Identifying axial and cognitive correlates in patients with Parkinson’s disease motor subtype using the instrumented Timed Up and Go

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.

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Effects of Onabotulinum Toxin A on Gait in Parkinson’s Disease Patients with Foot Dystonia

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2021.42 ◽

2021 ◽

pp. 1-6

Author(s):

Pei Huang ◽

Yuan-Yuan Li ◽

Jung E. Park ◽

Ping Huang ◽

Qin Xiao ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Botulinum Toxin ◽

Gait Analysis ◽

Rating Scale ◽

Analog Scale ◽

Toxin A ◽

Timed Up And Go ◽

Balance Test ◽

Onabotulinum Toxin A

ABSTRACT: We investigated the effects of botulinum toxin on gait in Parkinson’s disease (PD) patients with foot dystonia. Six patients underwent onabotulinum toxin A injection and were assessed by Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS), visual analog scale (VAS) of pain, Timed Up and Go (TUG), Berg Balance Test (BBT), and 3D gait analysis at baseline, 1 month, and 3 months. BFMDRS (p = 0.002), VAS (p = 0.024), TUG (p = 0.028), and BBT (p = 0.034) were improved. Foot pressures at Toe 1 (p = 0.028) and Midfoot (p = 0.018) were reduced, indicating botulinum toxin’s effects in alleviating the dystonia severity and pain and improving foot pressures during walking in PD.

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Temporal Characteristics of High-Frequency Lower-Limb Oscillation during Freezing of Gait in Parkinson’s Disease

Parkinson s Disease ◽

10.1155/2014/606427 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Don A. Yungher ◽

Tiffany R. Morris ◽

Valentina Dilda ◽

James M. Shine ◽

Sharon L. Naismith ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

High Frequency ◽

Freezing Of Gait ◽

Body Motion ◽

High Frequency Oscillation ◽

Frequency Oscillation ◽

Timed Up And Go ◽

Clinical Onset ◽

Acceleration Data

A cardinal feature of freezing of gait (FOG) is high frequency (3–8 Hz) oscillation of the legs, and this study aimed to quantify the temporal pattern of lower-body motion prior to and during FOG. Acceleration data was obtained from sensors attached to the back, thighs, shanks, and feet in 14 Parkinson’s disease patients performing timed-up-and-go tasks, and clinical assessment of FOG was performed by two experienced raters from video. A total of 23 isolated FOG events, defined as occurring at least 5 s after gait initiation and with no preceding FOG, were identified from the clinical ratings. The corresponding accelerometer records were analyzed within a 4 s window centered at the clinical onset of freezing. FOG-related high-frequency oscillation (an increase in power in the 3–8 Hz band >3 SD from baseline) followed a distal to proximal onset pattern, appearing at the feet, shanks, thighs, and then back over a period of 250 ms. Peak power tended to decrease as the focus of oscillation moved from feet to back. There was a consistent delay (mean 872 ms) between the onset of high frequency oscillation at the feet and clinical onset of FOG. We infer that FOG is characterized by high frequency oscillation at the feet, which progresses proximally and is mechanically damped at the torso.

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Timed Up and Go evaluation with wearable devices: Validation in Parkinson's disease

Journal of Bodywork and Movement Therapies ◽

10.1016/j.jbmt.2017.07.006 ◽

2018 ◽

Vol 22 (2) ◽

pp. 390-395 ◽

Cited By ~ 11

Author(s):

Ana Francisca Rozin Kleiner ◽

Ilaria Pacifici ◽

Alessandro Vagnini ◽

Filippo Camerota ◽

Claudia Celletti ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Wearable Devices ◽

Timed Up And Go

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RISING FROM THE FLOOR IN PERSONS WITH PARKINSON’S DISEASE

Innovation in Aging ◽

10.1093/geroni/igz038.1768 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S474-S475

Author(s):

Dennis W Klima ◽

Jeremy Stewart ◽

Frank Freijomil ◽

Mary DiBartolo

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Physical Performance ◽

Performance Measure ◽

Community Dwelling ◽

Gait Velocity ◽

Performance Tests ◽

Motor Patterns ◽

Timed Up And Go ◽

Cross Sectional

Abstract While considerable research has targeted gait, balance and preventing falls in individuals with Parkinson’s disease (PD), less in known about the ability to rise from the floor in this population. The aims of this study were to 1) Examine the relationship between locomotion and physical performance tests and the timed supine to stand performance measure and to 2) Identify both the time required and predominant motor patterns utilized by persons with PD to complete to floor rise transition. A cross-sectional design was utilized. Twenty community-dwelling older adults with PD (mean age 74.8+/-9.5 years; 13 men) performed a standardized floor rise test and locomotion tests in a structured task circuit. Subject demographic and anthropometric data were also collected. Statistical analyses included descriptive statistics and Pearson Product Moment correlations. Fifteen subjects (75%) demonstrated the crouch kneel pattern and fourteen (70%) used an all-4’s strategy to rise to stand. The mean time to rise from the floor was 14.9 (+/- 7.6) seconds and slower than published norms for persons without PD. Nine subjects required the use of a chair to perform floor recovery. Supine to stand performance time was significantly correlated with the: Dynamic Gait Index (r= - 0.66; p<0.002), Five Times Sit to Stand Test (r=0.78; p<0.001), Timed Up and Go Test (r=0.74; p<0.001), and gait velocity (r= -0.77; p<0.001). Rising from the floor demonstrates concurrent validity with locomotion and physical performance tests. Floor recovery techniques can be incorporated in fall prevention initiatives in conjunction with PD symptom management.

