Paradoxical Gait at a Narrowed Entrance in a Patient with Hoehn-Yahr Stage III Parkinson’s Disease

2012 ◽  
Vol 68 (5) ◽  
pp. 276-278 ◽  
Author(s):  
Hiroshi Kataoka ◽  
Noriyuki Tanaka ◽  
Takao Kiriyama ◽  
Nobuyuki Eura ◽  
Hirosei Horikawa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Stage Iii ◽  
Yahr Stage

scholarly journals Quantitative Analysis of Postural Instability in Patients with Parkinson’s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yang Yu ◽  
Siquan Liang ◽  
Yue Wang ◽  
Yanan Zhao ◽  
Jiaojiao Zhao ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Stage Iv ◽  
Postural Instability ◽  
Stage Ii ◽  
Stage Iii ◽  
Clinical Trial Registry ◽  
Yahr Stage ◽  
Significant Difference ◽  
Postural Abnormalities

Introduction. Postural instability is commonly observed in Parkinson’s disease, leading to an increasing risk of falling and worsening as the disease progresses. We found that limit of stability can be applied to reflect the dynamic evolution of postural instability in patients with Parkinson's disease. Methods. Forty-three patients (9 of Hoehn and Yahr stage I, 12 of stage II, 14 of stage III, and 8 of stage IV) met the criteria for the diagnosis of idiopathic Parkinson’s disease and could stand independently for at least 10 minutes. Twelve healthy controls with no sign of parkinsonism were also recruited. Postural instability was assessed by posturography in different directions (forward, backward, right, left, forward-right, forward-left, backward-right, and backward-left). This study trial was registered with the Chinese Clinical Trial Registry (no. ChiCTR1900022715). Results. All participants were able to complete the limit of stability tasks without any complications. Patients in stages II to IV exhibited smaller end point excursion and slower time to complete than controls, suggesting an impaired limit of stability. The patients in stage II exhibited a remarkable decline in most directions compared to controls, except for right and left, and forward and backward decline occurred the earliest. For patients in stage III, right was the only direction with no significant difference from controls. In stage IV patients, the limit of stability declined significantly in all directions ( p < 0.05 ). Conclusions. The postural abnormalities of Parkinson’s disease can occur at early stages, and the pattern of decline is more severe in the forward-backward direction. This trial is registered with ChiCTR1900022715.

Risk of Falling in Parkinson’s Disease at the Hoehn-Yahr Stage III

2011 ◽  
Vol 66 (5) ◽  
pp. 298-304 ◽  
Author(s):  
Hiroshi Kataoka ◽  
Noriyuki Tanaka ◽  
M. Eng ◽  
Keigo Saeki ◽  
Takao Kiriyama ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Stage Iii ◽  
Risk Of Falling ◽  
Yahr Stage

At which Hoehn&Yahr stage of Parkinson's disease should the patients be screened for dysphagia?

2020 ◽  
Vol 39 (1) ◽  
pp. 313
Author(s):  
Gülistan Bahat ◽  
Tuğba Erdoğan ◽  
Mehmet Akif Karan
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Yahr Stage

scholarly journals Clinical Profile of Parkinson's Disease: Experience of Niger

2018 ◽  
Vol 09 (02) ◽  
pp. 214-218 ◽  
Author(s):  
Hamid Assadeck ◽  
Moussa Toudou Daouda ◽  
Fatimata Hassane Djibo ◽  
Djibo Douma Maiga ◽  
Eric Adehossi Omar
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Features ◽  
Outpatient Clinic ◽  
Clinical Profile ◽  
Stage Ii ◽  
Stage Iii ◽  
The Mean ◽  
Mean Time

ABSTRACT Background: Parkinson's disease (PD) is a chronic neurodegenerative pathology with unknown etiology. It is characterized clinically by the classic triad that associated tremors, bradykinesia, and rigidity. In Niger, there are no data on PD. Aims: We aimed to provide the demographic and clinical profile of PD in patients from Niger to create a database on PD in Niger. Patients and Methods: We conducted a retrospective study at the Neurology Outpatient Clinic of the Hôpital National de Niamey (HNN, Niger) over a period of 4.42 years from February 2009 to July 2013 collecting all cases of PD. The demographic and clinical features of all patients were collected and analyzed. Results: During the period of the study, 1695 patients consulted at the Neurology Outpatient Clinic of the HNN, among which 76 patients (4.48%) had secondary parkinsonism and 25 patients (1.47%) had features compatible with PD. Only patients with PD were included in this study. The mean age at onset of symptoms was 58 years (range: 42–74 years). The male sex was predominant (60%) with a sex ratio of 1.5. The mean time interval from the onset of symptoms to diagnosis of PD was 1.8 years (range: 1–5 years). The tremor was the most common symptom (84%). Bradykinesia represented 64% of the symptoms and rigidity 20%. At the time of the diagnosis of PD, 8 patients (32%) were in Stage I of the classification of Hoehn and Yahr, 16 patients (64%) in Stage II, and 1 patient (4%) in Stage III. The levodopa/carbidopa combination was the most used antiparkinsonian drug in our patients (88%). The mean time of follow-up of the patients was 2.5 years (range: 1–4.42 years). During the course of the disease, 9 patients (36%) were in Stage II of the classification of Hoehn and Yahr, 13 patients (52%) in Stage III, and 3 patients (12%) in Stage IV. Conclusion: Our study provides demographic and clinical data of PD in patients from Niger and shows that the hospital frequency of this disease is low (1.47%). The demographic and clinical features of our patients are similar to those of the patients of the prior studies reported in sub-Saharan Africa.

