Altered joint kinetic strategies of healthy older adults and individuals with Parkinson’s disease to walk at faster speeds

2018 ◽  
Vol 79 ◽  
pp. 112-118 ◽  
Author(s):  
Daniel Kuhman ◽  
Kelley G. Hammond ◽  
Christopher P. Hurt
2021 ◽  
pp. 1-13
Author(s):  
Matthew N. Petrucci ◽  
Sommer Amundsen Huffmaster ◽  
Jae Woo Chung ◽  
Elizabeth T. Hsiao-Wecksler ◽  
Colum D. MacKinnon

Background: An external cue can markedly improve gait initiation in people with Parkinson’s disease (PD) and is often used to overcome freezing of gait (FOG). It is unknown if the effects of external cueing are comparable if the imperative stimulus is triggered by the person receiving the cue (self-triggered) or an external source. Objective: Two experiments were conducted to compare the effects of self- versus externally triggered cueing on anticipatory postural adjustments (APAs) during gait initiation in people with PD. Methods: In experiment 1, 10 individuals with PD and FOG initiated gait without a cue or in response to a stimulus triggered by the experimenter or by the participant. Experiment 2 compared self- versus externally triggered cueing across three groups: healthy young adults (n = 16), healthy older adults (n = 11), and a group with PD (n = 10). Results: Experiment 1: Externally triggered cues significantly increased APA magnitudes compared to uncued stepping, but not when the same cue was self-triggered. Experiment 2: APAs were not significantly improved with a self-triggered cue compared to un-cued stepping in both the PD and healthy older adult groups, but the young adults showed a significant facilitation of APA magnitude. Conclusion: The effectiveness of an external cue on gait initiation in people with PD and older adults is critically dependent upon whether the source of the trigger is endogenous (self-produced) or exogenous (externally generated). These results may explain why cueing interventions that rely upon self-triggering of the stimulus are often ineffective in people with PD.


2003 ◽  
Vol 27 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Leslie D. Frazier ◽  
Victoria Cotrell ◽  
Karen Hooker

This study examined how future self-representations are affected by two different chronic illnesses, one focused on cognitive losses, early-stage Alzheimer's disease (AD), and one focused on physical losses, Parkinson's disease (PD). The impact of illness on possible selves (perceptions of self in the future) was made salient by a comparison with healthy older adults in order to better understand developmental issues in later life. Findings show that although there were no differences in the total number of domains reported by the groups, specific domains were reported differently by patient groups and all domains were likely to become infused with illness. As expected, patient groups had less self-efficacy and lower outcome expectancies for their future selves, and PD patients reported less distance from their feared selves. Although these findings are intuitive, this is the first empirical effort to document the impact of illness on older adults' self-representations. Group differences are explained in terms of disease context, and the importance of possible selves and self-regulatory functions as therapeutic mechanisms for adaptation to illness are emphasised.


2018 ◽  
Author(s):  
John Patrick Grogan ◽  
Lisa Emily Knight ◽  
Laura Smith ◽  
Nerea Irigoras Izagirre ◽  
Alexandra Howat ◽  
...  

ABSTRACTRationaleParkinson’s disease (PD) impairs working memory (WM) - the ability to maintain items in memory for short periods of time and manipulate them. There is conflicting evidence on the nature of the deficits caused by the disease, and the potential beneficial and detrimental effects of dopaminergic medication on different WM processes.ObjectivesWe hypothesised that PD impairs both maintenance and manipulation of items in WM and dopaminergic medications improve this in PD patients but impair it in healthy older adults.MethodsWe tested 68 PD patients ON and OFF their dopaminergic medication, 83 healthy age-matched controls, and 30 healthy older adults after placebo and levodopa administration. We used the digit span, a WM test with three components (forwards, backwards and sequence recall) that differ in the amount of manipulation required. We analysed the maximum spans and the percentage of lists correctly recalled, which probe capacity of WM and the accuracy of the memory processes within this capacity, respectively.ResultsPD patients had lower WM capacity across all three digit span components, but only showed reduced percentage accuracy on the components requiring manipulation (backwards and sequence spans). Dopaminergic medication did not affect performance in PD patients. In healthy older adults, levodopa did not affect capacity, but did impair accuracy on one of the manipulation components (sequence), without affecting the other (backwards).ConclusionsThis suggests a non-dopaminergic deficit of maintenance capacity and manipulation accuracy in PD patients, and a potential “overdosing” of intact manipulation mechanisms in healthy older adults by levodopa.


