scholarly journals Effects of Gait Inducing Assist for Patients with Parkinson’s Disease on Double Support Phase During Gait

2020 ◽  
Vol 32 (4) ◽  
pp. 798-811
Author(s):  
Ai Higuchi ◽  
Junichiro Shiraishi ◽  
Yuichi Kurita ◽  
Tomohiro Shibata ◽  
◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Step Length ◽  
Motor Symptom ◽  
Elderly Subjects ◽  
Healthy Elderly ◽  
Wide Range ◽  
Healthy Elderly Subjects ◽  
Support Phase

Parkinson’s disease (PD) is a common progressive neurodegenerative disease that affects a wide range of motor and non-motor symptoms. Freezing of gait (FOG) is such a motor symptom of PD that frequently results in falling, and almost half of PD patients suffer from FOG. In this study, we investigated the effectiveness of a robotic assistance system called UPS-PD, which was developed to suppress FOG. The double limb support phase (DLS) in a 10-m straight-line walking task, the gait time and step counts were measured in five PD subjects. In addition, the safety of the UPS-PD in a healthy person was investigated using OpenSim, and the DLS parameters in four healthy elderly subjects were evaluated. In the experiment with the PD patients, the DLS parameters of two subjects showed an improvement. Furthermore, the step length of one subject and the step length and walking speed of the other subject were improved. Moreover, there were no problems in terms of instability of gait in both the PD patients. The UPS-PD did not adversely affect the gait of healthy elderly subjects and the walking of a healthy subject model in the simulation. Therefore, the UPS-PD is considered to be a useful device for improving walking in PD patients.

scholarly journals Gait analysis comparing Parkinson's disease with healthy elderly subjects

2010 ◽  
Vol 68 (1) ◽  
pp. 81-86 ◽  
Author(s):  
Roberta de Melo Roiz ◽  
Enio Walker Azevedo Cacho ◽  
Manoela Macedo Pazinatto ◽  
Julia Guimarães Reis ◽  
Alberto Cliquet Jr ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gait Analysis ◽  
Elderly Subjects ◽  
Initial Contact ◽  
Kinematic Data ◽  
Healthy Elderly ◽  
Spatio Temporal ◽  
Clinical Measures ◽  
Healthy Elderly Subjects

There is a lack of studies comparing the kinematics data of idiopathic Parkinson's disease (IPD) patients with healthy elder (HE) subjects, and when there is such research, it is not correlated to clinical measures. OBJECTIVE: To compare the spatio-temporal and kinematic parameters of Parkinsonian gait with the HE subjects group and measure the relation between these parameters and clinical instruments. METHOD: Twelve patients with IPD and fifteen HE subjects were recruited and evaluated for clinical instruments and gait analysis. RESULTS: There were statistically significant differences between HE group and the IPD group, in stride velocity, in stride length (SL), and in the hip joint kinematic data: on initial contact, on maximum extension during terminal contact and on maximum flexion during mid-swing. Regarding the clinical instruments there were significant correlated with in stride velocity and SL. CONCLUSION: Clinical instruments used did not present proper psychometric parameters to measure the IPD patient's gait, while the 3D system characterized it better.

scholarly journals 3D visual cueing shortens the double support phase of the gait cycle in patients with advanced Parkinson's disease treated with DBS of the STN

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244676
Author(s):  
Kamila Poláková ◽  
Evžen Růžička ◽  
Robert Jech ◽  
David Kemlink ◽  
Jan Rusz ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Step Length ◽  
Double Support ◽  
Visual Cueing ◽  
Stn Dbs ◽  
Support Phase ◽  
Double Support Phase

Background Gait disturbances have emerged as some of the main therapeutic concerns in late-stage Parkinson’s disease (PD) treated with dopaminergic therapy and deep brain stimulation (DBS). External cues may help to overcome freezing of gait (FOG) and improve some of the gait parameters. Aim To evaluate the effect of 3D visual cues and STN-DBS on gait in PD group. Methods We enrolled 35 PD patients treated with DBS of nucleus subthalamicus (STN-DBS). Twenty-five patients (5 females; mean age 58.9 ±6.3) and 25 sex- and age-matched controls completed the gait examination. The gait in 10 patients deteriorated in OFF state. The severity of PD was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr (HY). The PD group filled the Falls Efficacy Scale-International (FES) and Freezing of Gait Questionnaire (FOGQ). Gait was examined using the GaitRite Analysis System, placed in the middle of the 10m marked path. The PD group was tested without dopaminergic medication with and without visual cueing together with the DBS switched ON and OFF. The setting of DBS was double-blind and performed in random order. Results The UPDRS was 21.9 ±9.5 in DBS ON state and 41.3 ±13.7 in DBS OFF state. HY was 2.5 ±0.6, FES 12.4 ±4.1 and FOGQ 9.4 ±5.7. In the DBS OFF state, PD group walked more slowly with shorter steps, had greater step length variability and longer duration of the double support phase compared to healthy controls. The walking speed and step length increased in the DBS ON state. The double support phase was reduced with 3D visual cueing and DBS; the combination of both cueing and DBS was even more effective. Conclusion Cueing with 3D visual stimuli shortens the double support phase in PD patients treated with DBS-STN. The DBS is more effective in prolonging step length and increasing gait speed. We conclude that 3D visual cueing can improve walking in patients with DBS.

