scholarly journals A pathophysiological model of gait captures the details of the impairment of pace/rhythm, variability and asymmetry in Parkinsonian patients at distinct stages of the disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marco Godi ◽  
Ilaria Arcolin ◽  
Marica Giardini ◽  
Stefano Corna ◽  
Marco Schieppati

AbstractLocomotion in people with Parkinson’ disease (pwPD) worsens with the progression of disease, affecting independence and quality of life. At present, clinical practice guidelines recommend a basic evaluation of gait, even though the variables (gait speed, cadence, step length) may not be satisfactory for assessing the evolution of locomotion over the course of the disease. Collecting variables into factors of a conceptual model enhances the clinical assessment of disease severity. Our aim is to evaluate if factors highlight gait differences between pwPD and healthy subjects (HS) and do it at earlier stages of disease compared to single variables. Gait characteristics of 298 pwPD and 84 HS able to walk without assistance were assessed using a baropodometric walkway (GAITRite®). According to the structure of a model previously validated in pwPD, eight spatiotemporal variables were grouped in three factors: pace/rhythm, variability and asymmetry. The model, created from the combination of three factor scores, proved to outperform the single variables or the factors in discriminating pwPD from HS. When considering the pwPD split into the different Hoehn and Yahr (H&Y) stages, the spatiotemporal variables, factor scores and the model showed that multiple impairments of gait appear at H&Y stage 2.5, with the greatest difference from HS at stage 4. A contrasting behavior was found for the asymmetry variables and factor, which showed differences from the HS already in the early stages of PD. Our findings support the use of factor scores and of the model with respect to the single variables in gait staging in PD.

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Chayanin Angthong

Category: Gait analysis Introduction/Purpose: The purpose of this study was to report the relationships between validated patient-reported outcome, health-related quality of life, and gait characteristics using a wearable foot inertial-sensor assessment in patients with foot-ankle conditions. In addition, the inter-metrics correlations were analyzed to determine the relationships between each spatiotemporal or gait parameter. Methods: Fifty-three patients with foot-ankle conditions (38 female/15 male, aged 21–75 years) were collected for this study. Clinical assessments, including evaluations with validated patient-reported outcomes using the visual analogue scale foot and ankle (VAS-FA) score, health-related quality of life using the validated Short Form-36 (SF-36)9, and gait characteristics assessment using a wearable foot inertial-sensor device, were performed and recorded in each patient. Results: Negative correlation between physical component summary (PCS) and maximal cadence only showed a significant value at Pearson’s correlation coefficient (r) = –0.308, P = 0.025. Positive correlations (r) were found between mean walking speed and mean cadence (r = 0.776, P < 0.001) and between maximal walking speed and mean step length (r = 0.498, P < 0.001). Negative correlations (r) were found between mean cadence and mean step length (r = –0.491, P < 0.001) and between maximal cadence and mean step length (r = –0.355, P = 0.009). Conclusion: Regarding relationships among several spatiotemporal parameters and patient-reported outcome measures, cadence is the only parameter that was significantly negatively related with PCS in health-related quality of life. Based on inter-metrics relationships, increased cadence might be used to maintain walking speed as a compensatory mechanism in patients with foot- ankle conditions.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mengyu Wang ◽  
Wen Fu ◽  
Lingcui Meng ◽  
Jia Liu ◽  
Lihua Wu ◽  
...  

Abstract Background Ankylosing spondylitis (AS) is a high-incidence disease in young men that interferes with patients’ physical and mental wellbeing and overall quality of life (QoL). It is often accompanied by arthralgia, stiffness, and limited lumbar flexibility. Acupuncture is safe and effective for reducing the symptoms of AS, but the underlying mechanisms by which it does so are not fully understood. Therefore, to objectively assess acupuncture efficacy, which is critical for patients making informed decisions about appropriate treatments, we will use shear-wave elastography (SWE) and superb microvascular imaging (SMI) ultrasound techniques to evaluate elasticity of lumbar paraspinal muscles and blood flow to the sacroiliac joint (SIJ) in AS. Methods We will recruit a total of 60 participants diagnosed with AS and 30 healthy subjects. Participants will be randomly allocated 1:1 to either an acupuncture group or a sham control acupuncture group. Primary-outcome measures will be musculoskeletal ultrasound, Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing Spondylitis Metrology Index (BASMI), and the Visual Analogue Scale (VAS) for pain. Secondary outcome measures will be the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), and Fatigue Scale-14 (FS-14). We will monitor the effect of acupuncture or sham acupuncture on blood flow and SIJ inflammation using SMI, lumbar-muscle stiffness using SWE and the lumbar paraspinal-muscle cross-sectional area (CSA) using a two-dimensional (2D) grayscale imaging. QoL, physical function, and fatigue will be assessed using an evaluation scale or questionnaire developed for this study, with outcomes measured by the ASQoL, BASMI, BASDAI, BASFI, and FS-14. Healthy subjects will not receive acupuncture but undergo only musculoskeletal ultrasound at baseline. Acupuncture and sham control acupuncture interventions will be conducted for 30 min, 2–3 times/week for 12 weeks. Musculoskeletal ultrasound will be conducted at baseline and post-intervention, while other outcomes will be measured at baseline, 6 weeks, and post-intervention. The statistician, outcome assessor, and participants will be blinded to treatment allocation. Discussion The results of this single-blinded, randomized trial with sham controls could help demonstrate the efficacy of acupuncture and clarify whether musculoskeletal ultrasound could be used to evaluate AS. Trial registration ClinicalTrials.gov ChiCTR2000031476. Registered 3 April 2020.


