scholarly journals A Survey of Older Adults’ Perspectives of In-Person and Virtual Parkinson’s-Specific Exercise Classes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 932-932
Author(s):  
Holly Bennett ◽  
Jennifer Vincenzo ◽  
Chris Oholendt
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Online Survey ◽  
Exercise Program ◽  
Computer Usage ◽  
Computer Access ◽  
Specific Exercise ◽  
Virtual Classes ◽  
Exercise Classes

Abstract Due to COVD-19, many health/wellness programs transitioned from in-person to virtual. This mixed methods study aims to explore older adults with Parkinson’s disease (PD) perceptions of in-person versus virtual Parkinson’s-specific exercise classes. Attitudes, perceptions, and experiences were determined through focus groups (n=9; Male=4; aged 75 years) among older adults with PD and an online survey (n=23; Male=14; aged 74 years). Eighteen respondents attended both in-person and virtually (n=18; Male=9). Four respondents only attended in-person, citing reasons such as difficulty with computer access to virtual classes, limited internet, easier accessibility to in-person classes, and physical injury preventing attendance to any classes. Respondents who participated in both delivery methods preferred virtual classes. Time, convenience, comfort at home, and not having to navigate transportation barriers supported participants’ preference for virtual classes. The majority of respondents indicated their fatigue and mental health were either unchanged or improved. Eighty-nine percent reported improved mobility since attending either class; specifically, in balance (n=8), flexibility (n=7), and coordination (n=3). Older adults with PD who attended both classes had minimal difficulty with computer usage and accessing the virtual program with only one participant reporting difficulty transitioning from in-person to virtual classes. Seventy percent stated they would enjoy a combination of on-site and virtual programming. Eighty-nine percent and seventy-seven perfect felt the virtual-based program was safe and beneficial, respectively. Participants who transitioned from an in-person to a virtual exercise program for people with Parkinson’s disease felt the program was safe, effective, and improved or prevented declines in their mobility.

scholarly journals Validation of IMU-based gait event detection during curved walking and turning in older adults and Parkinson’s Disease patients

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Robbin Romijnders ◽  
Elke Warmerdam ◽  
Clint Hansen ◽  
Julius Welzel ◽  
Gerhard Schmidt ◽  
...  
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daily Life ◽  
Neurological Diseases ◽  
Detection Performance ◽  
Measurement Unit ◽  
Straight Line ◽  
Optical Motion ◽  
Task Conditions

Abstract Background Identification of individual gait events is essential for clinical gait analysis, because it can be used for diagnostic purposes or tracking disease progression in neurological diseases such as Parkinson’s disease. Previous research has shown that gait events can be detected from a shank-mounted inertial measurement unit (IMU), however detection performance was often evaluated only from straight-line walking. For use in daily life, the detection performance needs to be evaluated in curved walking and turning as well as in single-task and dual-task conditions. Methods Participants (older adults, people with Parkinson’s disease, or people who had suffered from a stroke) performed three different walking trials: (1) straight-line walking, (2) slalom walking, (3) Stroop-and-walk trial. An optical motion capture system was used a reference system. Markers were attached to the heel and toe regions of the shoe, and participants wore IMUs on the lateral sides of both shanks. The angular velocity of the shank IMUs was used to detect instances of initial foot contact (IC) and final foot contact (FC), which were compared to reference values obtained from the marker trajectories. Results The detection method showed high recall, precision and F1 scores in different populations for both initial contacts and final contacts during straight-line walking (IC: recall $$=$$ = 100%, precision $$=$$ = 100%, F1 score $$=$$ = 100%; FC: recall $$=$$ = 100%, precision $$=$$ = 100%, F1 score $$=$$ = 100%), slalom walking (IC: recall $$=$$ = 100%, precision $$\ge$$ ≥ 99%, F1 score $$=$$ = 100%; FC: recall $$=$$ = 100%, precision $$\ge$$ ≥ 99%, F1 score $$=$$ = 100%), and turning (IC: recall $$\ge$$ ≥ 85%, precision $$\ge$$ ≥ 95%, F1 score $$\ge$$ ≥ 91%; FC: recall $$\ge$$ ≥ 84%, precision $$\ge$$ ≥ 95%, F1 score $$\ge$$ ≥ 89%). Conclusions Shank-mounted IMUs can be used to detect gait events during straight-line walking, slalom walking and turning. However, more false events were observed during turning and more events were missed during turning. For use in daily life we recommend identifying turning before extracting temporal gait parameters from identified gait events.