2018 ◽  
Vol 26 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Lei Zhou ◽  
Marie-Anne Gougeon ◽  
Julie Nantel

We investigated the impact of Nordic walking (NW) on gait patterns in individuals with Parkinson’s disease (PD) following a 6-week NW familiarization. Twelve participants with PD and 12 healthy older adults took part in a gait analysis walking with and without poles (NP). Results showed larger knee power (knee extensor: K2) on the most affected leg in NW compared to NP (P = .01). On the less affected side, larger power absorption (knee extensor: K3) was found during preswing (K3) compared to older adults in both NP and NW (P = 0.01). NW showed longer stride length and single support time (P < .01) compared to NP. Walking with poles improved gait spatial–temporal characteristics and power profiles at the knee joint both on the less and most affected sides in individuals with PD. NW could be beneficial to help regain a more functional gait pattern in PD.


2016 ◽  
Vol 34 (2-3) ◽  
pp. 113-123 ◽  
Author(s):  
Chad Swank ◽  
Elaine Trudelle-Jackson ◽  
Ann Medley ◽  
Mary Thompson ◽  
Allen Jackson

2012 ◽  
Vol 260 (2) ◽  
pp. 580-589 ◽  
Author(s):  
Lucia Bartmann Wild ◽  
Daiane Borba Lima ◽  
Joana Bisol Balardin ◽  
Luana Rizzi ◽  
Bruno Lima Giacobbo ◽  
...  

2015 ◽  
Vol 21 (3) ◽  
pp. 244-249
Author(s):  
Ellen Lirani-Silva ◽  
Rodrigo Vitório ◽  
Fabio Augusto Barbieri ◽  
André Macari Baptista ◽  
Paulo Cezar Rocha dos Santos ◽  
...  

AbstractPlantar cutaneous stimulation has been shown to improve gait in Parkinson's disease (PD), but the effects of different types of insoles have not been tested. We evaluated the immediate effect of different types of insoles on gait in PD patients and healthy older adults. Nineteen PD patients and nineteen healthy older adults performed and performed a walking task at their self-selected speed in three conditions: conventional insole, insole with a raised ridge around the foot perimeter, and insole with half-spheres. Plantar sensation was evaluated before and after the walking protocol. There were no differences between groups for plantar sensation before and after the walking task. PD patients demonstrated reduced stride length and stride velocity. There were no immediate benefits offered by the insoles on gait of either group. The increased plantar cutaneous stimulation does not promote immediate benefits on gait in PD patients and healthy older adults.


2017 ◽  
Vol 123 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Alexandra E. Brandimore ◽  
Karen W. Hegland ◽  
Michael S. Okun ◽  
Paul W. Davenport ◽  
Michelle S. Troche

Cough is an airway-protective mechanism that serves to detect and forcefully eject aspirate material. Existing research has identified the ability of healthy young adults to suppress or modify cough motor output based on external cueing. However, no study has evaluated the ability of people with Parkinson’s disease (PD) and healthy older adults (HOAs) to upregulate cough motor output. The goal of this study was to evaluate the ability of people with PD and healthy age-matched controls (HOAs) to upregulate reflex and voluntary cough function volitionally with verbal instruction and visual biofeedback of airflow targets. Sixteen participants with PD and twenty-eight HOAs (56–83 yr old) were recruited for this study. Experimental procedures used spirometry to evaluate 1) baseline reflex cough (evoked with capsaicin) and voluntary sequential cough and 2) reflex and voluntary cough with upregulation biofeedback. Cough airflow was recorded and repeated-measures ANOVA was used to analyze differences in cough airflow parameters. Cough peak expiratory airflow rate and cough expired volume were significantly greater in the cueing condition for both induced reflex ( P < 0.001) and voluntary cough ( P < 0.001) compared with baseline measures. This is the first study to demonstrate the ability of people with PD and HOAs to upregulate induced reflex and voluntary cough motor output volitionally. These results support the development of studies targeting improved cough effectiveness in patients with airway-protective deficits. NEW & NOTEWORTHY Aspiration pneumonia is a leading cause of death in Parkinson’s disease (PD) and results from concurrent dysphagia and dystussia (cough dysfunction). This is the first study to demonstrate that people with PD and healthy age-matched controls can volitionally upregulate induced reflex and voluntary cough effectiveness when presented with novel cueing strategies. Thus targeting upregulation of cough effectiveness via biofeedback may be a viable way to enhance airway protection in people with PD.


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