scholarly journals Sicca Symptoms in Parkinson’s Disease: Association with Other Nonmotor Symptoms and Health-Related Quality of Life

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Tino Prell ◽  
Denise Schaller ◽  
Caroline Perner ◽  
Otto W. Witte ◽  
Julian Grosskreutz
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Well Being ◽  
Nonmotor Symptoms ◽  
Yahr Stage ◽  
Autonomic Symptoms ◽  
Related Quality ◽  
Health Related ◽  
Sicca Symptoms

Background. Frequently used nonmotor scales do not cover all aspects of dysautonomia in Parkinson’s disease (PD). This study explores the association between autonomic symptoms and sicca symptoms with other nonmotor symptoms and health-related quality of life (QoL) in PD. Methods. Autonomic symptoms (Survey of Autonomic Symptoms, SASs), motor function (Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale III, MDS-UPDRS III), nonmotor symptoms (nonmotor symptoms questionnaire, NMS-Quest), and QoL (PD Questionnaire-39, PDQ-39) were analysed in 93 PD patients without dementia. Multivariable and multivariate analyses were performed to study the association between clinical parameters and PDQ-39 domains. Results. Among the autonomic symptoms, sicca symptoms (xerostomia and dry eyes) were the most commonly reported (69%), followed by sexual dysfunction in men, leaking of urine, vasomotor dysfunction, constipation, sudomotor dysfunction, and orthostatic symptoms. The autonomic symptom burden (SAS total) correlated with the NMS-Quest and Hoehn and Yahr stage, but not with age, levodopa equivalent daily dose, disease duration, and the MDS-UPDRS III. The SAS total score was an independent predictor of the PDQ-39 summary index and mainly affected the PDQ-39 cognition and emotional well-being domains. Sicca symptoms were not associated with age, MDS-UPDRS III, disease duration, Hoehn and Yahr stage, and levodopa equivalent daily dose but aggravated the PDQ-39 domains: cognition, emotional well-being, bodily discomfort, and mobility. Sicca symptoms frequently occur together with other nonmotor symptoms, namely, urine urgency, orthostatic problems, and concentration problems. Overall, 75% of the subjects took at least one drug that can cause sicca symptoms (anti-PD medication, antidepressant drugs, antihypertensive drugs, antipsychotic drugs, antimuscarinic drugs, and analgesic drugs). Conclusion. Sicca symptoms are common in PD and negatively influence QoL. The observed association between sicca symptoms and other nonmotor symptoms provides further preliminary evidence for the growing recognition of different nonmotor clusters in PD.

scholarly journals Early Postural Instability in Parkinson’s Disease: A Biomechanical Analysis of the Pull Test

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Javier Ricardo Pérez-Sánchez ◽  
Francisco Grandas
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Healthy Subjects ◽  
Postural Instability ◽  
Biomechanical Analysis ◽  
Stage Iii ◽  
Clinical Test ◽  
Pull Force ◽  
Pull Test ◽  
Postural Responses

Postural instability in Parkinson’s disease (PD) is commonly assessed by the pull test. This clinical test may be biased by the variability of the pull force applied. Our objective was to study the postural responses elicited by reproducible pull forces in healthy subjects and PD patients at different stages of the disease. We performed a multimodal approach that included a systematic analysis of the pull force needed to reach the backward limit of stability (FBLoS) assessed by mechanically produced forces, the displacements of the center of pressure (CoP) recorded on a force platform, and the latencies and patterns of activation of the stabilizing muscles. Comparisons between groups were performed by univariate and multivariate statistical analyses. Sixty-four healthy subjects and 32 PD patients, 22 Hoehn–Yahr (H–Y) stages I-II and 10 H–Y stage III, were studied. In healthy subjects, FBLoS decreased with aging and was lower in females. Mean (SD) FBLoS was 98.1 (48.9) Newtons (N) in healthy subjects, 70.5 (39.8) N in PD patients H–Y stages I-II, and 37.7 (18.9) N in PD patients H–Y stage III. Compared to healthy subjects and when adjusted for age and gender, PD patients H–Y stages I-II exhibited the following: (a) a reduced FBLoS; (b) larger CoP displacements and higher velocities for the same applied force; and (c) combined ankle and hip strategies elicited by less intense pull forces. All of these abnormalities were more pronounced in H–Y stage III PD patients compared to H–Y stages I-II PD patients. In conclusion, patients in the early stages of PD already exhibit a degree of postural instability due to inefficient postural adjustments, and they can more easily be destabilized by small perturbations than healthy subjects. This balance impairment becomes more pronounced in more advanced PD. In the pull test, pull force to step back should be a variable to consider when testing balance in clinical practice.

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