Author(s):  
Carmen Ricós ◽  
Pilar Fernández-Calle ◽  
Elisabet Gonzalez-Lao ◽  
Margarida Simón ◽  
Jorge Díaz-Garzón ◽  
...  

AbstractObjectivesNumerous biological variation (BV) studies have been performed over the years, but the quality of these studies vary. The objectives of this study were to perform a systematic review and critical appraisal of BV studies on glycosylated albumin and to deliver updated BV estimates for glucose and HbA1c, including recently published high-quality studies such as the European Biological Variation study (EuBIVAS).MethodsSystematic literature searches were performed to identify BV studies. Nine publications not included in a previous review were identified; four for glycosylated albumin, three for glucose, and three for HbA1c. Relevant studies were appraised by the Biological Variation Data Critical Appraisal Checklist (BIVAC). Global BV estimates were derived by meta-analysis of BIVAC-compliant studies in healthy subjects with similar study design.ResultsOne study received BIVAC grade A, 2B, and 6C. In most cases, the C-grade was associated with deficiencies in statistical analysis. BV estimates for glycosylated albumin were: CVI=1.4% (1.2–2.1) and CVG=5.7% (4.7–10.6), whereas estimates for HbA1c, CVI=1.2% (0.3–2.5), CVG=5.4% (3.3–7.3), and glucose, CVI=5.0% (4.1–12.0), CVG=8.1% (2.7–10.8) did not differ from previously published global estimates.ConclusionsThe critical appraisal and rating of BV studies according to their methodological quality, followed by a meta-analysis, generate robust, and reliable BV estimates. This study delivers updated and evidence-based BV estimates for glycosylated albumin, glucose and HbA1c.


Author(s):  
Piero Sciavilla ◽  
Francesco Strati ◽  
Monica Di Paola ◽  
Monica Modesto ◽  
Francesco Vitali ◽  
...  

Abstract Studies so far conducted on irritable bowel syndrome (IBS) have been focused mainly on the role of gut bacterial dysbiosis in modulating the intestinal permeability, inflammation, and motility, with consequences on the quality of life. Limited evidences showed a potential involvement of gut fungal communities. Here, the gut bacterial and fungal microbiota of a cohort of IBS patients have been characterized and compared with that of healthy subjects (HS). The IBS microbial community structure differed significantly compared to HS. In particular, we observed an enrichment of bacterial taxa involved in gut inflammation, such as Enterobacteriaceae, Streptococcus, Fusobacteria, Gemella, and Rothia, as well as depletion of health-promoting bacterial genera, such as Roseburia and Faecalibacterium. Gut microbial profiles in IBS patients differed also in accordance with constipation. Sequence analysis of the gut mycobiota showed enrichment of Saccharomycetes in IBS. Culturomics analysis of fungal isolates from feces showed enrichment of Candida spp. displaying from IBS a clonal expansion and a distinct genotypic profiles and different phenotypical features when compared to HS of Candida albicans isolates. Alongside the well-characterized gut bacterial dysbiosis in IBS, this study shed light on a yet poorly explored fungal component of the intestinal ecosystem, the gut mycobiota. Our results showed a differential fungal community in IBS compared to HS, suggesting potential for new insights on the involvement of the gut mycobiota in IBS. Key points • Comparison of gut microbiota and mycobiota between IBS and healthy subjects • Investigation of cultivable fungi in IBS and healthy subjects • Candida albicans isolates result more virulent in IBS subjects compared to healthy subjects


