scholarly journals Dual-task walking reduces lower limb range of motion in individuals with Parkinson’s disease and freezing of gait: But does it happen during what events through the gait cycle?

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243133
Author(s):  
Camila Pinto ◽  
Ana Paula Salazar ◽  
Ewald Max Hennig ◽  
Graham Kerr ◽  
Aline Souza Pagnussat
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Range Of Motion ◽  
Dual Task ◽  
Lower Limb ◽  
Gait Cycle ◽  
Freezing Of Gait ◽  
Heel Strike ◽  
Discrete Analysis ◽  
Flexion Extension

Background It is unclear how dual-task gait influences the lower limb range of motion (RoM) in people with Parkinson’s disease (PD) and freezing of gait (FOG). The lower limb kinematics during dual-task gait might differ from regular gait, but during what events in the gait cycle? Methods This is an observational within-subjects study. Thirty-two individuals with PD and FOG underwent a gait analysis. Single and dual-task gait was assessed by a 3D motion analysis system and the RoM data of the lower limb were extracted from hips, knees and ankles in the sagittal plane. Dual-task assignment was performed using word-color interference test. To compare both gait conditions, we used two different analyses: (1) common discrete analysis to provide lower limb RoM and (2) Statistical Parametric Mapping analysis (SPM) to provide lower limb joint kinematics. A correlation between lower limb RoM and spatiotemporal gait parameters was also performed for each gait condition. Results Common discrete analysis evidenced reductions in RoM of hips, knees and ankles during the dual task gait when compared to single gait. SPM analysis showed reductions in flexion-extension of hip, knees and ankles joints when dual task was compared to single task gait. These reductions were observed in specific gait events as toe off (for knees and ankles) and heel strike (for all joints). The reduction in lower limb RoM was positively correlated with the reduction in step length and gait speed. Conclusions Lower limb joints kinematics were reduced during toe off and heel strike in dual task gait when compared to single gait. These findings might help physiotherapists to understand the influence of dual and single walking in lower limb RoM throughout the gait cycle in people with PD and FOG.

The efficacy of cognitive-cycling dual-task training in patients with early-stage Parkinson’s disease: A pilot study

2020 ◽  
Vol 47 (4) ◽  
pp. 415-426
Author(s):  
Hsiu-Chen Chang ◽  
Chiung-Chu Chen ◽  
Yi-Hsin Weng ◽  
Wei-Da Chiou ◽  
Ya-Ju Chang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Dual Task ◽  
Rating Scale ◽  
Early Stage ◽  
Freezing Of Gait ◽  
Timed Up And Go ◽  
Gait Performance ◽  
The Mean

BACKGROUND: Recent studies have suggested that cognitive-motor dual-task (DT) training might improve gait performance, locomotion automaticity, balance, and cognition in patients with Parkinson’s disease (PD). OBJECTIVE: We aimed to investigate the efficacy of cognitive-cycling DT training in patients with early-stage PD. METHODS: Participants were scheduled to perform cognitive tasks simultaneously with the cycling training twice per week for eight weeks for a total of 16 sessions during their on-states. Clinical assessments were conducted using the unified Parkinson’s disease rating scale (UPDRS), modified Hoehn and Yahr stage, Timed Up and Go (TUG) test, gait and cognitive performances under dual-task paradigm, the new freezing of gait questionnaire, Schwab and England Activities of Daily Living scale, 39-item Parkinson’s disease questionnaire, and cognitive performance. RESULTS: Thirteen eligible patients were enrolled in the study. The mean age was 60.64±5.32 years, and the mean disease duration was 7.02±3.23 years. Twelve PD patients completed 16 serial cognitive-cycling sessions for two months. After 16 sessions of training (T2), the UPDRS III scores improved significantly in both the off- and on-states, and TUG were significantly less than those at pretraining (T0). During both the single-task and the DT situations, gait performance and spatial memory cognitive performance significantly improved from T0 to T2. CONCLUSION: The present study demonstrated that cognitive-cycling DT training improves the motor functions, gait and cognitive performances of PD patients.

