scholarly journals Effectiveness of non-pharmacological falls prevention interventions for people with Multiple Sclerosis, Parkinson’s Disease and stroke: protocol for an umbrella review

2020 ◽  
Vol 3 ◽  
pp. 17
Author(s):  
Nicola O'Malley ◽  
Amanda M. Clifford ◽  
Laura Comber ◽  
Susan Coote
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Systematic Reviews ◽  
Evaluation Framework ◽  
Falls Prevention ◽  
Umbrella Review ◽  
Effective Interventions ◽  
Prevention Interventions

Background: Falls are common among people with neurological diseases and have many negative physical, psychosocial and economic consequences. Implementation of single-diagnosis falls prevention interventions is currently problematic due to lack of participants and resources. Given the similarities in falls risk factors across stroke, Parkinson’s Disease (PD) and Multiple Sclerosis (MS), the development of an intervention designed for mixed neurological populations seems plausible and may provide a pragmatic solution to current implementation challenges. This umbrella review aims to summarise the totality of evidence regarding the effectiveness of non-pharmacological falls prevention interventions for people with MS, PD and stroke and identify the commonalities and differences between effective interventions for each disease to inform the development of an evidence-based intervention that can be tailored for people with mixed diagnoses. Methods: This umbrella review will be conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. 15 electronic databases and grey literature will be searched. Systematic reviews of randomised controlled trials and studies investigating the effects of non-pharmacological falls prevention interventions on falls outcomes among people with MS, PD and stroke will be included. Methodological quality of included reviews will be assessed using the Assessment of Multiple Systematic Reviews 2 tool. The Grading of Recommendations Assessments, Development and Evaluation framework will be used to rate the quality of evidence. A summary of evidence table and narrative synthesis will be utilised to clearly indicate the findings. Discussion: This umbrella review presents a novel and timely approach to synthesise existing falls literature to identify effective non-pharmacological interventions for people with MS, PD and stroke. Of importance, a robust methodology will be used to explore the differences and similarities in effective interventions for individuals with these neurological conditions to facilitate the development of an intervention for these mixed neurological groups.

scholarly journals Effectiveness of non-pharmacological falls prevention interventions for people with Multiple Sclerosis, Parkinson’s Disease and stroke: protocol for an umbrella review

2020 ◽  
Vol 3 ◽  
pp. 17
Author(s):  
Nicola O'Malley ◽  
Amanda M. Clifford ◽  
Laura Comber ◽  
Susan Coote
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Systematic Reviews ◽  
Neurological Diseases ◽  
Evaluation Framework ◽  
Falls Prevention ◽  
Umbrella Review ◽  
Prevention Interventions

Background: Falls are common among people with neurological diseases and are associated with many negative physical, psychosocial and economic consequences. Implementation of single diagnosis falls prevention interventions is currently problematic due to lack of participants and resources. Given the similarities in falls risk factors across stroke, Parkinson’s Disease (PD) and Multiple Sclerosis (MS), the development of an intervention designed for mixed neurological populations seems plausible and may provide a solution to current implementation challenges. This umbrella review aims to summarise the totality of evidence regarding the effectiveness of non-pharmacological falls prevention interventions for people with MS, PD and stroke and to identify the commonalities and differences between interventions that are effective for each disease to inform the development of an intervention for mixed diagnoses. Methods: This umbrella review will be conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Electronic databases and grey literature will be searched. Systematic reviews of randomised controlled trials (RCTS) and studies investigating the effects of non-pharmacological falls prevention interventions on falls outcomes among people with MS, PD and stroke will be included. Methodological quality of included reviews will be assessed using the Assessment of Multiple Systematic Reviews 2 tool. The Grading of Recommendations Assessments, Development and Evaluation framework will be used to rate the quality of evidence. A summary of evidence table and narrative synthesis will be utilised to clearly indicate the findings. Discussion: This umbrella review presents a novel and timely approach to synthesise existing falls literature to identify effective non-pharmacological interventions for people with MS, PD and stroke. Of importance, this umbrella review will use a robust methodology to explore the key differences and similarities in effective interventions for individuals with these neurological diseases to facilitate the development of an intervention for mixed neurological groups.

scholarly journals Effectiveness of interventions to prevent falls for people with multiple sclerosis, Parkinson’s disease and stroke: an umbrella review

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicola O’Malley ◽  
Amanda M. Clifford ◽  
Mairéad Conneely ◽  
Bláthín Casey ◽  
Susan Coote
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Systematic Reviews ◽  
Methodological Quality ◽  
Falls Prevention ◽  
Umbrella Review ◽  
Falls Risk ◽  
Prevention Interventions ◽  
Evidence Table

