit to the inpatient rehabilitation unit. Case description: A 45-year-old woman, with past medical history of fibromyalgia and morbid obesity, presented with complaints of shortness of breath. She tested positive for SARS-CoV-2, was transferred to the intensive care unit, and was intubated for 17 days. The day after extubation, she experienced worsened mental status; computed tomography and magnetic resonance imaging scans revealed bilateral strokes. On hospital day 21, she was transferred to the stroke step-down unit. On hospital day 24, she recovered some cognitive ability and movement of her lower extremities. On hospital day 30, she was admitted to the inpatient rehabilitation unit. Examination by occupational and physiotherapists found motor and sensory impairments of multiple peripheral nerves, including musculocutaneous, axillary and radial nerves. Interventions included passive range of motion, sitting balance, transfer training, rigid taping, upper extremity strengthening and functional training (gait, stair, activities of daily living). Her activities of daily living performance was limited by upper extremity weakness, sensory loss and pain. Conclusions This case highlights the medical, neurological and functional implications of COVID-19 on patients after prolonged hospitalisation. The plan of care was informed by collaboration between rehabilitation disciplines. Causes of her injuries are unclear but could include positioning, brachial plexus injuries, or post-critical illness syndrome. Further research on the evaluation and care of patients with COVID-19 that result in profound neurological impairments is warranted.
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Affiliation(s)
- Lorenzo Casertano
- Advanced Clinician-Acute Care Neurology Service, Department of Physical Therapy, New York-Presbyterian Hospital, New York, USA
| | - Rae Nathanson
- Department of Occupational Therapy, New York-Presbyterian Hospital, New York, USA
| | - Clare C Bassile
- Department of Rehabilitation and Regenerative Medicine (Physical Therapy Programs), Columbia University Irving Medical Center, New York, USA
| | - Lori Quinn
- Movement Science and Kinesiology, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, USA
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Parker SG, Mallett S, Quinn L, Wood CPJ, Boulton RW, Jamshaid S, Erotocritou M, Gowda S, Collier W, Plumb AAO, Windsor ACJ, Archer L, Halligan S. Corrigendum to: Identifying predictors of ventral hernia recurrence: systematic review and meta-analysis. BJS Open 2021; 5:6299993. [PMID: 34131707 PMCID: PMC8205854 DOI: 10.1093/bjsopen/zrab047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Desai R, Fritz NE, Muratori L, Hausdorff JM, Busse M, Quinn L. Evaluation of gait initiation using inertial sensors in Huntington's Disease: insights into anticipatory postural adjustments and cognitive interference. Gait Posture 2021; 87:117-122. [PMID: 33906090 DOI: 10.1016/j.gaitpost.2021.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 03/15/2021] [Accepted: 04/14/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Understanding the contribution of anticipatory postural adjustments (APA) to walking ability in individuals with Huntington's disease (HD) may provide insight into motor planning and the functional consequences of HD-specific cortical-basal ganglia pathway dysfunctions. RESEARCH QUESTION How do inertial measurement unit (IMU)-derived APAs and first step parameters differ between individuals with HD and non-HD peers under no load and cognitive load conditions, and what is their relationship to gait speed and clinical measures? METHODS 33 individuals with manifest HD and 15 non-HD peers wore three Opal APDM IMUs during a 14-meter walk under no load and cognitive load conditions. APA acceleration amplitudes, APA durations, first step range of motion (ROM), and first step durations were compared, along with their relationship to gait speed. RESULTS Individuals with HD had greater APA acceleration amplitudes, smaller first step ROM and longer first step durations compared to non-HD peers. No differences in APA durations were present between groups in both conditions. Cognitive loading influenced first step ROM but not other APA parameters. Mediolateral APA acceleration amplitudes were a significant predictor of gait speed and were related to disease-specific measures. SIGNIFICANCE Larger acceleration amplitudes and smaller first step ROMs of greater duration, accompanied by the preservation of APA durations, reveal a discrepancy in movement scaling in HD. Additionally, the mediolateral component of the APA is likely a rate-limiting factor that drives a compensatory response in gait initiation. Further research is needed to explore the neural correlates of HD-related movement scaling.
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Affiliation(s)
- Radhika Desai
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA.
| | - Nora E Fritz
- Wayne State University, Program in Physical Therapy, Detroit, MI, USA.
| | - Lisa Muratori
- Physical Therapy Program, Stony Brook University, Stony Brook, NY, USA.
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition, and Mobility, Neurological Institute,Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Physical Therapy and Sagol School of Neuroscience, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, UK.
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA; Centre for Trials Research, Cardiff University, Cardiff, UK.
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Parker SG, Mallett S, Quinn L, Wood CPJ, Boulton RW, Jamshaid S, Erotocritou M, Gowda S, Collier W, Plumb AAO, Windsor ACJ, Archer L, Halligan S. Identifying predictors of ventral hernia recurrence: systematic review and meta-analysis. BJS Open 2021; 5:6220253. [PMID: 33839749 PMCID: PMC8038271 DOI: 10.1093/bjsopen/zraa071] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/08/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Ventra hernias are increasing in prevalence and many recur despite attempted repair. To date, much of the literature is underpowered and divergent. As a result there is limited high quality evidence to inform surgeons succinctly which perioperative variables influence postoperative recurrence. This systematic review aimed to identify predictors of ventral hernia recurrence. METHODS PubMed was searched for studies reporting prognostic data of ventral hernia recurrence between 1 January 1995 and 1 January 2018. Extracted data described hernia type (primary/incisional), definitions of recurrence, methods used to detect recurrence, duration of follow-up, and co-morbidity. Data were extracted for all potential predictors, estimates and thresholds described. Random-effects meta-analysis was used. Bias was assessed with a modified PROBAST (Prediction model Risk Of Bias ASsessment Tool). RESULTS Screening of 18 214 abstracts yielded 274 individual studies for inclusion. Hernia recurrence was defined in 66 studies (24.1 per cent), using 41 different unstandardized definitions. Three patient variables (female sex, age 65 years or less, and BMI greater than 25, 30, 35 or 40 kg/m2), five patient co-morbidities (smoking, diabetes, chronic obstructive pulmonary disease, ASA grade III-IV, steroid use), two hernia-related variables (incisional/primary, recurrent/primary), six intraoperative variables (biological mesh, bridged repair, open versus laparoscopic surgery, suture versus mesh repair, onlay/retrorectus, intraperitoneal/retrorectus), and six postoperative variables (any complication, surgical-site occurrence, wound infection, seroma, haematoma, wound dehiscence) were identified as significant prognostic factors for hernia recurrence. CONCLUSION This study summarized the current evidence base for predicting ventral hernia recurrence. Results should inform best practice and future research.
