scholarly journals Overload From Anxiety: A Non-Motor Cause for Gait Impairments in Parkinson’s Disease

2018 ◽  
Vol 30 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Kaylena A. Ehgoetz Martens ◽  
Carolina R.A. Silveira ◽  
Brittany N. Intzandt ◽  
Quincy J. Almeida
Physiology ◽  
2016 ◽  
Vol 31 (2) ◽  
pp. 95-107 ◽  
Author(s):  
D. S. Peterson ◽  
F. B. Horak

People with Parkinson's disease exhibit debilitating gait impairments, including gait slowness, increased step variability, and poor postural control. A widespread supraspinal locomotor network including the cortex, cerebellum, basal ganglia, and brain stem contributes to the control of human locomotion, and altered activity of these structures underlies gait dysfunction due to Parkinson's disease.


2020 ◽  
Vol 100 (4) ◽  
pp. 3253-3276
Author(s):  
P. A. Pérez-Toro ◽  
J. C. Vásquez-Correa ◽  
T. Arias-Vergara ◽  
E. Nöth ◽  
J. R. Orozco-Arroyave

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Meir Plotnik ◽  
Nir Giladi ◽  
Jeffrey M. Hausdorff

Several gait impairments have been associated with freezing of gait (FOG) in patients with Parkinson's disease (PD). These include deteriorations in rhythm control, gait symmetry, bilateral coordination of gait, dynamic postural control and step scaling. We suggest that these seemingly independent gait features may have mutual interactions which, during certain circumstances, jointly drive the predisposed locomotion system into a FOG episode. This new theoretical framework is illustrated by the evaluation of the potential relationships between the so-called “sequence effect”, that is, impairments in step scaling, and gait asymmetry just prior to FOG. We further discuss what factors influence gait control to maintain functional gait. “Triggers”, for example, such as attention shifts or trajectory transitions, may precede FOG. We propose distinct categories of interventions and describe examples of existing work that support this idea: (a) interventions which aim to maintain a good level of locomotion control especially with respect to aspects related to FOG; (b) those that aim at avoiding FOG “triggers”; and (c) those that merely aim to escape from FOG once it occurs. The proposed theoretical framework sets the stage for testable hypotheses regarding the mechanisms that lead to FOG and may also lead to new treatment ideas.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zhuang Wu ◽  
Xu Jiang ◽  
Min Zhong ◽  
Bo Shen ◽  
Jun Zhu ◽  
...  

Background and Purpose. Patients with early-stage Parkinson’s disease (PD) have gait impairments, and gait parameters may act as diagnostic biomarkers. We aimed to (1) comprehensively quantify gait impairments in early-stage PD and (2) evaluate the diagnostic value of gait parameters for early-stage PD. Methods. 32 patients with early-stage PD and 30 healthy control subjects (HC) were enrolled. All participants completed the instrumented stand and walk test, and gait data was collected using wearable sensors. Results. We observed increased variability of stride length (SL) ( P < 0.001 ), stance phase time (StPT) ( P = 0.004 ), and swing phase time (SwPT) ( P = 0.011 ) in PD. There were decreased heel strike (HS) ( P = 0.001 ), range of motion of knee ( P = 0.036 ), and hip joints ( P < 0.001 ) in PD. In symmetry analysis, no difference was found in any of the assessed gait parameters between HC and PD. Only total steps ( AUC = 0.763 , P < 0.001 ), SL ( AUC = 0.701 , P = 0.007 ), SL variability ( AUC = 0.769 , P < 0.001 ), StPT variability ( AUC = 0.712 , P = 0.004 ), and SwPT variability ( AUC = 0.688 , P = 0.011 ) had potential diagnostic value. When these five gait parameters were combined, the predictive power was found to increase, with the highest AUC of 0.802 ( P < 0.001 ). Conclusions. Patients with early-stage PD presented increased variability but still symmetrical gait pattern. Some specific gait parameters can be applied to diagnose early-stage PD which may increase diagnosis accuracy. Our findings are helpful to improve patient’s quality of life.


2020 ◽  
Vol 10 (4) ◽  
pp. 1775-1778
Author(s):  
Anouk Tosserams ◽  
Maarten J. Nijkrake ◽  
Ingrid H.W.M. Sturkenboom ◽  
Bastiaan R. Bloem ◽  
Jorik Nonnekes

Compensation strategies are an essential part of managing gait impairments in people with Parkinson’s disease (PD). We conducted an online survey among 320 healthcare professionals with specific expertise in PD management, to evaluate their knowledge of compensation strategies for gait impairments in people with PD, and whether they applied these in daily practice. Only 35% of professionals was aware of all categories of compensation strategies. Importantly, just 23% actually applied all seven available categories of strategies when treating people with PD in clinical practice. We discuss the clinical implications, and provide recommendations to overcome this knowledge gap.


2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Valerie E. Kelly ◽  
Alexis J. Eusterbrock ◽  
Anne Shumway-Cook

Gait impairments in Parkinson's disease (PD) are exacerbated under dual-task conditions requiring the simultaneous performance of cognitive or motor tasks. Dual-task walking deficits impact functional mobility, which often requires walking while performing concurrent tasks such as talking or carrying an object. The consequences of gait impairments in PD are significant and include increased disability, increased fall risk, and reduced quality of life. However, effective therapeutic interventions for dual-task walking deficits are limited. The goals of this narrative review are to describe dual-task walking deficits in people with PD, to discuss motor and cognitive factors that may contribute to these deficits, to review potential mechanisms underlying dual-task deficits, and to discuss the effect of therapeutic interventions on dual-task walking deficits in persons with PD.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246528
Author(s):  
Marco Sica ◽  
Salvatore Tedesco ◽  
Colum Crowe ◽  
Lorna Kenny ◽  
Kevin Moore ◽  
...  

Parkinson’s disease (PD) is a progressive neurological disorder of the central nervous system that deteriorates motor functions, while it is also accompanied by a large diversity of non-motor symptoms such as cognitive impairment and mood changes, hallucinations, and sleep disturbance. Parkinsonism is evaluated during clinical examinations and appropriate medical treatments are directed towards alleviating symptoms. Tri-axial accelerometers, gyroscopes, and magnetometers could be adopted to support clinicians in the decision-making process by objectively quantifying the patient’s condition. In this context, at-home data collections aim to capture motor function during daily living and unobstructedly assess the patients’ status and the disease’s symptoms for prolonged time periods. This review aims to collate existing literature on PD monitoring using inertial sensors while it focuses on papers with at least one free-living data capture unsupervised either directly or via videotapes. Twenty-four papers were selected at the end of the process: fourteen investigated gait impairments, eight of which focused on walking, three on turning, two on falls, and one on physical activity; ten articles on the other hand examined symptoms, including bradykinesia, tremor, dyskinesia, and motor state fluctuations in the on/off phenomenon. In summary, inertial sensors are capable of gathering data over a long period of time and have the potential to facilitate the monitoring of people with Parkinson’s, providing relevant information about their motor status. Concerning gait impairments, kinematic parameters (such as duration of gait cycle, step length, and velocity) were typically used to discern PD from healthy subjects, whereas for symptoms’ assessment, researchers were capable of achieving accuracies of over 90% in a free-living environment. Further investigations should be focused on the development of ad-hoc hardware and software capable of providing real-time feedback to clinicians and patients. In addition, features such as the wearability of the system and user comfort, set-up process, and instructions for use, need to be strongly considered in the development of wearable sensors for PD monitoring.


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