scholarly journals Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jia-Hung Chen ◽  
Tsai-Wei Huang ◽  
Chien-Tai Hong
Keyword(s):  
Parkinson Disease ◽  
Gait Speed ◽  
Cholinesterase Inhibitors ◽  
Meta Analysis ◽  
Gait Disturbance ◽  
Beneficial Effects ◽  
Gait Parameters ◽  
Evidence Based Treatments ◽  
Chei Treatment ◽  
Undesirable Consequence

AbstractGait disturbance and imbalance are the major symptoms of Parkinson disease (PD), with fall being the most undesirable consequence. However, few effective evidence-based treatments are available for alleviating these symptoms and preventing falls. Cholinesterase inhibitors (ChEIs) are a well-established treatment for PD dementia with possible impacts on gait, balance, and fall reduction. The present study involved a meta-analysis of randomized controlled trials (RCTs) to investigate the effects of ChEIs on gait, balance, and fall in patients with PD. We searched for studies using the PubMed, Embase, and Web of Science databases. The major outcomes were effects on gait parameters, balance, and fall. This study was registered with PROSPERO (CRD42021254733). Five RCTs were included in the present meta-analysis. ChEIs did not significantly increase gait speed in PD patients (mean difference [MD]: 0.03 m/s, 95% confidence interval [CI]: −0.02 to 0.07, p = 0.29). However, ChEI treatment significantly decreased step or stride variability during the single task (standard MD: −0.43, 95% CI = −0.79 to −0.06, p = 0.02). Regarding fall and balance, trending but nonsignificant beneficial effects were observed with ChEI treatment. In conclusion, although ChEI treatment did not significantly improve gait speed and reduce fall, it can significantly reduce step or stride variability. Considering that gait disorder is a challenging issue in patients with PD and that ChEIs are generally tolerable, the present meta-analysis may provide more evidence for the benefit of ChEIs on PD gait disturbance as an alternative treatment consideration.

scholarly journals Gait parameters of individuals with Parkinson disease decline during one-year period

2020 ◽  
Vol 25 ◽  
pp. 7-18
Author(s):  
Kadri Medijainen ◽  
Mati Pääsuke ◽  
Aet Lukmann ◽  
Pille Taba
Keyword(s):  
Parkinson Disease ◽  
Gait Speed ◽  
Stride Length ◽  
Rating Scale ◽  
Double Support ◽  
Healthy Elderly ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Gait Function ◽  
One Year

Parkinson’s disease (PD) is a neurodegenerative disease, influencing mainly elderly. The key motor factor affecting the level of participation in activities of daily living is the gait function, which is known to be progressively impaired in PD. However, gait characteristics also worsen due to normal aging. The main aim of this study was to investigate whether gait parameters decline in individuals with PD in an interval of one year compared to healthy elderly. Selected gait characteristics were recorded using 3-D optoelectronic movement analysis system ELITE in 13 patients with mild-to-moderate PD and 13 age- and gender-matched controls. Hoehn and Yahr Scale and Unified Parkinson Disease Rating Scale were used for clinical assessment. It was found that PD patients walk with significantly shorter steps and stride and reduced gait speed. In one year, the stride length initiated with right foot and stride walk ratio further decrease in PD patients. On re-evaluation the percentages of stance, swing and double support phase differed significantly between groups. In second measurement, control subjects walked with reduced step width. It was concluded that gait speed and stride length decline in patients with PD in a period of one year, whereas no indication of deterioration of gait function is evident in healthy controls.

The Influence of a Cognitive Dual Task on the Gait Parameters of Healthy Older Adults: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 25 (4) ◽  
pp. 671-686 ◽  
Author(s):  
Erin Smith ◽  
Tara Cusack ◽  
Caitriona Cunningham ◽  
Catherine Blake
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Dual Task ◽  
Gait Speed ◽  
Meta Analysis ◽  
Data Sets ◽  
Dual Task Condition ◽  
Healthy Older Adults ◽  
Gait Parameters ◽  
Task Assessment

This review examines the effect of a dual task on the gait parameters of older adults with a mean gait speed of 1.0 m/s or greater, and the effect of type and complexity of task. A systematic review of Web of Science, PubMed, SCOPUS, Embase, and PsycINFO was performed in July 2016. Twenty-three studies (28 data sets) were reviewed and pooled for meta-analysis. The effect size on seven gait parameters was measured as the raw mean difference between single- and dual-task performance. Gait speed significantly reduced with the addition of a dual task, with increasing complexity showing greater decrements. Cadence, stride time, and measures of gait variability were all negatively affected under the dual-task condition. In older adults, the addition of a dual task significantly reduces gait speed and cadence, with possible implications for the assessment of older people, as the addition of a dual task may expose deficits not observed under single-task assessment.