Evaluation of Motor and Cognitive Performance in People with Parkinson’s Disease Using Instrumented Trail-Making Test

Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Ram kinker Mishra ◽  
Catherine Park ◽  
He Zhou ◽  
Bijan Najafi ◽  
T. Adam Thrasher
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Pairwise Comparison ◽  
Walking Test ◽  
Cognitively Normal ◽  
Early Results ◽  
Trail Making ◽  
Changes Over Time

<b><i>Introduction:</i></b> Parkinson’s disease (PD) progressively impairs motor and cognitive performance. The current tools to detect decline in motor and cognitive functioning are often impractical for busy clinics and home settings. To address the gap, we designed an instrumented trail-making task (iTMT) based on a wearable sensor (worn on the shin) with interactive game-based software installed on a tablet. The iTMT test includes reaching to 5 indexed circles, a combination of numbers (1–3) and letters (A&amp;B) randomly positioned inside target circles, in a sequential order, which virtually appears on a screen kept in front of the participants, by rotating one’s ankle joint while standing and holding a chair for safety. By measuring time to complete iTMT task (iTMT time), iTMT enables quantifying cognitive-motor performance. <b><i>Purpose:</i></b> This study’s objective is to examine the feasibility of iTMT to detect early cognitive-motor decline in PDs. <b><i>Method:</i></b> Three groups of volunteers, including 14 cognitively normal (CN) older adults, 14 PDs, and 11 mild cognitive impaireds (MCI), were recruited. Participants completed MoCA, 20 m walking test, and 3 trials of iTMT. <b><i>Results:</i></b> All participants enabled to complete iTMT with &#x3c;3 min, indicating high feasibility. The average iTMT time for CN-Older, PD, and MCI participants were 20.9 ± 0.9 s, 32.3 ± 2.4 s, and 40.9 ± 4.5 s, respectively. After adjusting for age and education level, pairwise comparison suggested large effect sizes for iTMT between CN-older versus PD (Cohen’s <i>d</i> = 1.7, <i>p</i> = 0.024) and CN-older versus MCI (<i>d</i> = 1.57, <i>p</i> &#x3c; 0.01). Significant correlations were observed when comparing iTMT time with the gait speed (<i>r</i> = −0.4, <i>p</i> = 0.011) and MoCA score (<i>r</i> = −0.56, <i>p</i> &#x3c; 0.01). <b><i>Conclusion:</i></b> This study demonstrated the feasibility and early results supporting the potential application of iTMT to determine cognitive-motor and distinguishing individuals with MCI and PD from CN-older adults. Future studies are warranted to test the ability of iTMT to track its subtle changes over time.

scholarly journals Sleep fragmentation and Parkinson's disease pathology in older adults without Parkinson's disease

2017 ◽  
Vol 32 (12) ◽  
pp. 1729-1737 ◽  
Author(s):  
Shahmir Sohail ◽  
Lei Yu ◽  
Julie A. Schneider ◽  
David A. Bennett ◽  
Aron S. Buchman ◽  
...  
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Fragmentation

scholarly journals Intensive Rehabilitation Enhances Lymphocyte BDNF-TrkB Signaling in Patients With Parkinson’s Disease

2015 ◽  
Vol 30 (5) ◽  
pp. 411-418 ◽  
Author(s):  
Cecilia Fontanesi ◽  
Svetlana Kvint ◽  
Giuseppe Frazzitta ◽  
Rossana Bera ◽  
Davide Ferrazzoli ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Function ◽  
Rating Scale ◽  
Cortical Plasticity ◽  
Day Treatment ◽  
Human Study ◽  
Exercise Program ◽  
Peripheral Lymphocytes ◽  
Intensive Rehabilitation