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Affiliation(s)
- S G Parker
- Abdominal Wall Unit, Department of Surgery, University College Hospital, London, UK
| | - S Mallett
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - L Quinn
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.,University College London Medical School, London, UK
| | - C P J Wood
- Abdominal Wall Unit, Department of Surgery, University College Hospital, London, UK
| | - R W Boulton
- Abdominal Wall Unit, Department of Surgery, University College Hospital, London, UK
| | - S Jamshaid
- Abdominal Wall Unit, Department of Surgery, University College Hospital, London, UK
| | - M Erotocritou
- Abdominal Wall Unit, Department of Surgery, University College Hospital, London, UK
| | - S Gowda
- Abdominal Wall Unit, Department of Surgery, University College Hospital, London, UK
| | - W Collier
- Abdominal Wall Unit, Department of Surgery, University College Hospital, London, UK
| | - A A O Plumb
- Centre of Medical Imaging, University College Hospital, London, UK
| | - A C J Windsor
- Abdominal Wall Unit, Department of Surgery, University College Hospital, London, UK
| | - L Archer
- Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Keele, UK
| | - S Halligan
- Centre of Medical Imaging, University College Hospital, London, UK
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Koriath C, Kenny J, Adamson G, Druyeh R, Taylor W, Beck J, Quinn L, Mok TH, Dimitriadis A, Norsworthy P, Bass N, Carter J, Walker Z, Kipps C, Coulthard E, Polke JM, Bernal-Quiros M, Denning N, Thomas R, Raybould R, Williams J, Mummery CJ, Wild EJ, Houlden H, Tabrizi SJ, Rossor MN, Hummerich H, Warren JD, Rowe JB, Rohrer JD, Schott JM, Fox NC, Collinge J, Mead S. Predictors for a dementia gene mutation based on gene-panel next-generation sequencing of a large dementia referral series. Mol Psychiatry 2020; 25:3399-3412. [PMID: 30279455 PMCID: PMC6330090 DOI: 10.1038/s41380-018-0224-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 06/28/2018] [Accepted: 07/18/2018] [Indexed: 11/09/2022]
Abstract
Next-generation genetic sequencing (NGS) technologies facilitate the screening of multiple genes linked to neurodegenerative dementia, but there are few reports about their use in clinical practice. Which patients would most profit from testing, and information on the likelihood of discovery of a causal variant in a clinical syndrome, are conspicuously absent from the literature, mostly for a lack of large-scale studies. We applied a validated NGS dementia panel to 3241 patients with dementia and healthy aged controls; 13,152 variants were classified by likelihood of pathogenicity. We identified 354 deleterious variants (DV, 12.6% of patients); 39 were novel DVs. Age at clinical onset, clinical syndrome and family history each strongly predict the likelihood of finding a DV, but healthcare setting and gender did not. DVs were frequently found in genes not usually associated with the clinical syndrome. Patients recruited from primary referral centres were compared with those seen at higher-level research centres and a national clinical neurogenetic laboratory; rates of discovery were comparable, making selection bias unlikely and the results generalisable to clinical practice. We estimated penetrance of DVs using large-scale online genomic population databases and found 71 with evidence of reduced penetrance. Two DVs in the same patient were found more frequently than expected. These data should provide a basis for more informed counselling and clinical decision making.
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Affiliation(s)
- C Koriath
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - J Kenny
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - G Adamson
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - R Druyeh
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - W Taylor
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - J Beck
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - L Quinn
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - T H Mok
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - A Dimitriadis
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - P Norsworthy
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - N Bass
- UCL Division of Psychiatry, Maple House, University College London, London, UK
| | - J Carter
- UCL Division of Psychiatry, Maple House, University College London, London, UK
| | - Z Walker
- UCL Division of Psychiatry, Maple House, University College London, London, UK
- Essex Partnership University NHS Foundation Trust, Essex, SS11 7XX, UK
| | - C Kipps
- Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - E Coulthard
- Institute of Clinical Neuroscience, University of Bristol, Level 1 Learning and Research Building, Bristol, BS10 5NB, UK
| | - J M Polke
- Neurogenetics Laboratory, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - M Bernal-Quiros
- Neurogenetics Laboratory, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - N Denning
- Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK
| | - R Thomas
- Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK
| | - R Raybould
- Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK
| | - J Williams
- Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ, UK
| | - C J Mummery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - E J Wild
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - H Houlden
- Neurogenetics Laboratory, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - S J Tabrizi
- Huntington's Disease Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - M N Rossor
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - H Hummerich
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - J D Warren
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - J B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SZ, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - J D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - J M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - N C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - J Collinge
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK
| | - S Mead
- MRC Prion Unit at UCL, UCL Institute of Prion Diseases, Courtauld Building, London, W1W 7FF, UK.
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Abstract
The "wobble room" is a wellness intervention designed to guide staff through unpredictable times that are not going away quickly. Emergency department teams are accustomed to trauma events and trauma debriefing, but the prolonged uncertainties and fears associated with COVID-19 have posed a unique challenge for healthcare workers. The wobble room has become a place where staff can make sense of how the pandemic is affecting them and create a "new normal" with respect to personal safety and team cohesion.
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Affiliation(s)
- Lara Gurney
- Head Nurse Educator Emergency Department, Vancouver General Hospital, Vancouver, BC
| | - Julie Lockington
- Nurse Clinician, Emergency Department, Vancouver General Hospital, Vancouver, BC
| | - Lori Quinn
- Manager, Emergency Department, Vancouver General Hospital, Vancouver, BC
| | - Maura MacPhee
- Professor, School of Nursing, University of British Columbia, Vancouver, BC
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Miller A, Quinn L, Duff SV, Wade E. Comparison of Machine Learning approaches for Classifying Upper Extremity Tasks in Individuals Post-Stroke. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:4330-4336. [PMID: 33018954 DOI: 10.1109/embc44109.2020.9176331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
After a stroke, individuals often exhibit upper extremity (UE) motor dysfunction, influencing the performance of everyday tasks. Characterizing UE movements is useful to track recovery and response to intervention. Yet, due to the complexity of the recovery process, UE movements may be extremely variable and person-specific. While this renders automatic recognition of these gestures challenging, machine learning methods could be used to classify UE movements in atypical populations. In the current study, we utilize data from 20 individuals post-stroke and 20 age-matched controls to identify an optimal set of sensor-extracted features for the classification of unimanual and bimanual gestures during task performance. We found that using fewer than 100 features along with a random forest classifier produced the best performance across both groups, with both user-dependent and user-independent models.
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Harrison EC, Earhart GM, Leventhal D, Quinn L, Pietro Mazzoni. A walking dance to improve gait speed for people with Parkinson disease: a pilot study. Neurodegener Dis Manag 2020; 10:301-308. [PMID: 32878538 DOI: 10.2217/nmt-2020-0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim: To determine the effectiveness of a targeted dance intervention to improve walking speed for people with Parkinson disease (PD) by increasing motor motivation. Materials & methods: 11 participants with PD participated in a 6-week pilot study in which they learned a contemporary dance composed of walking steps and designed to mimic everyday walking. 1 h classes occurred twice-weekly. Results: Pre- and post-intervention assessments revealed a significant increase in gait speed (t9 = 3.30; p = 0.009), cadence (t9 = 2.345; p = 0.044), and stride length (t9 = 3.757; p = 0.005), and a significant decrease (improvement) in single support time variability (t9 = -2.744; p = 0.022). There were no significant changes in other measures of gait variability nor in motor symptoms, mood and anxiety, extent of life-space mobility, or quality of life. No adverse events were reported. Conclusion: Joywalk provides preliminary evidence that a targeted physical intervention for people with PD may specifically counter bradykinesia.