scholarly journals Analysis of functional profile and mobility in Parkinson’s disease: a cross sectional study

2020 ◽  
pp. 1-6
Author(s):  
Wildja de Lima Gomes ◽  
Larissa Melo de Souza Miranda ◽  
Neildja Maria da Silva ◽  
Gisele Kariny Souza Davi ◽  
Robison Carlos Silva Costa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Muscle Strength ◽  
Healthy Subjects ◽  
Rating Scale ◽  
Assessment Tools ◽  
Elderly Subjects ◽  
Cross Sectional ◽  
Healthy Elderly ◽  
Healthy Elderly Subjects

Background: Idiopathic Parkinson’s disease (PD) is a progressive neurodegenerative disease that has a prevalence of 18–328 per 100,000 in habitants in developing countries, with an estimated 3.3% of the Brazilian elderly population affected by PD throughout life. The classic symptoms include a resting tremor, muscular rigidity, bradykinesia and postural instability, which are all motor symptoms. The mobility of the subjects is compromised early, thus impairing their balance and limiting their ability to perform simple tasks. The restricted movement prevents dissociation between the head and trunk during walking, and freezing occurs as advanced disease reduces the progression of movements during walking. Objective: To analyze mobility and functionality profiles in subjects with Parkinson’s disease and compare them with healthy subjects. Method: A sample was consisted of 10 subjects with PD and 10 healthy elderly subjects. Assessment tools were used to quantify the severity of PD the scale Hoehn and Yah (HY), for mobility were used the Dynamic Parkinson’s Gait Scale (DYPAGS) and Modified Parkinson Activity Scale (PAS modified), for functionality were used the Unified Parkinson’s Disease Rating Scale (UPDRS) and dual task (DT) performance. Results: The subjects with PD showed worse performance in mobility and DT as determined by the modified PAS (p=0.0001) and DYPAGS (p=0.0001). Correlations were found between the UPDRS, the Gait Freezing Questionnaire (FOG), the PAS modified score, left-hand grip strength and the HY values (p<0.05). There were no differences in prehensile muscle strength between PD and healthy subjects. Conclusions: Subjects with PD showed decreased mobility and functionality for activities related to ADLs, gait and DT compared to healthy elderly subjects. Disease severity, muscle strength and freezing were correlated with the mobility and DT performance in subjects with PD.

scholarly journals Abnormal Olfaction in Parkinson’s Disease Is Related to Faster Disease Progression

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Sara Cavaco ◽  
Alexandra Gonçalves ◽  
Alexandre Mendes ◽  
Nuno Vila-Chã ◽  
Inês Moreira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Motor Symptom ◽  
Identification Test ◽  
Disease Rating ◽  
Abnormal Performance ◽  
Smell Identification

Introduction. A possible association between olfactory dysfunction and Parkinson’s disease (PD) severity has been a topic of contention for the past 40 years. Conflicting reports may be partially explained by procedural differences in olfactory assessment and motor symptom evaluation.Methods. One hundred and sixty-six nondemented PD patients performed the Brief-Smell Identification Test and test scores below the estimated 20th percentile as a function of sex, age, and education (i.e., 80% specificity) were considered demographically abnormal. Patients underwent motor examination after 12 h without antiparkinsonian medication.Results. Eighty-two percent of PD patients had abnormal olfaction. Abnormal performance on the Brief-Smell Identification Test was associated with higher disease severity (i.e., Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III, Freezing of Gait questionnaire, and levodopa equivalent dose), even when disease duration was taken into account.Conclusions. Abnormal olfaction in PD is associated with increased severity and faster disease progression.