The impact of turning and dual task on freezing of gait in Parkinson's disease

2018 ◽  
Vol 66 ◽  
pp. S3-S4
Author(s):  
M. Bertoli ◽  
A. Cereatti ◽  
U. Della Croce ◽  
M. Mancini
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Freezing Of Gait ◽  
The Impact

Brain activity during lower limb movements in Parkinson’s disease patients with and without freezing of gait

2020 ◽  
Vol 267 (4) ◽  
pp. 1116-1126 ◽  
Author(s):  
Noemi Piramide ◽  
Federica Agosta ◽  
Elisabetta Sarasso ◽  
Elisa Canu ◽  
Maria Antonietta Volontè ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Lower Limb ◽  
Brain Activity ◽  
Freezing Of Gait ◽  
Limb Movements

scholarly journals Trunk Range of Motion Is Related to Axial Rigidity, Functional Mobility and Quality of Life in Parkinson’s Disease: An Exploratory Study

Sensors ◽  
2020 ◽  
Vol 20 (9) ◽  
pp. 2482
Author(s):  
Roberto Cano-de-la-Cuerda ◽  
Lydia Vela-Desojo ◽  
Marcos Moreno-Verdú ◽  
María del Rosario Ferreira-Sánchez ◽  
Yolanda Macías-Macías ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Range Of Motion ◽  
Exploratory Study ◽  
Functional Mobility ◽  
Trunk Flexion ◽  
Flexion Extension ◽  
Flexion And Extension

Background: People with Parkinson’s disease (PD) present deficits of the active range of motion (ROM), prominently in their trunk. However, if these deficits are associated with axial rigidity, the functional mobility or health related quality of life (HRQoL), remains unknown. The aim of this paper is to study the relationship between axial ROM and axial rigidity, the functional mobility and HRQoL in patients with mild to moderate PD. Methods: An exploratory study was conducted. Non-probabilistic sampling of consecutive cases was used. Active trunk ROM was assessed by a universal goniometer. A Biodex System isokinetic dynamometer was used to measure the rigidity of the trunk. Functional mobility was determined by the Get Up and Go (GUG) test, and HRQoL was assessed with the PDQ-39 and EuroQol-5D questionnaires. Results: Thirty-six mild to moderate patients with PD were evaluated. Significant correlations were observed between trunk extensors rigidity and trunk flexion and extension ROM. Significant correlations were observed between trunk flexion, extension and rotation ROM and GUG. Moreover, significant correlations were observed between trunk ROM for flexion, extension and rotations (both sides) and PDQ-39 total score. However, these correlations were considered poor. Conclusions: Trunk ROM for flexion and extension movements, measured by a universal goniometer, were correlated with axial extensors rigidity, evaluated by a technological device at 30°/s and 45°/s, and functional mobility. Moreover, trunk ROM for trunk flexion, extension and rotations were correlated with HRQoL in patients with mild to moderate PD.

scholarly journals Dual task interference on postural sway, postural transitions and gait in people with Parkinson’s disease and freezing of gait

2017 ◽  
Vol 56 ◽  
pp. 76-81 ◽  
Author(s):  
Ana Claudia de Souza Fortaleza ◽  
Martina Mancini ◽  
Patty Carlson-Kuhta ◽  
Laurie A. King ◽  
John G. Nutt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Postural Sway ◽  
Freezing Of Gait ◽  
Task Interference ◽  
Dual Task Interference

scholarly journals Executive Control of Walking in People With Parkinson’s Disease With Freezing of Gait

2020 ◽  
Vol 34 (12) ◽  
pp. 1138-1149
Author(s):  
Rodrigo Vitorio ◽  
Samuel Stuart ◽  
Martina Mancini
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Executive Control ◽  
Dual Task ◽  
Near Infrared ◽  
Inertial Sensors ◽  
Cognitive Task ◽  
Freezing Of Gait ◽  
Functional Near Infrared Spectroscopy ◽  
Indirect Measures

Background Walking abnormalities in people with Parkinson’s disease (PD) are characterized by a shift in locomotor control from healthy automaticity to compensatory prefrontal executive control. Indirect measures of automaticity of walking (eg, step-to-step variability and dual-task cost) suggest that freezing of gait (FoG) may be associated with reduced automaticity of walking. However, the influence of FoG status on actual prefrontal cortex (PFC) activity during walking remains unclear. Objective To investigate the influence of FoG status on automaticity of walking in people with PD. Methods Forty-seven people with PD were distributed into 2 groups based on FoG status, which was assessed by the New Freezing of Gait Questionnaire: PD−FoG (n = 23; UPDRS-III = 35) and PD+FoG (n = 24; UPDRS-III = 43.1). Participants walked over a 9-m straight path (with a 180° turn at each end) for 80 seconds. Two conditions were tested off medication: single- and dual-task walking (ie, with a concomitant cognitive task). A portable functional near-infrared spectroscopy system recorded PFC activity while walking (including turns). Wearable inertial sensors were used to calculate spatiotemporal gait parameters. Results PD+FoG had greater PFC activation during both single and dual-task walking than PD−FoG ( P = .031). There were no differences in gait between PD−FoG and PD+FoG. Both groups decreased gait speed ( P = .029) and stride length ( P < .001) during dual-task walking compared with single-task walking. Conclusions These findings suggest that PD+FoG have reduced automaticity of walking, even in absence of FoG episodes. PFC activity while walking seems to be more sensitive than gait measures in identifying reduction in automaticity of walking in PD+FoG.

scholarly journals Dealing with the Heterogeneous Presentations of Freezing of Gait: How Reliable are the Freezing Index and Heart Rate for Freezing Detection?