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Affiliation(s)
- Elinor C Harrison
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Gammon M Earhart
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110, USA.,Program in Physical Therapy, Washington University School of Medicine, St Louis, MO 63110, USA.,Department of Neuroscience, Washington University School of Medicine, St Louis, MO 63110, USA
| | - David Leventhal
- Dance For PD®, Mark Morris Dance Group, Brooklyn, NY 11217, USA
| | - Lori Quinn
- Department of Movement Science & Kinesiology, Teachers College, Columbia University, New York City, NY 10027, USA
| | - Pietro Mazzoni
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110, USA
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Duff S, Miller A, Quinn L, Youdan G, Bishop L, Ruthrauff H, Wade E. Novel Method to Assess Interlimb Coordination in Persons With Hemiparesis. Am J Occup Ther 2020. [DOI: 10.5014/ajot.2020.74s1-po3730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 03/26/20
Tasks requiring intra- and interlimb coordination (ILC) can be difficult for persons with hemiparesis. Clinical tools are often not sensitive to small changes in ILC that can occur with recovery or rehabilitation. Our goal is to develop a quantitative measure of upper-extremity ILC and validate it against clinical tools. Future implementation of this sensor-based system would allow OTs to better quantify ILC in the community and home settings.
Primary Author and Speaker: Susan Duff
Contributing Authors: Aaron Miller, Lori Quinn, Gregory Youdan, Lauri Bishop, Heather Ruthrauff, Eric Wade
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Affiliation(s)
| | | | - Lori Quinn
- Teacher’s College, Columbia University, New York
| | | | - Lauri Bishop
- University of Southern California, Los Angeles, CA, USA
| | | | - Eric Wade
- California Polytechnic State University, San Luis Obispo, CA, USA, University of Tennessee, Knoxville, TN, USA
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Quinn L, Macpherson C, Long K, Shah H. Promoting Physical Activity via Telehealth in People With Parkinson Disease: The Path Forward After the COVID-19 Pandemic? Phys Ther 2020; 100:1730-1736. [PMID: 32734298 PMCID: PMC7454884 DOI: 10.1093/ptj/pzaa128] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/08/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE There is mounting evidence in support of exercise and physical activity as a first-line approach to managing symptoms and potentially altering disease progression in people with Parkinson disease (PD). For many patients, a critical gap is the need for expert guidance to overcome barriers, set realistic goals, and provide personalized advice to optimize exercise uptake and adherence. The purpose of this case report is to describe a physical activity coaching program (Engage-PD) for individuals newly diagnosed with PD and to highlight rapid modifications made to this program in response to the COVID-19 pandemic. METHODS (CASE DESCRIPTION) Engage-PD is a single cohort implementation study of a coaching intervention grounded in self-determination theory being conducted at Columbia University Parkinson's Foundation Center of Excellence in New York City, NY (USA), the early epicenter of the COVID-19 pandemic in the United States. The project was uniquely positioned to be adapted to telehealth delivery and to address an immediate need for support and guidance in the home environment, including people with early-mid-stage PD. Participants completed baseline and follow-up (3 months) assessments and participated in up to 4 coaching sessions, all delivered via a telehealth platform. The intervention incorporated 1:1 coaching, goal-setting, physical activity monitoring, and use of a disease-specific workbook to promote and support safe exercise uptake. RESULTS While the program is ongoing, 52 referrals were received and 27 individuals with PD enrolled in the first 2 months of the pandemic for a recruitment rate of 52%. Although direct comparisons with pre-coronavirus recruitment are difficult due to the recency of the Engage-PD implementation study, this recruitment rate was larger than expected, which may have been due to several factors (eg, most patients had limited, if any, access to in-person programs and therapy services during this time, so the Engage program filled an immediate need to provide exercise and activity guidance). There was a wide range of scores for both baseline physical activity and self-efficacy measures. CONCLUSION Remotely delivered interventions may serve as a sustainable platform for physical activity coaching programs for people with PD as well as other neurodegenerative diseases. IMPACT With the uncertainty brought about by the current pandemic, this case report highlights the opportunity to shift the current model of care for individuals with neurodegenerative diseases such as PD.
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Affiliation(s)
- Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, and Department of Rehabilitation and Regenerative Medicine (Physical Therapy), Columbia University Irving Medical Center, 525 W 120th St, Box 199, New York City, NY 10027 USA,Address all correspondence to Dr Quinn at:
| | - Chelsea Macpherson
- Department of Biobehavioral Sciences, Teachers College, Columbia University
| | - Katrina Long
- Department of Biobehavioral Sciences, Teachers College, Columbia University
| | - Hiral Shah
- Department of Neurology, Columbia University Irving Medical Center
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Abstract
In this edition of the Huntington's Disease Clinical Trials Corner we expand on the GENERATION-HD1 and PACE-HD trials, and we list all currently registered and ongoing clinical trials in Huntington's disease.
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Affiliation(s)
- Filipe B Rodrigues
- UCL Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, UK.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, PT.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, PT
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, USA
| | - Edward J Wild
- UCL Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, UK
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Quinn L, Kegelmeyer D, Kloos A, Rao AK, Busse M, Fritz NE. Clinical recommendations to guide physical therapy practice for Huntington disease. Neurology 2020; 94:217-228. [PMID: 31907286 PMCID: PMC7080285 DOI: 10.1212/wnl.0000000000008887] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/08/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE In the past decade, an increasing number of studies have examined the efficacy of physical therapy interventions in people with Huntington disease (HD). METHODS We performed a mixed-methods systematic review using Joanna Briggs Institute (JBI) methodology and included experimental and observational study designs. The search resulted in 23 quantitative studies and 3 qualitative studies from which we extracted data using JBI standardized extraction tools. Results of this review suggested that physical therapy interventions may improve motor impairments and activity limitations in people with HD. Here, we expand on the review findings to provide specific recommendations to guide clinical practice. RESULTS We recommend the following specific physical therapy interventions for people with HD: aerobic exercise (grade A evidence), alone or in combination with resistance training to improve fitness and motor function, and supervised gait training (grade A evidence) to improve spatiotemporal features of gait. In addition, there is weak (grade B) evidence that exercise training improves balance but does not show a reduction in the frequency of falls; inspiratory and expiratory training improves breathing function and capacity; and training of transfers, getting up from the floor, and providing strategies to caregivers for involvement in physical activity in the midstages of HD may improve performance. There is expert consensus for the use of positioning devices, seating adaptations, and caregiver training in late stages of HD. CONCLUSIONS There is strong evidence to support physical therapy interventions to improve fitness, motor function, and gait in persons with HD.