Digital Biomarkers of Cognitive Frailty: The Value of Detailed Gait Assessment Beyond Gait Speed

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
He Zhou ◽  
Catherine Park ◽  
Mohammad Shahbazi ◽  
Michele K. York ◽  
Mark E. Kunik ◽  
...  
Keyword(s):  
Older Adults ◽  
Steady State ◽  
Dual Task ◽  
Gait Speed ◽  
Stride Length ◽  
Cognitive Frailty ◽  
Single Task ◽  
Double Support ◽  
Gait Parameters ◽  
Digital Biomarkers

<b><i>Background:</i></b> Cognitive frailty (CF), defined as the simultaneous presence of cognitive impairment and physical frailty, is a clinical symptom in early-stage dementia with promise in assessing the risk of dementia. The purpose of this study was to use wearables to determine the most sensitive digital gait biomarkers to identify CF. <b><i>Methods:</i></b> Of 121 older adults (age = 78.9 ± 8.2 years, body mass index = 26.6 ± 5.5 kg/m<sup>2</sup>) who were evaluated with a comprehensive neurological exam and the Fried frailty criteria, 41 participants (34%) were identified with CF and 80 participants (66%) were identified without CF. Gait performance of participants was assessed under single task (walking without cognitive distraction) and dual task (walking while counting backward from a random number) using a validated wearable platform. Participants walked at habitual speed over a distance of 10 m. A validated algorithm was used to determine steady-state walking. Gait parameters of interest include steady-state gait speed, stride length, gait cycle time, double support, and gait unsteadiness. In addition, speed and stride length were normalized by height. <b><i>Results:</i></b> Our results suggest that compared to the group without CF, the CF group had deteriorated gait performances in both single-task and dual-task walking (Cohen’s effect size <i>d</i> = 0.42–0.97, <i>p</i> &#x3c; 0.050). The largest effect size was observed in normalized dual-task gait speed (<i>d</i> = 0.97, <i>p</i> &#x3c; 0.001). The use of dual-task gait speed improved the area under the curve (AUC) to distinguish CF cases to 0.76 from 0.73 observed for the single-task gait speed. Adding both single-task and dual-task gait speeds did not noticeably change AUC. However, when additional gait parameters such as gait unsteadiness, stride length, and double support were included in the model, AUC was improved to 0.87. <b><i>Conclusions:</i></b> This study suggests that gait performances measured by wearable sensors are potential digital biomarkers of CF among older adults. Dual-task gait and other detailed gait metrics provide value for identifying CF above gait speed alone. Future studies need to examine the potential benefits of gait performances for early diagnosis of CF and/or tracking its severity over time.

The Effect of Water-Based Therapy Compared to Land-Based Therapy on Balance and Gait Parameters of Patients with Stroke: A Systematic Review

2021 ◽  
pp. 1-9
Author(s):  
Nour Zughbor ◽  
Aisha Alwahshi ◽  
Rahaf Abdelrahman ◽  
Zeina Elnekiti ◽  
Hoda Elkareish ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Berg Balance Scale ◽  
Primary Outcome Measure ◽  
Balance System ◽  
Effect Of Water ◽  
Gait Parameters ◽  
Water Based ◽  
Biodex Balance System ◽  
Therapy Studies ◽  
The Brain

<b><i>Introduction:</i></b> Stroke is defined as the lack of blood supply to the brain, leading to rapid loss of brain function presenting with impairments such as muscle weakness, spasticity, lack of coordination, and proprioception loss. Both hydrotherapy and land-based therapy aim to target these aspects in the process of rehabilitation. The study aims to determine the effectiveness of water-based therapy on balance and gait of patients with stroke compared to land-based therapy. <b><i>Methods:</i></b> Data for this review were extracted from databases such as CINAHL, OTseeker, Ovid, PEDro, and PubMed (MEDLINE) and other sources such as Google Scholar. PRISMA guidelines were followed to exclude irrelevant studies. Only randomized controlled trials (RCTs) were included, and methodological quality was assessed using the PEDro scale. A meta-analysis of extracted data was conducted. <b><i>Results:</i></b> A total of 16 relevant RCTs were included for the review (<i>n</i> = 412 participants). All RCTs investigated the effect of water-based therapy compared to land-based therapy on balance and gait of patients with stroke. Meta-analysis of studies that used the Berg Balance Scale (BBS) as a primary outcome measure favored land-based therapy. Studies that used the Good Balance System (GBS) and the Biodex Balance System (BioBS) to measure the changes in anteroposterior sway and mediolateral sway favored water-based therapy. The overall pooled effect favored land-based therapy in improving gait parameters. <b><i>Conclusion:</i></b> Findings from meta-analysis support the effectiveness of land-based therapy in the improvement of balance and gait parameters of patients with stroke. However, the evidence for water-based therapy continues to be limited, and higher quality studies are required to determine the effectiveness of water-based therapy on patients with stroke, particularly on balance and gait.