Abstract Background The implementation of condition-specific falls prevention interventions is proving challenging due to lack of critical mass and resources. Given the similarities in falls risk factors across stroke, Parkinson’s Disease (PD) and Multiple Sclerosis (MS), the development of an intervention designed for groups comprising of people with these three neurological conditions may provide a pragmatic solution to these challenges. The aims of this umbrella review were to investigate the effectiveness of falls prevention interventions in MS, PD and stroke, and to identify the commonalities and differences between effective interventions for each condition to inform the development of an intervention for mixed neurological groups. Methods A systematic literature search was conducted using 15 electronic databases, grey literature searches and hand-screening of reference lists. Systematic reviews of studies investigating the effects of falls prevention interventions in MS, PD and stroke were included. Methodological quality of reviews was assessed using the A MeaSurement Tool to Assess Systematic Reviews 2. A matrix of evidence table was used to assess the degree of overlap. The Grading of Recommendations Assessments, Development and Evaluation framework was used to rate the quality of evidence. Findings were presented through narrative synthesis and a summary of evidence table. Results Eighteen reviews were included; three investigating effectiveness of falls prevention interventions in MS, 11 in PD, three in stroke, and one in both PD and stroke. Exercise-based interventions were the most commonly investigated for all three conditions, but differences were identified in the content and delivery of these interventions. Low to moderate quality evidence was found for the effectiveness of exercise-based interventions at reducing falls in PD. Best available evidence suggests that exercise is effective at reducing falls in stroke but no evidence of effect was identified in MS. Conclusions The findings suggest that exercise-based interventions are effective at reducing falls in PD, however, the evidence for MS and stroke is less conclusive. A strong theoretical rationale remains for the use of exercise-based interventions to address modifiable physiological falls risk factors for people with MS, PD and stroke, supporting the feasibility of a mixed-diagnosis intervention. Given the high overlap and low methodological quality of primary studies, the focus should be on the development of high-quality trials investigating the effectiveness of falls prevention interventions, rather than the publication of further systematic reviews.

scholarly journals Protocol for the development of a core outcome set for evaluating mixed-diagnosis falls prevention interventions for people with Multiple Sclerosis, Parkinson’s Disease and stroke

2021 ◽  
Vol 4 ◽  
pp. 123
Author(s):  
Nicola O'Malley ◽  
Susan Coote ◽  
Amanda M Clifford
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Core Outcome Set ◽  
Delphi Survey ◽  
Falls Prevention ◽  
Core Outcome ◽  
Policy Makers ◽  
Outcome Set ◽  
Prevention Interventions

Background: Given the high incidence of falls and their associated negative effects, the development of effective falls prevention interventions for people with Multiple Sclerosis (MS), Parkinson's Disease (PD) and stroke is a priority. Currently the implementation of condition-specific falls prevention interventions is challenging in the community due to lack of participants and resources. Given the similarities in falls risk factors across stroke, PD and MS, the design of mixed-diagnosis interventions for groups comprising of people with these three neurological conditions may solve these implementation challenges. Having a core outcome set (COS) for evaluating these interventions would enable the comparison and combination of data, thereby facilitating progress in this research area. Therefore, the aim of this research study is to develop a COS for evaluating mixed-diagnosis falls prevention interventions for people with MS, PD and stroke. Methods: This will be a mixed-methods, international, multi-perspective Delphi consensus study with five stages. Stage one will involve the identification of potential outcomes through a systematic literature search, patient focus groups, and consultation with our Public and Patient Involvement (PPI) panel. The second stage will be the development of the Delphi survey using the outcomes elicited from stage one. Stage three will be the prioritisation of outcomes using a two-round online Delphi survey involving patients, clinicians, researchers and policy-makers/service-planners. The fourth stage will be to identify and recommend outcome measures and definitions. The final stage will be a consensus meeting with representatives from each stakeholder group to agree upon the final COS. Discussion: Adoption of this COS in future trials investigating the effectiveness of mixed-diagnosis falls prevention interventions for people with MS, PD and stroke will facilitate the comparison and combination of research findings. This should translate into improved decision-making by service-planners/policy-makers and clinicians regarding the implementation of evidence-based falls prevention interventions into practice.

scholarly journals DeepFoG: An IMU-Based Detection of Freezing of Gait Episodes in Parkinson’s Disease Patients via Deep Learning

2021 ◽  
Vol 8 ◽  
Author(s):  
Thomas Bikias ◽  
Dimitrios Iakovakis ◽  
Stelios Hadjidimitriou ◽  
Vasileios Charisis ◽  
Leontios J. Hadjileontiadis
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Learning ◽  
Life Stress ◽  
Freezing Of Gait ◽  
Measurement Unit ◽  
Effective Interventions ◽  
Risk Of Falls