Age-Related Accelerated Tapping Response in Healthy Population

2003 ◽  
Vol 96 (1) ◽  
pp. 227-235 ◽  
Author(s):  
Anat Scheiman Elazary ◽  
Hagai Bergman ◽  
Revital Attia ◽  
Hilla Ben-Pazi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Elderly Subjects ◽  
Healthy Population ◽  
Healthy Elderly ◽  
Age Related ◽  
Different Types ◽  
Finger Tapping Test ◽  
Healthy Elderly People ◽  
Abnormal Motor

Different types of rapid tapping responses were described in the finger-tapping test. The “Hastening phenomenon” was described as an abnormal motor response in patients with Parkinson's disease. Accelerated tapping has been shown in a healthy elderly sample. It is not clear whether accelerated tapping relates to the hastening phenomenon or characterizes normal aging. We hypothesized that this sample of 21 healthy elderly people showed increased accelerated tapping but not hastening phenomenon. To assess this hypothesis, 20 healthy young and 21 elderly subjects performed a tapping test, requiring responses from 1 to 6 Hz. The healthy elderly sample showed increased accelerated tapping but not increased “hastening phenomenon.” We conclude that Accelerated tapping may represent age-related motor processes unlike the hastening phenomenon characterizing Parkinson's disease.

scholarly journals Transcranial direct current stimulation (tDCS) in addition to walking training on walking, mobility, and reduction of falls in Parkinson’s disease: study protocol for a randomized clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lucas Rodrigues Nascimento ◽  
Ester Miyuki Nakamura-Palacios ◽  
Augusto Boening ◽  
Daniel Lyrio Cabral ◽  
Alessandra Swarowsky ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Fear Of Falling ◽  
Cortical Excitability ◽  
Freezing Of Gait ◽  
Step Length ◽  
Control Group ◽  
Direct Current Stimulation

Abstract Background Transcranial direct current stimulation (tDCS) has the potential to modulate cortical excitability and enhance the effects of walking training in people with Parkinson’s disease. This study will examine the efficacy of the addition of tDCS to a task-specific walking training to improve walking and mobility and to reduce falls in people with Parkinson’s disease. Methods This is a two-arm, prospectively registered, randomized trial with concealed allocation, blinded assessors, participants and therapists, and intention-to-treat analysis. Twenty-four individuals with Parkinson’s disease, categorized as slow or intermediate walkers (walking speeds ≤ 1.0 m/s), will be recruited. The experimental group will undertake a 30-min walking training associated with tDCS, for 4 weeks. The control group will undertake the same walking training, but with sham-tDCS. The primary outcome will be comfortable walking speed. Secondary outcomes will include walking step length, walking cadence, walking confidence, mobility, freezing of gait, fear of falling, and falls. Outcomes will be collected by a researcher blinded to group allocation at baseline (week 0), after intervention (week 4), and 1 month beyond intervention (week 8). Discussion tDCS associated with walking training may help improve walking of slow and intermediate walkers with Parkinson’s disease. If walking is enhanced, the benefits may be accompanied by better mobility and reduced fear of falling, and individuals may experience greater free-living physical activity at home and in the community. Trial registration Brazilian Registry of Clinical Trials (ReBEC) RBR-6bvnx6. Registered on September 23, 2019

scholarly journals Comprehensive Analysis of Walking Characteristics of Patients with Parkinson’s disease: Impact of Freezing of Gait

2020 ◽  
Author(s):  
Minji Son ◽  
Sang-Myung Cheon ◽  
Changhong Youm ◽  
Jae Kim
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Walking Speed ◽  
Freezing Of Gait ◽  
Step Length ◽  
Asymmetry Index ◽  
Comprehensive Analysis ◽  
Backward Walking ◽  
Ankle Joints ◽  
Disease Impact

Abstract Patients with Parkinson’s disease (PD) suffer from walking disturbances. This study was done to comprehensively analyze walking characteristics of PD, including forward and backward walking and turning. Impacts of freezing of gait (FoG) were also determined. Forward and backward walking and 360° turning was recorded at preferred speed in defined ‘off’ state. PD showed narrower step length, slower walking speed, and higher asymmetry index (AI) of step length during forward and backward walking. During turning, PD had more turning steps, longer turning time, and shorter step length than control. There was no difference at forward walking according to FoG, but freezer showed narrower step length and decreased range of motion in ankle joints at backward walking. Freezer showed longer step time and higher AI of step length at turning. The severity of FoG was correlated with step length and walking speed during forward and backward walking, total step count, total step time, and walking speed during turning. Comprehensive analysis showed that PD had narrower step length, slower walking speed, and increased asymmetry of step length. These features were the most prominent during turning, followed by backward and forward walking. Impacts of FoG were also the most prominent during turning.

scholarly journals Recurrent Falls in Parkinson’s Disease: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-16 ◽  
Author(s):  
Natalie E. Allen ◽  
Allison K. Schwarzel ◽  
Colleen G. Canning
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Fear Of Falling ◽  
Freezing Of Gait ◽  
Motor Impairment ◽  
Journal Articles ◽  
Factors Associated ◽  
Recurrent Falls ◽  
Wide Range ◽  
Reduced Physical Activity