scholarly journals Effects of n-3 Polyunsaturated Fatty Acid Supplementation in the Prevention and Treatment of Depressive Disorders—A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1070
Author(s):  
Maike Wolters ◽  
Annkathrin von der Haar ◽  
Ann-Kristin Baalmann ◽  
Maike Wellbrock ◽  
Thomas L. Heise ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Treatment Duration ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Pufa Supplementation ◽  
Depressive Symptomology ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Significant Difference

N-3 polyunsaturated fatty acids (PUFAs) have been suggested to affect depressive disorders. This review aims to determine the effect of n-3 PUFAs on depressive symptoms in people with or without diagnosed depression. Medline, PsycINFO, and Cochrane CENTRAL databases were searched for randomized controlled trials (RCTs) assessing the association between n-3 PUFAs and depressive symptoms or disorders as outcomes. A random-effects meta-analysis of standardized mean difference (SMD) with 95% confidence intervals (CI) was performed. Twenty-five studies (7682 participants) were included. Our meta-analysis (20 studies) indicated that n-3 PUFA supplementation lowered depressive symptomology as compared with placebo: SMD = −0.34, 95% CI: −0.55, −0.12, I2 = 86%, n = 5836, but a possible publication bias cannot be ruled out. Subgroup analyses indicated no statistically significant difference by treatment duration of <12 vs. ≥12 weeks, presence of comorbidity, or severity of depressive symptoms. Nevertheless, beneficial effects were seen in the subgroups of studies with longer treatment duration and with no depression and mild to moderate depression. Subgroup analysis by eicosapentaenoic acid (EPA) dosage revealed differences in favor of the lower EPA dosage. Sensitivity analysis including studies with low risk of bias seems to confirm the overall result. Supplementation of n-3 PUFA appears to have a modest beneficial effect on depressive symptomology, although the quality of evidence is still insufficient.

Correlation of paretic knee extension strength with gait speed after stroke: A meta-analysis

2021 ◽  
pp. 1-5
Author(s):  
Richard W. Bohannon
Keyword(s):  
Gait Speed ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Knee Extension ◽  
Bibliographic Databases ◽  
Knee Extension Strength ◽  
Extension Force ◽  
Correlational Data ◽  
Using Data ◽  
The Relationship

BACKGROUND AND OBJECTIVE: Numerous studies have addressed the relationship between paretic knee extension strength and comfortable walking speed after stroke. However, the correlations reported are highly variable. This review sought to summarize the correlational data using meta-analysis. METHODS: Relevant literature was identified via a search of 3 bibliographic databases. Articles were screened and perused for inclusion. Included articles were examined for information on the sample studied, procedures for measuring strength and gait speed, and correlations reported between the 2 variables. Meta-analysis was used to calculate a summary correlation. RESULTS: Of 299 unique articles, 18 met inclusion criteria. Articles were diverse in regard to samples studied, procedures described, and correlations reported. Meta-analysis using data from all included studies revealed a summary correlation of 0.51. For studies using hand-held or isokinetic dynamometry, the summary correlation was 0.46 and 0.59 respectively. CONCLUSIONS: This study provides a better indication of the correlation between paretic knee extension strength and comfortable gait speed than individual studies. The correlation is high enough to provide support for the routine measurement of paretic knee extension force for individuals who have experienced a stroke.

scholarly journals Birth weight and adult earnings: a systematic review and meta-analysis

2021 ◽  
pp. 1-8
Author(s):  
Mark J. Lambiris ◽  
Mia M. Blakstad ◽  
Nandita Perumal ◽  
Goodarz Danaei ◽  
Lilia Bliznashka ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Income ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Economic Outcomes ◽  
Childhood Development ◽  
Low Income Countries ◽  
Standard Deviation Increase ◽  
Beneficial Effects ◽  
Adult Earnings

Abstract While substantial evidence has identified low birth weight (LBW; <2500 g) as a risk factor for early life morbidity, mortality and poor childhood development, relatively little is known on the links between birth weight and economic outcomes in adulthood. The objective of this study was to systematically review the economics (EconLit) and biomedical literature (Medline) and estimate the pooled association between birth weight and adult earnings. A total of 15 studies from mostly high-income countries were included. On average, each standard deviation increase in birth weight was associated with a 2.75% increase in annual earnings [(95% CI: 1.44 to 4.07); 9 estimates]. A negative, but not statistically significant, association was found between being born LBW and earnings, compared to individuals not born LBW [mean difference: −3.41% (95% CI: −7.55 to 0.73); 7 estimates]. No studies from low-income countries were identified and all studies were observational. Overall, birth weight was consistently associated with adult earnings, and therefore, interventions that improve birth weight may provide beneficial effects on adult economic outcomes.

Sign in / Sign up

Export Citation Format

Share Document