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Affiliation(s)
- Lori Quinn
- From the Department of Biobehavioral Sciences (L.Q.), Teachers College, Columbia University, New York, NY; Physical Therapy Division (D.K., A.K.), School of Health and Rehabilitation Sciences, The Ohio State University, Columbus; Program in Physical Therapy (A.K.R.), Department of Rehabilitative and Regenerative Medicine, G.H. Sergievsky Center, Columbia University, New York, NY; Centre for Trials Research (M.B.), College of Biomedical and Life Sciences, Cardiff University, United Kingdom; and Program in Physical Therapy (N.E.F.), Wayne State University, Detroit, MI
| | - Deb Kegelmeyer
- From the Department of Biobehavioral Sciences (L.Q.), Teachers College, Columbia University, New York, NY; Physical Therapy Division (D.K., A.K.), School of Health and Rehabilitation Sciences, The Ohio State University, Columbus; Program in Physical Therapy (A.K.R.), Department of Rehabilitative and Regenerative Medicine, G.H. Sergievsky Center, Columbia University, New York, NY; Centre for Trials Research (M.B.), College of Biomedical and Life Sciences, Cardiff University, United Kingdom; and Program in Physical Therapy (N.E.F.), Wayne State University, Detroit, MI
| | - Anne Kloos
- From the Department of Biobehavioral Sciences (L.Q.), Teachers College, Columbia University, New York, NY; Physical Therapy Division (D.K., A.K.), School of Health and Rehabilitation Sciences, The Ohio State University, Columbus; Program in Physical Therapy (A.K.R.), Department of Rehabilitative and Regenerative Medicine, G.H. Sergievsky Center, Columbia University, New York, NY; Centre for Trials Research (M.B.), College of Biomedical and Life Sciences, Cardiff University, United Kingdom; and Program in Physical Therapy (N.E.F.), Wayne State University, Detroit, MI
| | - Ashwini K Rao
- From the Department of Biobehavioral Sciences (L.Q.), Teachers College, Columbia University, New York, NY; Physical Therapy Division (D.K., A.K.), School of Health and Rehabilitation Sciences, The Ohio State University, Columbus; Program in Physical Therapy (A.K.R.), Department of Rehabilitative and Regenerative Medicine, G.H. Sergievsky Center, Columbia University, New York, NY; Centre for Trials Research (M.B.), College of Biomedical and Life Sciences, Cardiff University, United Kingdom; and Program in Physical Therapy (N.E.F.), Wayne State University, Detroit, MI
| | - Monica Busse
- From the Department of Biobehavioral Sciences (L.Q.), Teachers College, Columbia University, New York, NY; Physical Therapy Division (D.K., A.K.), School of Health and Rehabilitation Sciences, The Ohio State University, Columbus; Program in Physical Therapy (A.K.R.), Department of Rehabilitative and Regenerative Medicine, G.H. Sergievsky Center, Columbia University, New York, NY; Centre for Trials Research (M.B.), College of Biomedical and Life Sciences, Cardiff University, United Kingdom; and Program in Physical Therapy (N.E.F.), Wayne State University, Detroit, MI
| | - Nora E Fritz
- From the Department of Biobehavioral Sciences (L.Q.), Teachers College, Columbia University, New York, NY; Physical Therapy Division (D.K., A.K.), School of Health and Rehabilitation Sciences, The Ohio State University, Columbus; Program in Physical Therapy (A.K.R.), Department of Rehabilitative and Regenerative Medicine, G.H. Sergievsky Center, Columbia University, New York, NY; Centre for Trials Research (M.B.), College of Biomedical and Life Sciences, Cardiff University, United Kingdom; and Program in Physical Therapy (N.E.F.), Wayne State University, Detroit, MI.
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Miller A, Duff SV, Quinn L, Bishop L, Youdan G, Ruthrauff H, Wade E. Development of Sensor-Based Measures of Upper Extremity Interlimb Coordination. Annu Int Conf IEEE Eng Med Biol Soc 2019; 2018:3160-3164. [PMID: 30441065 DOI: 10.1109/embc.2018.8512903] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The development of motor impairment after the onset of an injury such as stroke may result in long-term compensatory behaviors. Because compensation often evolves in ambient settings (outside the purview of monitoring clinicians), there is a need for quantitative tools capable of accurately detecting the subtleties of compensation and related reduction in interlimb coordination. Improvement in interlimb coordination may serve as a marker of recovery from stroke, and rehabilitation progress. The current study investigates measures of upper extremity interlimb coordination in persons post-stroke and healthy controls. It introduces a novel algorithm for objective characterization of interlimb coordination during the performance of real-world tasks.
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Hamana K, Quinn L, Gambling T, Busse M. An exploration of physical activity experiences throughout the Huntington's disease journey: supporting development of theoretically underpinned complex interventions. Disabil Rehabil 2019; 43:1565-1575. [PMID: 31588808 DOI: 10.1080/09638288.2019.1671501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Huntington's disease is an autosomal dominant neurodegenerative disease. Progressive physical, behavioural and cognitive impairments cause loss of independent function. Physical activity interventions are important components of comprehensive intervention strategies and may help alter the functional decline trajectory. Qualitative research has an important role to play in developing theoretically sound, well-defined physical activity interventions in Huntington's disease. MATERIALS AND METHODS Eight focus groups were conducted with people with prodromal to late stage Huntington's disease, caregivers (family members/formal), and healthcare professionals. An analytical coding framework was developed from the data and Levanthal's self-regulation model to assist analysis. RESULTS AND CONCLUSIONS Key themes were identified: evolving representations of Huntington's disease and physical activity; varying social environment of the person with Huntington's disease and the impact on physical activity; achieving physical activity participation while coping with the nuances of Huntington's disease. Levanthal's model facilitated understanding of physical activity experiences, however with progression, self-regulation of activities needs to become more collaborative with caregivers. A modified self-regulation model specific to physical activity in Huntington's disease is presented. Using a novel approach to generate new understanding of physical activity across the Huntington's disease lifespan facilitated development of an original and significant theoretical foundation to underpin development of a range of much needed physical activity and exercise interventions in Huntington's disease.Implications for rehabilitationSocial and familial context of individuals with HD is a key consideration for health care professionals supporting physical activity participation.Strategies such as using physical activity as a way of achieving control and adjusting expectations can help people with HD to continue to be active.People with HD adapt physical activity from high level to more functional activities with symptom progression.