Background. In a combined animal and human study, we have previously found that a 5-day treatment that enhances cortical plasticity also facilitates brain-derived neurotrophic factor (BDNF)-tyrosine receptor kinase B (TrkB) signaling and increases activated TrkB and N-methyl-d-aspartate receptor (NMDAR) association in both the cortex and the peripheral lymphocytes. Patients with Parkinson’s disease (PD), in general, show decreased cortical plasticity, as demonstrated by electrophysiological and behavioral studies. Here, we test the hypothesis that an exercise program that improves motor function and seems to slow down symptom progression can enhance BDNF-TrkB signaling in lymphocytes. Methods. A total of 16 patients with PD underwent a 4-week multidisciplinary intensive rehabilitation treatment (MIRT), which included aerobic training and physical and occupational therapy. Blood was collected before and after 2 and 4 weeks of MIRT. Lymphocytes were isolated to examine BDNF-TrkB signaling induced by incubation with recombinant human BDNF. TrkB signaling complexes, extracellular-signal-regulated kinase-2 and protein-kinase-B were immunoprecipitated; the content of immunocomplexes was determined by Western blotting. Results. After MIRT, all patients showed improvement in motor function. TrkB interaction with NMDAR and BDNF-TrkB signaling increased in peripheral lymphocytes at receptor, intracellular mediator, and downstream levels. The decrements in Unified Parkinson’s Disease Rating Scale II (UPDRSII) and total scores were significantly correlated with the increases in TrkB signaling at receptor, intracellular mediator, and NMDAR interaction levels. Conclusions. The significant correlation between reduced UPDRS scores and the changes in lymphocyte activity suggest that enhanced BDNF-TrkB signaling in lymphocyte and reduced severity of PD symptoms may be related.

scholarly journals Response to Telemedicine Visits From Patients With Parkinsonism During the COVID-19 Pandemic on Postvisit Surveys

2021 ◽  
Vol 8 ◽  
pp. 237437352199722
Author(s):  
Wissam Deeb ◽  
Christopher W Hess ◽  
Noheli Gamez ◽  
Bhavana Patel ◽  
Kathryn Moore ◽  
...  
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorders ◽  
Tertiary Care ◽  
Specialty Clinic ◽  
Cognitive Limitations ◽  
Time Savings ◽  
Ease Of Access ◽  
Almost All

Parkinson’s disease and parkinsonism are common chronic neurodegenerative disorders that tend to affect older adults and cause physical and sometimes cognitive limitations. Given that these limitations could impact successful telemedicine use, we aimed to investigate the experiences of patients with parkinsonism using telemedicine during the COVID-19 pandemic. A 19-item survey was emailed to patients with parkinsonism following telemedicine visits at a single US tertiary care parkinsonism specialty clinic. Seventy-four individuals responded, out of 270 invitations sent. Almost two-thirds (61.6%) of the respondents were comfortable with using technology in general, and almost all were very satisfied with their telemedicine experience. The most commonly reported benefits included cost and travel savings, ease of access to a specialist, and time savings. Issues with technology and previsit instructions were the most commonly identified challenges (28%). Urgent implementation, due to the pandemic, of telemedicine care for patients with parkinsonism was feasible and well received. The challenges most commonly reported by patients could be potentially alleviated by better education and support.

scholarly journals Rapid Transition to Telehealth Group Exercise and Functional Assessments in Response to COVID-19

2020 ◽  
Vol 6 ◽  
pp. 233372142098031
Author(s):  
Stephen C. Jennings ◽  
Kenneth M. Manning ◽  
Janet Prvu Bettger ◽  
Katherine M. Hall ◽  
Megan Pearson ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Exercise Program ◽  
Performance Testing ◽  
Group Exercise ◽  
Health Maintenance ◽  
Functional Assessments ◽  
Wide Scale ◽  
Rapid Transition ◽  
Exercise Classes

Exercise is critical for health maintenance in late life. The COVID-19 shelter in place and social distancing orders resulted in wide-scale interruptions of exercise therapies, placing older adults at risk for the consequences of decreased mobilization. The purpose of this paper is to describe rapid transition of the Gerofit facility-based group exercise program to telehealth delivery. This Gerofit-to-Home (GTH) program continued with group-based synchronous exercise classes that ranged from 1 to 24 Veterans per class and 1 to 9 classes offered per week in the different locations. Three hundred and eight of 1149 (27%) Veterans active in the Gerofit facility-based programs made the transition to the telehealth delivered classes. Participants’ physical performance testing continued remotely as scheduled with comparisons between most recent facility-based and remote testing suggesting that participants retained physical function. Detailed protocols for remote physical performance testing and sample exercise routines are described. Translation to remote delivery of exercise programs for older adults could mitigate negative health effects.

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