2021 ◽  
pp. 154596832110175
Author(s):  
Elizabeth L. Dvorak ◽  
Davetrina S. Gadson ◽  
Elizabeth H. Lacey ◽  
Andrew T. DeMarco ◽  
Peter E. Turkeltaub

Background Health-related quality of life (HRQL) in stroke survivors is related to numerous factors, but more research is needed to delineate factors related to HRQL in people with aphasia. Objective To examine the relationship between HRQL and demographic factors, impairment-based measures, and lesion characteristics in chronic aphasia. Methods A total of 41 left-hemisphere stroke survivors with aphasia underwent cognitive testing and magnetic resonance imaging. To address relationships with demographic and impairment-based measures, test scores were entered into a principal component analysis (PCA) and multiple linear regression was performed for overall and domain (physical, communication, psychosocial) scores of the Stroke and Aphasia Quality of Life Scale (SAQOL-39g). Independent variables included factor scores from the PCA, motricity, lesion volume, depressed mood, and demographic variables. To address relationships with lesion location, multivariate support vector regression lesion-symptom mapping (SVR-LSM) was used to localize lesions associated with SAQOL-39g scores. Results The PCA yielded 3 factors, which were labeled Language Production, Nonlinguistic Cognition, and Language Comprehension. Multiple linear regression revealed that depression symptoms predicted lower SAQOL-39g average and domain scores. Lower motricity scores predicted lower SAQOL-39g average and physical scores, and lower Language Production factor scores predicted lower communication scores. SVR-LSM demonstrated that basal ganglia lesions were associated with lower physical scores, and inferior frontal lesions were associated with lower psychosocial scores. Conclusions HRQL in chronic left-hemisphere stroke survivors with aphasia relates to lesion location, depression symptoms, and impairment-based measures. This information may help identify individuals at risk for specific aspects of low HRQL and facilitate targeted interventions to improve well-being.


Author(s):  
Waleska Reyes-Ferrada ◽  
Luis Chirosa-Rios ◽  
Angela Rodriguez-Perea ◽  
Daniel Jerez-Mayorga ◽  
Ignacio Chirosa-Rios

Background: The purpose of this systematic review was to: (I) determine the quality of evidence from studies assessing trunk isokinetic strength in subjects with acute low back pain (ALBP) compared to healthy subjects and (II) establish reference values of isokinetic trunk strength in subjects with ALBP. Methodology: Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statements were followed using keywords associated with trunk, strength and low back pain. Four databases were used: PubMed, Web of Science, Scopus and SPORTDiscus. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Results: A total of 1604 articles were retrieved, four included in this review. All were evaluated as high risk of bias (Rob). Due to the high Rob and the diversity of protocols, instruments and variables used, it was not possible to determine reference values for subjects with ALBP, we can only establish a range of flexion peak torque (PT) between 175.1 and 89.7 Nm at 60°/s and between 185 and 81.5 Nm at 120°/s, and for extension PT between 240.0 and 91.5 Nm at 60°/s and between 217.5 and 69.2 Nm at 120°/s in subjects with ALBP. Conclusions: Due to the low quality of the evidence and the diversity of protocols used when measuring trunk isokinetic strength, it is necessary to carry out new high-quality research to establish reference values of trunk strength in subjects with ALBP.


2013 ◽  
Vol 28 (4) ◽  
pp. 348-356 ◽  
Author(s):  
Wings TY Loo ◽  
Michael CW Yip ◽  
Louis WC Chow ◽  
Qing Liu ◽  
Elizabeth LY Ng ◽  
...  

Background Short-term memory (STM) decline in breast cancer patients resulting from chemotherapy was evaluated by means of blood biomarkers, a questionnaire, and a computerized STM test. Methods This study was conducted from January 2013 to June 2013, recruiting 90 subjects: 30 breast cancer patients beginning the 3rd of 4th cycles of docetaxel and cyclophosphamide chemotherapy, 30 recovered patients (who completed 4 cycles of docetaxel for a minimum of 6 months), and 30 healthy subjects (disease-free females). The levels of hemoglobin, red and white blood cells, and cortisol in serum, and a computerized STM test were analyzed to estimate the effects of chemotherapy on STM. A questionnaire was given to all subjects to assess quality of life. Results Statistically significant differences were observed for the blood parameters (hemoglobin, red and white blood cells, and cortisol levels) between healthy and on-treatment subjects (respectively 13.47±0.96 g/dL vs 5.37±0.38 g/dL, 4.58±0.41 1012/L vs 2.07±0.13 1012/L, and 6.15±1.03 109/L vs 0.86±0.41 109/L). Scores of the STM test were significantly lower for patients compared to healthy subjects. As indicated by the results of the questionnaire, breast cancer patients had a higher tendency to forget than healthy controls (X2=3.15; p<0.0001) and recovered subjects (X2=3.15; p<0.0001). Conclusion We found depleted levels of hemoglobin, red and white blood cells as a result of chemotherapy, and elevated levels of stress correlated with poor performances in the computerized STM test. A higher cortisol level might be an important precursor of STM deterioration. Monitoring cortisol would be beneficial for evaluating the quality of life of breast cancer patients on chemotherapy.