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Affiliation(s)
- Katy Hamana
- School of Healthcare Sciences, Cardiff University, Cardiff, Wales
| | - Lori Quinn
- Teachers College, Columbia University, New York, NY, USA
| | - Tina Gambling
- School of Healthcare Sciences, Cardiff University, Cardiff, Wales
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, Wales
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Drew CJG, Quinn L, Hamana K, Williams-Thomas R, Marsh L, Dimitropoulou P, Playle R, Griffin BA, Kelson M, Schubert R, Muratori L, Reilmann R, Rosser A, Busse M. Physical Activity and Exercise Outcomes in Huntington Disease (PACE-HD): Protocol for a 12-Month Trial Within Cohort Evaluation of a Physical Activity Intervention in People With Huntington Disease. Phys Ther 2019; 99:1201-1210. [PMID: 31101920 DOI: 10.1093/ptj/pzz075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 02/18/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND Exercise is emerging as an important aspect in the management of disease-related symptoms and functional decline in people with Huntington disease (HD). Long-term evaluation of physical activity and exercise participation in HD has yet to be undertaken. OBJECTIVE The objective is to investigate the feasibility of a nested randomized controlled trial (RCT) alongside a longitudinal observational study of physical activity and exercise outcomes in people with HD. DESIGN This will be a 12-month longitudinal observational study (n = 120) with a nested evaluation of a physical activity intervention (n = 30) compared with usual activity (n = 30) using a "trial within a cohort" design. SETTING The study will take place in HD specialist clinics in Germany, Spain, and the United States, with intervention delivery in community settings. PARTICIPANTS The participants will have early-mid-stage HD and be participating in the Enroll-HD study. INTERVENTION This will be a 12-month physical activity behavioral change intervention, delivered by physical therapists in 18 sessions, targeting uptake of aerobic exercise and increased physical activity. MEASUREMENTS All participants (n = 120) will complete Enroll-HD assessments (motor, cognitive, behavioral, and quality of life) at baseline and at 12 months. Additional Physical ACtivity and Exercise Outcomes in Huntington Disease (PACE-HD) assessments include fitness (predicted maximal oxygen uptake [V o2max]), self-reported and quantitative measures of physical activity, disease-specific symptoms, and walking endurance. RCT participants (n = 60) will complete an additional battery of quantitative motor assessments and a 6-month interim assessment. Enroll-HD data will be linked to PACE-HD physical activity and fitness data. LIMITATIONS The limitations include that the embedded RCT is open, and assessors at RCT sites are not blinded to participant allocation. CONCLUSION PACE-HD will enable determination of the feasibility of long-term physical activity interventions in people with HD. The novel "trial within a cohort" design and incorporation of data linkage have potential to reduce participant burden. This design could be applied to other neurological diseases and movement disorders where recruitment and retention are challenging.
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Affiliation(s)
- Cheney J G Drew
- Centre for Trials Research, Cardiff University, South Glamorgan, United Kingdom
| | - Lori Quinn
- Centre for Trials Research, Cardiff University; and Teachers College, Columbia University, New York, New York
| | - Katy Hamana
- School of Health Care Sciences, Cardiff University
| | | | - Lucy Marsh
- Centre for Trials Research, Cardiff University, South Glamorgan, United Kingdom
| | | | - Rebecca Playle
- Centre for Trials Research, Cardiff University, South Glamorgan, United Kingdom
| | | | - Mark Kelson
- Department of Mathematics, University of Exeter, Exeter, United Kingdom
| | - Robin Schubert
- George Huntington Institute and Institute for Clinical Radiology, University of Münster, Münster, Germany
| | - Lisa Muratori
- George Huntington Institute and Institute for Clinical Radiology, University of Münster; and School of Health Technology and Management, Stony Brook University, Stony Brook, New York
| | - Ralf Reilmann
- George Huntington Institute and Institute for Clinical Radiology, University of Münster; and Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | | | - Monica Busse
- Centre for Trials Research, Cardiff University, 4th Floor, Neuadd Meirionydd Health Park, Cardiff, South Glamorgan CF14 7YS, United Kingdom
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Playle R, Dimitropoulou P, Kelson M, Quinn L, Busse M. Exercise Interventions in Huntington's Disease: An Individual Patient Data Meta-Analysis. Mov Disord Clin Pract 2019; 6:567-575. [PMID: 31538091 DOI: 10.1002/mdc3.12809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 05/03/2019] [Accepted: 06/07/2019] [Indexed: 12/18/2022] Open
Abstract
Background Physical activity may be beneficial in Huntington's disease (HD); however, studies to date have been underpowered to detect change. We combined data from five randomized controlled feasibility trials using individual patient data meta-analyses. Methods/Design All trial interventions comprised a combination of supervised and self-directed physical activity, with varied emphasis on aerobic, strength, endurance, flexibility, and task training. Duration ranged from 8 to 16 weeks. The primary outcome was the modified Unified Huntington's Disease Rating Motor Score. Secondary outcomes included the Symbol Digit Modality Test, Berg Balance Scale, 30-second Chair stand, Timed Up and Go, Gait Speed, Physical Performance Test, Six-Minute Walk, International Physical Activity Questionnaire, Hospital Anxiety and Depression Scale, EuroQol Health Utility Index, and Short-Form 36 Health Related Quality of Life Scale. The primary analysis utilized a two-stage approach. A one-stage approach was explored as a sensitivity analysis using a cross-classified (by study site) linear mixed-effects model. Results One hundred twenty-one participants provided complete data. Risk of bias was moderate; however, primary outcomes were blind assessed. Primary pooled effect estimates adjusted for baseline modified motor score (95% confidence interval) were 0.2 (-2.1 to 2.6) favoring control. There was considerable heterogeneity between the studies. Conclusions There was no evidence of an exercise effect on the modified motor score in these relatively short-duration interventions. Longer-duration trials incorporating supervised components meeting frequency, intensity, time, and type principles are required. Lack of common outcomes limited the analysis and highlight the importance of a core outcome set for evaluating exercise in HD.