Freezing of Gait (FoG) is a movement disorder that mostly appears in the late stages of Parkinson’s Disease (PD). It causes incapability of walking, despite the PD patient’s intention, resulting in loss of coordination that increases the risk of falls and injuries and severely affects the PD patient’s quality of life. Stress, emotional stimulus, and multitasking have been encountered to be associated with the appearance of FoG episodes, while the patient’s functionality and self-confidence are constantly deteriorating. This study suggests a non-invasive method for detecting FoG episodes, by analyzing inertial measurement unit (IMU) data. Specifically, accelerometer and gyroscope data from 11 PD subjects, as captured from a single wrist-worn IMU sensor during continuous walking, are processed via Deep Learning for window-based detection of the FoG events. The proposed approach, namely DeepFoG, was evaluated in a Leave-One-Subject-Out (LOSO) cross-validation (CV) and 10-fold CV fashion schemes against its ability to correctly estimate the existence or not of a FoG episode at each data window. Experimental results have shown that DeepFoG performs satisfactorily, as it achieves 83%/88% and 86%/90% sensitivity/specificity, for LOSO CV and 10-fold CV schemes, respectively. The promising performance of the proposed DeepFoG reveals the potentiality of single-arm IMU-based real-time FoG detection that could guide effective interventions via stimuli, such as rhythmic auditory stimulation (RAS) and hand vibration. In this way, DeepFoG may scaffold the elimination of risk of falls in PD patients, sustaining their quality of life in everyday living activities.

scholarly journals Quantity and quality of gait and turning in people with multiple sclerosis, Parkinson’s disease and matched controls during daily living

2020 ◽  
Vol 267 (4) ◽  
pp. 1188-1196 ◽  
Author(s):  
Vrutangkumar V. Shah ◽  
James McNames ◽  
Martina Mancini ◽  
Patricia Carlson-Kuhta ◽  
Rebecca I. Spain ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daily Living

scholarly journals Falls Prevention and Quality of Life Improvement by Square Stepping Exercise in People with Parkinson’s Disease: Project Report

2021 ◽  
Vol 11 (5) ◽  
pp. 361
Author(s):  
Asunción Mayoral-Moreno ◽  
Carlos Alexis Chimpén-López ◽  
Laura Rodríguez-Santos ◽  
María Isabel Ramos-Fuentes ◽  
Francisco José Vaz-Leal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Balance Training ◽  
Falls Prevention ◽  
Annual Number ◽  
Control Group ◽  
Stepping Exercise

Parkinson’s disease (PD) is a chronic neurodegenerative disorder that affects physical, psychological, and social quality of life. Square Stepping Exercise (SSE) is an effective balance training program to prevent falls and to stimulate cognitive function in the elderly; however, no study has analyzed the effect of SSE in people with PD. The main objective is to investigate whether the application of SSE is safe, applicable, and can improve balance, and is effective in preventing falls, improving cognitive and psychological aspects and thus maximize quality of life in people with PD. Methods/Design: SSE will be performed three times per week for 8 weeks with an additional month follow-up after the intervention. Sixty people with PD will participate, randomly distributed into two groups: experimental group (SSE: n = 30) and control group (Usual care: n = 30). The primary measurements will be: (1) Applicability, (2) Safety, (3) Balance, and (4) Annual number of falls. Secondary measurements will be: (1) Sociodemographic information, (2) Physical condition, (3) Health-related quality of life, (4) Depressive symptoms, (5) Cognitive aspects, (6) Perceived functional social support, and (7) Anticipatory cognition.

Type D, anxiety and depression in association with quality of life in patients with Parkinson’s disease and patients with multiple sclerosis

2012 ◽  
Vol 22 (6) ◽  
pp. 1353-1360 ◽  
Author(s):  
Tatiana Dubayova ◽  
Martina Krokavcova ◽  
Iveta Nagyova ◽  
Jaroslav Rosenberger ◽  
Zuzana Gdovinova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Anxiety And Depression ◽  
Type D

Critical issues of the biopsychosocial treatment of Parkinson’s disease

2015 ◽  
Vol 156 (12) ◽  
pp. 472-478 ◽  
Author(s):  
Péter Kincses ◽  
Norbert Kovács ◽  
Kázmér Karádi ◽  
János Kállai
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychological Health ◽  
Interdisciplinary Approach ◽  
Cognitive Status ◽  
Psychological Burden ◽  
Her Family ◽  
Critical Issues

This paper is a summary report on the basic questions of the biopsychosocial approach to Parkinson’s disease. It deals with cognitive, affective and psychological health issues which significantly influence the outcome of the physical rehabilitation. In spite of the unchanged cognitive status, the psychological burden of the changes in the quality of life, the obstruction, the change in the affective tone, and the shrinking ability to fulfil social roles decrease the patient’s quality of life. An interdisciplinary approach is best suited for mitigating these effects. Not only the patient but also his/her family and environment is seriously affected by the disease and its consequences. Treatment and rehabilitation options for increasing or maintaining the quality of life of the affected patients are diverse, and significantly depend on the features of the health care system. The authors believe that the following review emphasizing health psychological principles may contribute to the work of professionals working in clinical and rehabilitational fields and through them may increase the quality of life of patients and their family. Orv. Hetil., 2015, 156(12), 472–478.

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