scholarly journals Evaluating the Contributions of Dynamic Flow to Freezing of Gait in Parkinson's Disease

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Chad A. Lebold ◽  
Q. J. Almeida
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Optic Flow ◽  
Visual Cues ◽  
Freezing Of Gait ◽  
Underlying Mechanism ◽  
Step Length ◽  
Double Support ◽  
Double Support Time ◽  
Conscious Control

Although visual cues can improve gait in Parkinson's disease (PD), their underlying mechanism is poorly understood. Previous research suggests that cues contribute optical flow that is essential to elicit gait improvement. The present study manipulated how optic flow was provided, and how this might influence freezing of gait (FOG) in PD. Therefore, three groups; 15 PD FOG, 16 PD non-FOG, and 16 healthy controls were tested in 3 narrow doorway conditions; baseline (Narrow), ground lines (Ground), and laser (Laser). Step length indicated that the PD FOG group was only able to improve with ground lines, while the laser increased gait variability and double support time. These results suggest that optic flow in itself is not enough to elicit gait improvement in PD. When PD patients use visual cues, gait becomes less automatically controlled and hence preplanned conscious control may be an important factor contributing to gait improvement.

scholarly journals A Manipulation of Visual Feedback during Gait Training in Parkinson's Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Quincy J. Almeida ◽  
Haseel Bhatt
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Optic Flow ◽  
Visual Cues ◽  
Step Length ◽  
Gait Training ◽  
Control Group ◽  
Training Interventions ◽  
Visual Cueing ◽  
Walking Velocity

Visual cues are known to improve gait in Parkinson's disease (PD); however, the contribution of optic flow continues to be disputed. This study manipulated transverse line cues during two gait training interventions (6 weeks). PD subjects (N=42) were assigned to one of three groups: treadmill (TG), overground (OG), or control group (CG). Participants walked across lines placed on either treadmills or 16-meter carpets, respectively. The treadmill (TG) offered a reduced dynamic flow from the environment, while lines presented on the ground (OG) emphasized optic flow related to the participant's own displacement. Both interventions significantly improved (and maintained through retention period) step length, thus improving walking velocity. Only the OG improved in the TUG test, while only the TG showed hints of improving (and maintaining) motor symptoms. Since gait improvements were found in both training groups, we conclude that by reducing optic flow, gait benefits associated with visual cueing training can still be achieved.

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 Kinematic and Kinetic Patterns Related to Free-Walking in Parkinson’s Disease

Sensors ◽  
2018 ◽  
Vol 18 (12) ◽  
pp. 4224 ◽  
Author(s):  
Martín Martínez ◽  
Federico Villagra ◽  
Juan Castellote ◽  
María Pastor
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Feature Selection ◽  
Clinical Status ◽  
Automatic Classification ◽  
Healthy Controls ◽  
Double Support ◽  
Gait Asymmetry ◽  
Double Support Time ◽  
Support Time

The aim of this study is to compare the properties of free-walking at a natural pace between mild Parkinson’s disease (PD) patients during the ON-clinical status and two control groups. In-shoe pressure-sensitive insoles were used to quantify the temporal and force characteristics of a 5-min free-walking in 11 PD patients, in 16 young healthy controls, and in 12 age-matched healthy controls. Inferential statistics analyses were performed on the kinematic and kinetic parameters to compare groups’ performances, whereas feature selection analyses and automatic classification were used to identify the signature of parkinsonian gait and to assess the performance of group classification, respectively. Compared to healthy subjects, the PD patients’ gait pattern presented significant differences in kinematic parameters associated with bilateral coordination but not in kinetics. Specifically, patients showed an increased variability in double support time, greater gait asymmetry and phase deviation, and also poorer phase coordination. Feature selection analyses based on the ReliefF algorithm on the differential parameters in PD patients revealed an effect of the clinical status, especially true in double support time variability and gait asymmetry. Automatic classification of PD patients, young and senior subjects confirmed that kinematic predictors produced a slightly better classification performance than kinetic predictors. Overall, classification accuracy of groups with a linear discriminant model which included the whole set of features (i.e., demographics and parameters extracted from the sensors) was 64.1%.

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 The Effects of Augmented Reality Visual Cues on Turning in Place in Parkinson's Disease Patients With Freezing of Gait

2020 ◽  
Vol 11 ◽  
Author(s):  
Sabine Janssen ◽  
Jaap de Ruyter van Steveninck ◽  
Hizirwan S. Salim ◽  
Helena M. Cockx ◽  
Bastiaan R. Bloem ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Augmented Reality ◽  
Visual Cues ◽  
Freezing Of Gait

Gait in Parkinson's disease treated with levodopa/carbidopa: determinants of double support time

1990 ◽  
Vol 183 (2) ◽  
pp. 529-530 ◽  
Author(s):  
S.G. Bowes ◽  
P.K. Clark ◽  
A.L. Leeman ◽  
C.J.A. O'Neill ◽  
C. Weller ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Double Support ◽  
Double Support Time ◽  
Support Time

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.

223 ARE WHEELED WALKERS WITH VISUAL CUES EFFICACIOUS TO TREAT FREEZING OF GAIT IN PARKINSON'S DISEASE?

2010 ◽  
Vol 16 ◽  
pp. S64 ◽  
Author(s):  
H. Cianci ◽  
K. Robinson ◽  
L. Bunting-Perry ◽  
J. Sollenberger ◽  
J. Nooregian ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Visual Cues ◽  
Freezing Of Gait
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