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Affiliation(s)
- Rebecca Playle
- Centre for Trials Research Cardiff University Cardiff United Kingdom
| | | | - Mark Kelson
- School of Mathematics/The Alan Turing Institute University of Exeter Exeter United Kingdom
| | - Lori Quinn
- Centre for Trials Research Cardiff University Cardiff United Kingdom.,Teachers College Columbia University New York New York USA
| | - Monica Busse
- Centre for Trials Research Cardiff University Cardiff United Kingdom
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49
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Albert A, André M, Anghinolfi M, Anton G, Ardid M, Aubert JJ, Aublin J, Avgitas T, Baret B, Barrios-Martít J, Basa S, Belhorma B, Bertin V, Biagi S, Bormuth R, Boumaaza J, Bourret S, Bouwhuis MC, Brânzaş H, Bruijn R, Brunner J, Busto J, Capone A, Caramete L, Carr J, Celli S, Chabab M, Moursli RCE, Chiarusi T, Circella M, Coelho JAB, Coleiro A, Colomer M, Coniglione R, Costantini H, Coyle P, Creusot A, Díaz AF, Deschamps A, Distefano C, Palma ID, Domi A, Donzaud C, Dornic D, Drouhin D, Eberl T, Bojaddaini IE, Khayati NE, Elsässer D, Enzenhöfer A, Ettahiri A, Fassi F, Felis I, Fermani P, Ferrara G, Fusco LA, Gay P, Glotin H, Grégoire T, Ruiz RG, Graf K, Hallmann S, van Haren H, Heijboer AJ, Hello Y, Hernández-Rey JJ, Hößl J, Hofestädt J, Illuminati G, de Jong M, Jongen M, Kadler M, Kalekin O, Katz U, Khan-Chowdhury NR, Kouchner A, Kreter M, Kreykenbohm I, Kulikovskiy V, Lachaud C, Lahmann R, Lefèvre D, Leonora E, Levi G, Lotze M, Loucatos S, Marcelin M, Margiotta A, Marinelli A, Martínez-Mora JA, Mele R, Melis K, Migliozzi P, Moussa A, Navas S, Nezri E, Nuñez A, Organokov M, Păvălaş GE, Pellegrino C, Piattelli P, Popa V, Pradier T, Quinn L, Racca C, Randazzo N, Riccobene G, Sánchez-Losa A, Saldaña M, Salvadori I, Samtleben DFE, Sanguineti M, Sapienza P, Schüssler F, Spurio M, Stolarczyk T, Taiuti M, Tayalati Y, Trovato A, Vallage B, Van Elewyck V, Versari F, Vivolo D, Wilms J, Zaborov D, Zornoza JD, Zúñiga J. The cosmic ray shadow of the Moon observed with the ANTARES neutrino telescope. Eur Phys J C Part Fields 2018; 78:1006. [PMID: 30872956 PMCID: PMC6383875 DOI: 10.1140/epjc/s10052-018-6451-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 11/14/2018] [Indexed: 06/09/2023]
Abstract
One of the main objectives of the ANTARES telescope is the search for point-like neutrino sources. Both the pointing accuracy and the angular resolution of the detector are important in this context and a reliable way to evaluate this performance is needed. In order to measure the pointing accuracy of the detector, one possibility is to study the shadow of the Moon, i.e. the deficit of the atmospheric muon flux from the direction of the Moon induced by the absorption of cosmic rays. Analysing the data taken between 2007 and 2016, the Moon shadow is observed with 3.5 σ statistical significance. The detector angular resolution for downward-going muons is 0 . 73 ∘ ± 0 . 14 ∘ . The resulting pointing performance is consistent with the expectations. An independent check of the telescope pointing accuracy is realised with the data collected by a shower array detector onboard of a ship temporarily moving around the ANTARES location.
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Affiliation(s)
- A. Albert
- Université de Strasbourg, CNRS, IPHC UMR 7178, 67000 Strasbourg, France
| | - M. André
- Laboratory of Applied Bioacoustics, Technical University of Catalonia, Rambla Exposició, 08800 Vilanova i la Geltrú, Barcelona Spain
| | - M. Anghinolfi
- INFN, Sezione di Genova, Via Dodecaneso 33, 16146 Genova, Italy
| | - G. Anton
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, Erlangen, Germany
| | - M. Ardid
- Institut d’Investigació per a la Gestió Integrada de les Zones Costaneres (IGIC), Universitat Politècnica de València. C/ Paranimf 1, 46730 Gandia, Spain
| | - J. -J. Aubert
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - J. Aublin
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
| | - T. Avgitas
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
| | - B. Baret
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
| | - J. Barrios-Martít
- IFIC, Instituto de Física Corpuscular (CSIC, Universitat de València) c/ Catedrático José Beltrán, 2 E-46980 Paterna, Valencia, Spain
| | - S. Basa
- LAM - Laboratoire d’Astrophysique de Marseille, Pôle de l’Étoile Site de Château-Gombert, rue Frédéric Joliot-Curie 38, 13388 Marseille Cedex 13, France
| | - B. Belhorma
- National Center for Energy Sciences and Nuclear Techniques, B.P.1382, 10001 Rabat, Morocco
| | - V. Bertin
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - S. Biagi
- INFN, Laboratori Nazionali del Sud (LNS), Via S. Sofia 62, 95123 Catania, Italy
| | - R. Bormuth
- Nikhef, Science Park, Amsterdam, The Netherlands
- Huygens-Kamerlingh Onnes Laboratorium, Universiteit Leiden, Leiden, The Netherlands
| | - J. Boumaaza
- Faculty of Sciences, University Mohammed V in Rabat, 4 av. Ibn Battouta, B.P. 1014, 10000 Rabat, Morocco
| | - S. Bourret
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
| | | | - H. Brânzaş
- Institute of Space Science, RO-077125 Măgurele, Bucharest, Romania
| | - R. Bruijn
- Nikhef, Science Park, Amsterdam, The Netherlands
- Universiteit van Amsterdam, Instituut voor Hoge-Energie Fysica, Science Park 105, 1098 XG Amsterdam, The Netherlands
| | - J. Brunner
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - J. Busto
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - A. Capone
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Rome, Italy
- Dipartimento di Fisica dell’Università La Sapienza, P.le Aldo Moro 2, 00185 Rome, Italy
| | - L. Caramete
- Institute of Space Science, RO-077125 Măgurele, Bucharest, Romania
| | - J. Carr
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - S. Celli
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Rome, Italy
- Dipartimento di Fisica dell’Università La Sapienza, P.le Aldo Moro 2, 00185 Rome, Italy
- Gran Sasso Science Institute, Viale Francesco Crispi 7, 00167 L’Aquila, Italy
| | - M. Chabab
- LPHEA, Faculty of Science, Semlali, Cadi Ayyad University, P.O.B. 2390, Marrakech, Morocco
| | - R. Cherkaoui El Moursli
- Faculty of Sciences, University Mohammed V in Rabat, 4 av. Ibn Battouta, B.P. 1014, 10000 Rabat, Morocco
| | - T. Chiarusi
- INFN, Sezione di Bologna, Viale Berti-Pichat 6/2, 40127 Bologna, Italy
| | - M. Circella
- INFN, Sezione di Bari, Via E. Orabona 4, 70126 Bari, Italy
| | - J. A. B. Coelho
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
| | - A. Coleiro
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
- IFIC, Instituto de Física Corpuscular (CSIC, Universitat de València) c/ Catedrático José Beltrán, 2 E-46980 Paterna, Valencia, Spain
| | - M. Colomer
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
- IFIC, Instituto de Física Corpuscular (CSIC, Universitat de València) c/ Catedrático José Beltrán, 2 E-46980 Paterna, Valencia, Spain
| | - R. Coniglione
