Laryngeal Aerodynamics in Healthy Older Adults and Adults With Parkinson's Disease

Purpose The present study compared laryngeal aerodynamic function of healthy older adults (HOA) to adults with Parkinson's disease (PD) while speaking at a comfortable and increased vocal intensity. Method Laryngeal aerodynamic measures (subglottal pressure, peak-to-peak flow, minimum flow, and open quotient [OQ]) were compared between HOAs and individuals with PD who had a diagnosis of hypophonia. Increased vocal intensity was elicited via monaurally presented multitalker background noise. Results At a comfortable speaking intensity, HOAs and individuals with PD produced comparable vocal intensity, rates of vocal fold closure, and minimum flow. HOAs used smaller OQs, higher subglottal pressure, and lower peak-to-peak flow than individuals with PD. Both groups increased speaking intensity when speaking in noise to the same degree. However, HOAs produced increased intensity with greater driving pressure, faster vocal fold closure rates, and smaller OQs than individuals with PD. Conclusions Monaural background noise elicited equivalent vocal intensity increases in HOAs and individuals with PD. Although both groups used laryngeal mechanisms as expected to increase sound pressure level, they used these mechanisms to different degrees. The HOAs appeared to have better control of the laryngeal mechanism to make changes to their vocal intensity.

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Can People with Parkinson’s Disease Self-Trigger Gait Initiation? A Comparison of Cueing Strategies

Journal of Parkinson s Disease ◽

10.3233/jpd-212732 ◽

2021 ◽

pp. 1-13

Author(s):

Matthew N. Petrucci ◽

Sommer Amundsen Huffmaster ◽

Jae Woo Chung ◽

Elizabeth T. Hsiao-Wecksler ◽

Colum D. MacKinnon

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Young Adults ◽

Older Adult ◽

Freezing Of Gait ◽

External Source ◽

Anticipatory Postural Adjustments ◽

Gait Initiation ◽

Healthy Older Adults

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.

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

Journal of Biomechanics ◽

10.1016/j.jbiomech.2018.07.038 ◽

2018 ◽

Vol 79 ◽

pp. 112-118 ◽

Cited By ~ 6

Author(s):

Daniel Kuhman ◽

Kelley G. Hammond ◽

Christopher P. Hurt

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Healthy Older Adults

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Finger tapping as a proxy for gait: Similar effects on movement variability during external and self-generated cueing in people with Parkinson's disease and healthy older adults

Annals of Physical and Rehabilitation Medicine ◽

10.1016/j.rehab.2020.05.009 ◽

2020 ◽

Author(s):

Adam P. Horin ◽

Elinor C. Harrison ◽

Kerri S. Rawson ◽

Gammon M. Earhart

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Finger Tapping ◽

Movement Variability ◽

Healthy Older Adults

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Longitudinal Changes in Speech Breathing in Older Adults with and without Parkinson's Disease

Seminars in Speech and Language ◽

10.1055/s-0037-1602839 ◽

2017 ◽

Vol 38 (03) ◽

pp. 200-209 ◽

Cited By ~ 1

Author(s):

Meghan Darling-White ◽

Jessica Huber

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Speech Production ◽

Lung Volume ◽

Vital Capacity ◽

Speech Rate ◽

Work Of Breathing ◽

Speech Breathing ◽

Subglottal Pressure

AbstractThis longitudinal study examines changes to speech production and speech breathing in older adults with Parkinson's disease (PD) and older adults without PD. Eight participants with PD and eight age- and sex-matched older adults participated in two data collection sessions, separated by 3.7 years on average. Speech severity and speech rate increased for people with PD. Vital capacity decreased for both groups. Older adult control participants displayed significant increases in lung volume initiation and excursion and percent vital capacity expended per syllable. These changes allow older adults to utilize higher recoil pressures to generate subglottal pressure for speech production, potentially reducing work of breathing. Participants with PD displayed significant decreases in lung volume initiation and termination. Thus, unlike older adults, people with PD exert more expiratory muscle pressure during speech production, leading to increased effort. Speech-language pathologists need to consider direct treatment of respiratory patterns for speech to reduce effort and fatigue.

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Possible selves and illness: A comparison of individuals with Parkinson's disease, early-stage Alzheimer's disease, and healthy older adults

International Journal of Behavioral Development ◽

10.1080/01650250143000526 ◽

2003 ◽

Vol 27 (1) ◽

pp. 1-11 ◽

Cited By ~ 29

Author(s):

Leslie D. Frazier ◽

Victoria Cotrell ◽

Karen Hooker

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Parkinson’S Disease ◽

Alzheimer's Disease ◽

Parkinson's Disease ◽

Possible Selves ◽

Early Stage ◽

Healthy Older Adults ◽

Patient Groups ◽

The Impact

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.

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Effects of Parkinson’s disease and dopamine on digit span measures of working memory

10.1101/318311 ◽

2018 ◽

Author(s):

John Patrick Grogan ◽

Lisa Emily Knight ◽

Laura Smith ◽

Nerea Irigoras Izagirre ◽

Alexandra Howat ◽

...

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Working Memory ◽

Parkinson's Disease ◽

Digit Span ◽

The Other ◽

Healthy Older Adults ◽

Memory Processes ◽

Dopaminergic Medication ◽

Conflicting Evidence

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.

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Differential neural activation in healthy older adults compared to subjects with Parkinson's disease during motor imagery of walking in virtual environments

2015 International Conference on Virtual Rehabilitation (ICVR) ◽

10.1109/icvr.2015.7358572 ◽

2015 ◽

Author(s):

I Maidan ◽

K Rosenberg-Katz ◽

Y Jacob ◽

N Giladi ◽

J E Deutsch ◽

...

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Virtual Environments ◽

Motor Imagery ◽

Neural Activation ◽

Healthy Older Adults

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Nordic Walking Improves Gait Power Profiles at the Knee Joint in Parkinson’s Disease

Journal of Aging and Physical Activity ◽

10.1123/japa.2017-0031 ◽

2018 ◽

Vol 26 (1) ◽

pp. 84-88 ◽

Cited By ~ 3

Author(s):

Lei Zhou ◽

Marie-Anne Gougeon ◽

Julie Nantel

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Knee Joint ◽

Knee Extensor ◽

Gait Pattern ◽

Nordic Walking ◽

Healthy Older Adults ◽

Functional Gait ◽

The Impact

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.

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