Author(s):  
Barbora Kolářová ◽  
Jim Richards ◽  
Hana Ondráčková ◽  
Klára Lippertová ◽  
Louise Connell ◽  
...  

2006 ◽  
Vol 134 (9-10) ◽  
pp. 369-374 ◽  
Author(s):  
Zana Stankovic ◽  
Gordana Nikolic-Balkoski ◽  
Ljubica Leposavic ◽  
Ljiljana Popovic

Introduction: Depression is the most commonly present psychiatric entity in clinical practice, accompanied by significant impairment of both social and professional functioning. In addition, depression frequently develops as complication of other psychiatric disorders and various somatic diseases. Objective: To investigate subjective perception of quality of life and social adjustment, severity of depressive symptoms as well as level of correlation of severity of depressive symptoms and quality of life and social adjustment of patients with recurrent depression in comparison to the group of patients with diabetes and healthy subjects. Method: The study included 45 subjects of both sexes, ranging from 18 to 60 years of age, divided in three groups of 15 subjects each. The experimental group comprised the patients diagnosed with recurrent depression in remission (DSM-IV), one control group was consisted of patients diagnosed with Type 2 Diabetes mellitus and another one comprised healthy subjects. The instruments of assessment were: The Beck Depression Inventory- BDI, The Social Adaptation Self -evaluation scale - SASS, The Psychological General Well-Being Scale - WBQ. Results: Significant difference of both BDI and WBQ scales was found between the experimental and the control group of healthy subjects (ANOVA, Mann Whitney; p?0.01), as well as between two control groups (p?0.02). The level of inverse correlation of mean score values of BDI and SASS scales was significant in the control group of patients with diabetes while such levels of BDI and WBQ scales (Spearman correlation coefficient, p<0.01) were found in all groups of our study. Conclusion: In the group of patients with recurrent depression, significant decline of quality of life and significantly higher severity of depressive symptoms were present in comparison to the group of healthy subjects as well as significant level of inverse correlation of severity of depressive symptoms and quality of life.


2019 ◽  
Author(s):  
Jie Liu ◽  
Ruiling Wei ◽  
Dewei Wu ◽  
Hulin Chen ◽  
Juan Dong ◽  
...  

Abstract Abstract Background To evaluate the anorectal motility characteristics, the quality of life and psychological health of accident-related neurogenic fecal incontinence(ArNFI) patients. Methods A retrospective study was conducted on 26 patients with ArNFI visiting the gastrointestinal motility center of affiliated provincial hospital of Anhui medical university were collected as research objects from January 2016 to August 2019. The anorectal motility characteristics of these patients were recorded and analysed by high resolution manometry (HRM), 10 healthy subjects for the same period were recruited as the control group. The psychological characteristics of these patients and healthy subjects were compared by HAMA and HAMD scores,and their quality of life was investigated by SF36. Results Anal sphincter resting pressure in the ArNFI group was more lowwer than that of the control group (21.18± 4.68vs34.83± 14.13, P<0.05). Anorectal compliance in the ArNFI group was more lowwer than that of the control (1.41± 0.32vs4.03± 1.06, P<0.05). Maximal squeeze pressure were in the ArNFI group was also lowwer than that of the control(53.66±14.59 vs 143.95±19.82, P<0.05).HAMA ,HAMD scores of the ArNFI group in the ArNFI group were all higher than that of the control ( 21.29±2.06 vs 7.63±1.41 ;22.00±3.70 vs 8.75±1.91, respectively.all P<0.01). There were significant differences between SF36 scores of ArNFI group and the control group in the 8 dimensions of PF,RP,GH,VT,SF,RE and MH.(P<0.01) . Conclusion In patients with ArNFI,there were significantly reduced anorectal motility characteristics, increased HAMA.HAMD scores,and their life quality was obviously declined.


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