- INFN, Laboratori Nazionali del Sud (LNS), Via S. Sofia 62, 95123 Catania, Italy
| | - H. Costantini
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - P. Coyle
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - A. Creusot
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
| | - A. F. Díaz
- Department of Computer Architecture and Technology/CITIC, University of Granada, 18071 Granada, Spain
| | - A. Deschamps
- Géoazur, UCA, CNRS, IRD, Observatoire de la Côte d’Azur, Sophia Antipolis, France
| | - C. Distefano
- INFN, Laboratori Nazionali del Sud (LNS), Via S. Sofia 62, 95123 Catania, Italy
| | - I. Di Palma
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Rome, Italy
- Dipartimento di Fisica dell’Università La Sapienza, P.le Aldo Moro 2, 00185 Rome, Italy
| | - A. Domi
- INFN, Sezione di Genova, Via Dodecaneso 33, 16146 Genova, Italy
- Dipartimento di Fisica dell’Università, Via Dodecaneso 33, 16146 Genova, Italy
| | - C. Donzaud
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
- Université Paris-Sud, 91405 Orsay Cedex, France
| | - D. Dornic
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - D. Drouhin
- Université de Strasbourg, CNRS, IPHC UMR 7178, 67000 Strasbourg, France
| | - T. Eberl
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, Erlangen, Germany
| | - I. El Bojaddaini
- Laboratory of Physics of Matter and Radiations, University Mohammed I, B.P.717, 6000 Oujda, Morocco
| | - N. El Khayati
- Faculty of Sciences, University Mohammed V in Rabat, 4 av. Ibn Battouta, B.P. 1014, 10000 Rabat, Morocco
| | - D. Elsässer
- Institut für Theoretische Physik und Astrophysik, Universität Würzburg, Emil-Fischer Str. 31, 97074 Würzburg, Germany
| | - A. Enzenhöfer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, Erlangen, Germany
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - A. Ettahiri
- Faculty of Sciences, University Mohammed V in Rabat, 4 av. Ibn Battouta, B.P. 1014, 10000 Rabat, Morocco
| | - F. Fassi
- Faculty of Sciences, University Mohammed V in Rabat, 4 av. Ibn Battouta, B.P. 1014, 10000 Rabat, Morocco
| | - I. Felis
- Institut d’Investigació per a la Gestió Integrada de les Zones Costaneres (IGIC), Universitat Politècnica de València. C/ Paranimf 1, 46730 Gandia, Spain
| | - P. Fermani
- INFN, Sezione di Roma, P.le Aldo Moro 2, 00185 Rome, Italy
- Dipartimento di Fisica dell’Università La Sapienza, P.le Aldo Moro 2, 00185 Rome, Italy
| | - G. Ferrara
- INFN, Laboratori Nazionali del Sud (LNS), Via S. Sofia 62, 95123 Catania, Italy
| | - L. A. Fusco
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
- Dipartimento di Fisica e Astronomia dell’Università, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - P. Gay
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
- Laboratoire de Physique Corpusculaire, Clermont Université, Université Blaise Pascal, CNRS/IN2P3, BP 10448, 63000 Clermont-Ferrand, France
| | - H. Glotin
- LIS, UMR Université de Toulon, Aix Marseille Université, CNRS, 83041 Toulon, France
| | - T. Grégoire
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
| | - R. Gracia Ruiz
- Université de Strasbourg, CNRS, IPHC UMR 7178, 67000 Strasbourg, France
| | - K. Graf
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, Erlangen, Germany
| | - S. Hallmann
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, Erlangen, Germany
| | - H. van Haren
- Royal Netherlands Institute for Sea Research (NIOZ) and Utrecht University, Landsdiep 4, 1797 SZ ’t Horntje (Texel), The Netherlands
| | | | - Y. Hello
- Géoazur, UCA, CNRS, IRD, Observatoire de la Côte d’Azur, Sophia Antipolis, France
| | - J. J. Hernández-Rey
- IFIC, Instituto de Física Corpuscular (CSIC, Universitat de València) c/ Catedrático José Beltrán, 2 E-46980 Paterna, Valencia, Spain
| | - J. Hößl
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, Erlangen, Germany
| | - J. Hofestädt
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, Erlangen, Germany
| | - G. Illuminati
- IFIC, Instituto de Física Corpuscular (CSIC, Universitat de València) c/ Catedrático José Beltrán, 2 E-46980 Paterna, Valencia, Spain
| | - M. de Jong
- Nikhef, Science Park, Amsterdam, The Netherlands
- Huygens-Kamerlingh Onnes Laboratorium, Universiteit Leiden, Leiden, The Netherlands
| | - M. Jongen
- Nikhef, Science Park, Amsterdam, The Netherlands
| | - M. Kadler
- Institut für Theoretische Physik und Astrophysik, Universität Würzburg, Emil-Fischer Str. 31, 97074 Würzburg, Germany
| | - O. Kalekin
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, Erlangen, Germany
| | - U. Katz
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, Erlangen, Germany
| | - N. R. Khan-Chowdhury
- IFIC, Instituto de Física Corpuscular (CSIC, Universitat de València) c/ Catedrático José Beltrán, 2 E-46980 Paterna, Valencia, Spain
| | - A. Kouchner
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
- Institut Universitaire de France, 75005 Paris, France
| | - M. Kreter
- Institut für Theoretische Physik und Astrophysik, Universität Würzburg, Emil-Fischer Str. 31, 97074 Würzburg, Germany
| | - I. Kreykenbohm
- Dr. Remeis-Sternwarte and ECAP, Friedrich-Alexander-Universität Erlangen-Nürnberg, Sternwartstr. 7, 96049 Bamberg, Germany
| | - V. Kulikovskiy
- INFN, Sezione di Genova, Via Dodecaneso 33, 16146 Genova, Italy
- Skobeltsyn Institute of Nuclear Physics, Leninskie gory, Moscow State University, 119991 Moscow, Russia
| | - C. Lachaud
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
| | - R. Lahmann
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, Erlangen, Germany
| | - D. Lefèvre
- Mediterranean Institute of Oceanography (MIO), Aix-Marseille University, 13288 Marseille, Cedex 9, France
- Université du Sud Toulon-Var, CNRS-INSU/IRD UM 110, 83957 La Garde Cedex, France
| | - E. Leonora
- INFN, Sezione di Catania, Via S. Sofia 64, 95123 Catania, Italy
| | - G. Levi
- INFN, Sezione di Bologna, Viale Berti-Pichat 6/2, 40127 Bologna, Italy
- Dipartimento di Fisica e Astronomia dell’Università, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - M. Lotze
- IFIC, Instituto de Física Corpuscular (CSIC, Universitat de València) c/ Catedrático José Beltrán, 2 E-46980 Paterna, Valencia, Spain
| | - S. Loucatos
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - M. Marcelin
- LAM - Laboratoire d’Astrophysique de Marseille, Pôle de l’Étoile Site de Château-Gombert, rue Frédéric Joliot-Curie 38, 13388 Marseille Cedex 13, France
| | - A. Margiotta
- INFN, Sezione di Bologna, Viale Berti-Pichat 6/2, 40127 Bologna, Italy
- Dipartimento di Fisica e Astronomia dell’Università, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - A. Marinelli
- INFN, Sezione di Pisa, Largo B. Pontecorvo 3, 56127 Pisa, Italy
- Dipartimento di Fisica dell’Università, Largo B. Pontecorvo 3, 56127 Pisa, Italy
| | - J. A. Martínez-Mora
- Institut d’Investigació per a la Gestió Integrada de les Zones Costaneres (IGIC), Universitat Politècnica de València. C/ Paranimf 1, 46730 Gandia, Spain
| | - R. Mele
- INFN, Sezione di Napoli, Via Cintia, 80126 Napoli, Italy