Most people with Parkinson’s disease (PD) fall and many experience recurrent falls. The aim of this review was to examine the scope of recurrent falls and to identify factors associated with recurrent fallers. A database search for journal articles which reported prospectively collected information concerning recurrent falls in people with PD identified 22 studies. In these studies, 60.5% (range 35 to 90%) of participants reported at least one fall, with 39% (range 18 to 65%) reporting recurrent falls. Recurrent fallers reported an average of 4.7 to 67.6 falls per person per year (overall average 20.8 falls). Factors associated with recurrent falls include: a positive fall history, increased disease severity and duration, increased motor impairment, treatment with dopamine agonists, increased levodopa dosage, cognitive impairment, fear of falling, freezing of gait, impaired mobility and reduced physical activity. The wide range in the frequency of recurrent falls experienced by people with PD suggests that it would be beneficial to classify recurrent fallers into sub-groups based on fall frequency. Given that there are several factors particularly associated with recurrent falls, fall management and prevention strategies specifically targeting recurrent fallers require urgent evaluation in order to inform clinical practice.

scholarly journals The Effect of One Session Split-Belt Treadmill Training on Gait Adaptation in People With Parkinson’s Disease and Freezing of Gait

2020 ◽  
Vol 34 (10) ◽  
pp. 954-963
Author(s):  
Jana Seuthe ◽  
Nicholas D’Cruz ◽  
Pieter Ginis ◽  
Jos Steffen Becktepe ◽  
Burkhard Weisser ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Training Session ◽  
Step Length ◽  
Treadmill Training ◽  
Initial Exposure ◽  
Gait Adaptation ◽  
Gait Asymmetry ◽  
Adaptation Test

Background Freezing of gait (FOG) in Parkinson’s disease (PD) is associated with gait asymmetry and switching difficulty. A split-belt treadmill may potentially address those deficits. Objective To investigate the immediate and retention effects of one-session split-belt treadmill training (SBT) in contrast to regular tied-belt treadmill training (TBT) on gait asymmetry and adaptation in people with PD and FOG (PD + FOG) and healthy controls (HC). Additionally, to investigate differential effects of 3 SBT protocols and compare different gait adaptation outcomes. Methods PD + FOG (n = 45) and HC (n = 36) were randomized to 1 of 3 SBT groups (belt speeds’ ratio 0.75:1; 0.5:1 or changing ratios) or TBT group. Participants were tested at Pre, Post, and Retention after one treadmill training session. Gait asymmetry was measured during a standardized adaptation test on the split-belt treadmill Results SBT proved beneficial for gait adaptation in PD + FOG and HC ( P < .0001); however, HC improved more. SBT with changing ratios demonstrated significant effects on gait adaptation from Pre to Post in PD + FOG, supported by strong effect sizes ( d = 1.14) and improvements being retained for 24 hours. Mean step length asymmetry during initial exposure was lower in HC compared with PD + FOG ( P = .035) and differentiated best between the groups. Conclusions PD + FOG improved gait adaptation after a single SBT session although effects were smaller than in HC. SBT with changing ratios was the most effective to ameliorate gait adaptation in PD + FOG. These promising results warrant future study on whether long-term SBT strengthens adaptation in PD + FOG and has potential to induce a better resilience to FOG. Clinical trial ID: NCT03725215.

scholarly journals Towards Real-Time Prediction of Freezing of Gait in Patients With Parkinson’s Disease: Addressing the Class Imbalance Problem

Sensors ◽  
2019 ◽  
Vol 19 (18) ◽  
pp. 3898 ◽  
Author(s):  
Nader Naghavi ◽  
Aaron Miller ◽  
Eric Wade
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Class Imbalance ◽  
Ensemble Classifier ◽  
Motor Symptom ◽  
Support Vector ◽  
Ensemble Classifiers ◽  
Class Imbalance Problem ◽  
K Nearest Neighbors

Freezing of gait (FoG) is a common motor symptom in patients with Parkinson’s disease (PD). FoG impairs gait initiation and walking and increases fall risk. Intelligent external cueing systems implementing FoG detection algorithms have been developed to help patients recover gait after freezing. However, predicting FoG before its occurrence enables preemptive cueing and may prevent FoG. Such prediction remains challenging given the relative infrequency of freezing compared to non-freezing events. In this study, we investigated the ability of individual and ensemble classifiers to predict FoG. We also studied the effect of the ADAptive SYNthetic (ADASYN) sampling algorithm and classification cost on classifier performance. Eighteen PD patients performed a series of daily walking tasks wearing accelerometers on their ankles, with nine experiencing FoG. The ensemble classifier formed by Support Vector Machines, K-Nearest Neighbors, and Multi-Layer Perceptron using bagging techniques demonstrated highest performance (F1 = 90.7) when synthetic FoG samples were added to the training set and class cost was set as twice that of normal gait. The model identified 97.4% of the events, with 66.7% being predicted. This study demonstrates our algorithm’s potential for accurate prediction of gait events and the provision of preventive cueing in spite of limited event frequency.

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