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Automated Stage Discrimination of Parkinson’s Disease

BIO Integration ◽

10.15212/bioi-2020-0006 ◽

2020 ◽

Vol 1 (2) ◽

pp. 55-63

Author(s):

Vered Aharonson ◽

Nabeel Seedat ◽

Simon Israeli-Korn ◽

Sharon Hassin-Baer ◽

Michiel Postema ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Motor Fluctuation ◽

Step Length ◽

Disease Stage ◽

Physical Parameters ◽

Timed Up And Go ◽

Step Velocity ◽

Treatment Plans

Abstract Background: Treatment plans for Parkinson’s disease (PD) are based on a disease stage scale, which is generally determined using a manual, observational procedure. Automated, sensor-based discrimination saves labor and costs in clinical settings and may offer augmented stage determination accuracy. Previous automated devices were either cumbersome or costly and were not suitable for individuals who cannot walk without support.Methods: Since 2017, a device has been available that successfully detects PD and operates for people who cannot walk without support. In the present study, the suitability of this device for automated discrimination of PD stages was tested. The device consists of a walking frame fitted with sensors to simultaneously support walking and monitor patient gait. Sixty-five PD patients in Hoehn and Yahr (HY) stages 1 to 4 and 24 healthy controls were subjected to supported Timed Up and Go (TUG) tests, while using the walking frame. The walking trajectory, velocity, acceleration and force were recorded by the device throughout the tests. These physical parameters were converted into symptomatic spatiotemporal quantities that are conventionally used in PD gait assessment.Results: An analysis of variance (ANOVA) test extended by a confidence interval (CI) analysis indicated statistically significant separability between HY stages for the following spatiotemporal quantities: TUG time (p < 0.001), straight line walking time (p < 0.001), turning time (p < 0.001), and step count (p < 0.001). A negative correlation was obtained for mean step velocity (p < 0.001) and mean step length (p < 0.001). Moreover, correlations were established between these, as well as additional spatiotemporal quantities, and disease duration, L-dihydroxyphenylalanine-(L-DOPA) dose, motor fluctuation, dyskinesia and the mobile part of the Unified Parkinson Disease Rating Scale (UPDRS).Conclusions: We have proven that stage discrimination of PD can be automated, even to patients who cannot support themselves. A similar method might be successfully applied to other gait disorders.

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Functional Performance and Associations between Performance Tests and Neurological Assessment Differ in Men and Women with Parkinson’s Disease

Behavioural Neurology ◽

10.1155/2015/519801 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Kadri Medijainen ◽

Mati Pääsuke ◽

Aet Lukmann ◽

Pille Taba

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Functional Performance ◽

Clinical Stage ◽

Performance Tests ◽

Neurological Assessment ◽

Timed Up And Go ◽

Men And Women ◽

Assessment Tests

Background. Neurological assessment of a patient with Parkinson’s disease (PD) is expected to reflect upon functional performance. As women are known to report more limitations even for same observed functional performance level, present study was designed to examine whether associations between neurological assessments and functional performance differ across genders.Methods. 14 men and 14 women with PD participated. Functional performance was assessed by measuring walking speeds on 10-meter walk test (10MWT) and by performing timed-up-and-go-test (TUG). Neurological assessment included Hoehn and Yahr Scale (HY), Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Schwab and England Activities of Daily Living Scale (S-E), and Mini Mental State Examination (MMSE).Results. In women with PD, Kendall’s tau-b correlation analyses revealed significant correlations between functional performance tests and neurological assessment measures, with the exception in MMSE. No corresponding associations were found for men, although they demonstrated better functional performance, as expected.Conclusion. Men in similar clinical stage of the PD perform better on functional tests than women. Disease severity reflects upon functional performance differently in men and women with PD. Results indicate that when interpreting the assessment results of both functional performance and neurological assessment tests, the gender of the patient should be taken into consideration.

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Assessing mobility at home in people with early Parkinson’s disease using an instrumented Timed Up and Go test

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2010.08.001 ◽

2011 ◽

Vol 17 (4) ◽

pp. 277-280 ◽

Cited By ~ 61

Author(s):

Cris Zampieri ◽

Arash Salarian ◽

Patricia Carlson-Kuhta ◽

John G. Nutt ◽

Fay B. Horak

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Timed Up And Go ◽

Early Parkinson’S Disease ◽

At Home

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Long-Term Multimodal Exercise Program Enhances Mobility of Patients with Parkinson’s Disease

ISRN Rehabilitation ◽

10.5402/2012/491718 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Marcelo Pinto Pereira ◽

Maria Dilailça Trigueiro de Oliveira Ferreira ◽

Maria Joana Duarte Caetano ◽

Rodrigo Vitório ◽

Ellen Lirani-Silva ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Status ◽

Exercise Program ◽

Training Group ◽

Berg Balance Scale ◽

Disease Stage ◽

Control Group ◽

Timed Up And Go

Objective. This study aimed to evaluate the effect of a long-period multimodal exercise program on balance, mobility and clinical status of patients with Parkinson’s disease (PD). Methods. Thirty-three PD patients were assigned into two groups: a training group (TG—n=22; aged 67.23±8.39 years) and a control group (CG—n=9; aged 71.56±8.50 years). The TG patients were enrolled in a 6-month multimodal exercise program. This program was designed to improve physical capacity components and to reduce PD impairments. Balance and mobility were assessed immediately before and after the training protocol using the Berg Balance Scale (BBS), the “Timed up and go” (TUG), and the Posture Locomotion Test (PLM). Also, clinical variables were assessed (disease stage and impairments). Results. The TG showed an improvement in the TUG (P=0.006) while CG were not influenced by the 6-months period. Both groups showed no differences for BBS and PLM and for their disease impairments—assessed through the Unified Parkinson’s disease Scale. Conclusions. Long-term multimodal exercise programs are able to improve mobility of patients with Parkinson’s disease and therefore should be used on clinical day life.

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