- Dipartimento di Fisica dell’Università Federico II di Napoli, Via Cintia, 80126 Napoli, Italy
| | - K. Melis
- Nikhef, Science Park, Amsterdam, The Netherlands
- Universiteit van Amsterdam, Instituut voor Hoge-Energie Fysica, Science Park 105, 1098 XG Amsterdam, The Netherlands
| | - P. Migliozzi
- INFN, Sezione di Napoli, Via Cintia, 80126 Napoli, Italy
| | - A. Moussa
- Laboratory of Physics of Matter and Radiations, University Mohammed I, B.P.717, 6000 Oujda, Morocco
| | - S. Navas
- Dpto. de Física Teórica y del Cosmos & C.A.F.P.E., University of Granada, 18071 Granada, Spain
| | - E. Nezri
- LAM - Laboratoire d’Astrophysique de Marseille, Pôle de l’Étoile Site de Château-Gombert, rue Frédéric Joliot-Curie 38, 13388 Marseille Cedex 13, France
| | - A. Nuñez
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
- LAM - Laboratoire d’Astrophysique de Marseille, Pôle de l’Étoile Site de Château-Gombert, rue Frédéric Joliot-Curie 38, 13388 Marseille Cedex 13, France
| | - M. Organokov
- Université de Strasbourg, CNRS, IPHC UMR 7178, 67000 Strasbourg, France
| | - G. E. Păvălaş
- Institute of Space Science, RO-077125 Măgurele, Bucharest, Romania
| | - C. Pellegrino
- INFN, Sezione di Bologna, Viale Berti-Pichat 6/2, 40127 Bologna, Italy
- Dipartimento di Fisica e Astronomia dell’Università, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - P. Piattelli
- INFN, Laboratori Nazionali del Sud (LNS), Via S. Sofia 62, 95123 Catania, Italy
| | - V. Popa
- Institute of Space Science, RO-077125 Măgurele, Bucharest, Romania
| | - T. Pradier
- Université de Strasbourg, CNRS, IPHC UMR 7178, 67000 Strasbourg, France
| | - L. Quinn
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - C. Racca
- GRPHE, Université de Haute Alsace - Institut universitaire de technologie de Colmar, 34 rue du Grillenbreit, BP 50568, 68008 Colmar, France
| | - N. Randazzo
- INFN, Sezione di Catania, Via S. Sofia 64, 95123 Catania, Italy
| | - G. Riccobene
- INFN, Laboratori Nazionali del Sud (LNS), Via S. Sofia 62, 95123 Catania, Italy
| | | | - M. Saldaña
- Institut d’Investigació per a la Gestió Integrada de les Zones Costaneres (IGIC), Universitat Politècnica de València. C/ Paranimf 1, 46730 Gandia, Spain
| | - I. Salvadori
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - D. F. E. Samtleben
- Nikhef, Science Park, Amsterdam, The Netherlands
- Huygens-Kamerlingh Onnes Laboratorium, Universiteit Leiden, Leiden, The Netherlands
| | - M. Sanguineti
- INFN, Sezione di Genova, Via Dodecaneso 33, 16146 Genova, Italy
- Dipartimento di Fisica dell’Università, Via Dodecaneso 33, 16146 Genova, Italy
| | - P. Sapienza
- INFN, Laboratori Nazionali del Sud (LNS), Via S. Sofia 62, 95123 Catania, Italy
| | - F. Schüssler
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - M. Spurio
- INFN, Sezione di Bologna, Viale Berti-Pichat 6/2, 40127 Bologna, Italy
- Dipartimento di Fisica e Astronomia dell’Università, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - Th. Stolarczyk
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - M. Taiuti
- INFN, Sezione di Genova, Via Dodecaneso 33, 16146 Genova, Italy
- Dipartimento di Fisica dell’Università, Via Dodecaneso 33, 16146 Genova, Italy
| | - Y. Tayalati
- Faculty of Sciences, University Mohammed V in Rabat, 4 av. Ibn Battouta, B.P. 1014, 10000 Rabat, Morocco
| | - A. Trovato
- INFN, Laboratori Nazionali del Sud (LNS), Via S. Sofia 62, 95123 Catania, Italy
| | - B. Vallage
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - V. Van Elewyck
- APC, Univ Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Sorbonne Paris Cité, Paris, France
- Institut Universitaire de France, 75005 Paris, France
| | - F. Versari
- INFN, Sezione di Bologna, Viale Berti-Pichat 6/2, 40127 Bologna, Italy
- Dipartimento di Fisica e Astronomia dell’Università, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - D. Vivolo
- INFN, Sezione di Napoli, Via Cintia, 80126 Napoli, Italy
- Dipartimento di Fisica dell’Università Federico II di Napoli, Via Cintia, 80126 Napoli, Italy
| | - J. Wilms
- Dr. Remeis-Sternwarte and ECAP, Friedrich-Alexander-Universität Erlangen-Nürnberg, Sternwartstr. 7, 96049 Bamberg, Germany
| | - D. Zaborov
- Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - J. D. Zornoza
- IFIC, Instituto de Física Corpuscular (CSIC, Universitat de València) c/ Catedrático José Beltrán, 2 E-46980 Paterna, Valencia, Spain
| | - J. Zúñiga
- IFIC, Instituto de Física Corpuscular (CSIC, Universitat de València) c/ Catedrático José Beltrán, 2 E-46980 Paterna, Valencia, Spain
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McIsaac TL, Fritz NE, Quinn L, Muratori LM. Cognitive-Motor Interference in Neurodegenerative Disease: A Narrative Review and Implications for Clinical Management. Front Psychol 2018; 9:2061. [PMID: 30425673 PMCID: PMC6218850 DOI: 10.3389/fpsyg.2018.02061] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 10/05/2018] [Indexed: 11/13/2022] Open
Abstract
This paper provides a narrative review of cognitive motor interference in neurodegeneration, including brain imaging findings specific to interference effects in neurodegenerative disease, and dual task assessment and intervention in Parkinson’s disease (PD), multiple sclerosis (MS), and Huntington’s disease (HD). In a healthy central nervous system the ability to process information is limited. Limitations in capacity to select and attend to inputs influence the ability to prepare and perform multiple tasks. As a result, the system balances demands, switching attention to the most task-relevant information as it becomes available. Limitations may become more apparent in persons with neurodegenerative diseases (ND) with system-specific impairments in PD, MS, and HD. These ND affect both cognitive and motor function and are thus particularly susceptible to dual task interference. Issues related to performer and task characteristics and implications of these findings for both the standard assessment of dual task abilities as well as development and evaluation of interventions aimed at improving dual task ability are discussed. In addition, we address the need for optimizing individualized assessment, intervention and evaluation of dual task function by choosing cognitive and motor tasks and measures that are sensitive to and appropriate for the individual’s level of function. Finally, we use current evidence to outline a 5-step process of clinical decision making that uses the dual task taxonomy as a framework for assessment and intervention.
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Affiliation(s)
- Tara L McIsaac
- Department of Physical Therapy, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, United States
| | - Nora E Fritz
- Program in Physical Therapy and Department of Neurology, Wayne State University, Detroit, MI, United States
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
| | - Lisa M Muratori
- Department of Physical Therapy, SHTM, Stony Brook University, Stony Brook, NY, United States
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