2021 ◽  
Author(s):  
Helena Cockx ◽  
Jorik Nonnekes ◽  
Bastiaan Bloem ◽  
Richard van Wezel ◽  
Ian Cameron ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Heart Rate ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Freezing Of Gait ◽  
Heart Rate Change ◽  
Rate Change ◽  
Motion Sensors ◽  
Normal Gait ◽  
Fog Detection

Abstract Background: Freezing of gait (FOG) is an unpredictable gait arrest that hampers the lives of 40% of people with Parkinson’s disease. Because the symptom is heterogeneous in phenotypical presentation (it can present as trembling, shuffling, or akinesia) and manifests during various circumstances (it can be triggered by e.g. turning, passing doors, and dual-tasking), it is particularly difficult to detect with motion sensors. The freezing index (FI) is one of the most frequently used accelerometer-based methods for FOG detection. However, it might not adequately distinguish FOG from voluntary stops, certainly for the akinetic type of FOG. Interestingly, a previous study showed that heart rate signals could distinguish FOG from stopping and turning movements. This study aimed to investigate for which phenotypes and evoking circumstances the FI and heart rate might provide reliable signals for FOG detection.Methods: Sixteen people with Parkinson’s disease and daily freezing completed a gait trajectory designed to provoke FOG including turns, narrow passages, starting, and stopping, with and without a cognitive or motor dual-task. We compared the FI and heart rate of 406 FOG events to baseline levels, and to stopping and normal gait events (i.e. turns and narrow passages without FOG) using mixed-effects models. We specifically evaluated the influence of different types of FOG (trembling vs akinesia) and triggering situations (turning vs narrow passages; no dual-task vs cognitive dual-task vs motor dual-task) on both outcome measures. Results: The FI increased significantly for trembling FOG, but not for akinetic FOG. Furthermore, the index increased similarly during stopping and was therefore not significantly different from FOG. In contrast, heart rate change during FOG was for all types and during all triggering situations statistically different from stopping, but not from normal gait events. Conclusion: The FI has issues to distinguish FOG from voluntary stopping, especially of the akinetic type. In contrast, the clear distinction in heart rate change between FOG and voluntary stops, which was independent of the heterogeneous presentation of FOG, might provide a solution for this issue. Therefore, we suggest that combining a heart rate monitor with a motion sensor may be promising for future FOG detection.

scholarly journals Does conjunctive tissue massage increase range of motion in muscles with plastic hypertonia due to Parkinson's disease?

2020 ◽  
Vol 14 (01) ◽  
pp. 24-32
Author(s):  
Carolina Menezes Fiorelli ◽  
Amanda Camargo da Silva ◽  
Alexandre Fiorelli ◽  
Tiago Penedo ◽  
Fabiana Araújo-Silva ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Older People ◽  
Range Of Motion ◽  
Group Intervention ◽  
Single Session ◽  
After Effects ◽  
Flexion Extension ◽  
Main Effect ◽  
Cervical Rotation

BACKGROUND:Plastic hypertonia (rigidity), presented by individuals with Parkinson's disease (PD), leads to reduced range of motion (ROM), impairing daily activities and balance reactions. Connective tissue massage (CTM) promotes increased ROM in normotonic muscles, however its effects on hypertonic muscles are not yet known. AIM: To verify the immediate and acute (1h after) effects of CTM on cervical ROM in individuals with PD. METHOD: Cervical ROM during anterior flexion, extension, lateral flexion, and rotation was evaluated using a fleximeter at three moments: before (M1), immediately after (M2), and one hour after (M3) CTM in 14 older people with PD (PDG) and 13 neurologically healthy older people (CG). RESULTS: The CG presented a higher ROM than the PDG for the cervical rotation movement. In addition, there was interaction between group*intervention time. The cervical rotation movement was higher for the CG than PDG at M2 and M3. On the other hand, there was no main effect of intervention time. CONCLUSION: It was concluded that a single session of CTM was not sufficient to promote an increase in ROM in either normotonic or hypertonic muscles in older people, but the higher ROM for cervical rotation in the CG versus PDG was evident after CTM.

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