scholarly journals Automated Stage Discrimination of Parkinson’s Disease

2020 ◽  
Vol 1 (2) ◽  
pp. 55-63
Author(s):  
Vered Aharonson ◽  
Nabeel Seedat ◽  
Simon Israeli-Korn ◽  
Sharon Hassin-Baer ◽  
Michiel Postema ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Motor Fluctuation ◽  
Step Length ◽  
Disease Stage ◽  
Physical Parameters ◽  
Timed Up And Go ◽  
Step Velocity ◽  
Treatment Plans

Abstract Background: Treatment plans for Parkinson’s disease (PD) are based on a disease stage scale, which is generally determined using a manual, observational procedure. Automated, sensor-based discrimination saves labor and costs in clinical settings and may offer augmented stage determination accuracy. Previous automated devices were either cumbersome or costly and were not suitable for individuals who cannot walk without support.Methods: Since 2017, a device has been available that successfully detects PD and operates for people who cannot walk without support. In the present study, the suitability of this device for automated discrimination of PD stages was tested. The device consists of a walking frame fitted with sensors to simultaneously support walking and monitor patient gait. Sixty-five PD patients in Hoehn and Yahr (HY) stages 1 to 4 and 24 healthy controls were subjected to supported Timed Up and Go (TUG) tests, while using the walking frame. The walking trajectory, velocity, acceleration and force were recorded by the device throughout the tests. These physical parameters were converted into symptomatic spatiotemporal quantities that are conventionally used in PD gait assessment.Results: An analysis of variance (ANOVA) test extended by a confidence interval (CI) analysis indicated statistically significant separability between HY stages for the following spatiotemporal quantities: TUG time (p < 0.001), straight line walking time (p < 0.001), turning time (p < 0.001), and step count (p < 0.001). A negative correlation was obtained for mean step velocity (p < 0.001) and mean step length (p < 0.001). Moreover, correlations were established between these, as well as additional spatiotemporal quantities, and disease duration, L-dihydroxyphenylalanine-(L-DOPA) dose, motor fluctuation, dyskinesia and the mobile part of the Unified Parkinson Disease Rating Scale (UPDRS).Conclusions: We have proven that stage discrimination of PD can be automated, even to patients who cannot support themselves. A similar method might be successfully applied to other gait disorders.

scholarly journals Camera-based objective measures of Parkinson’s disease gait features

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Jannis van Kersbergen ◽  
Karen Otte ◽  
Nienke M. de Vries ◽  
Bastiaan R. Bloem ◽  
Hanna M. Röhling ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Walking Speed ◽  
Rating Scale ◽  
Step Length ◽  
Microsoft Kinect ◽  
Timed Up And Go ◽  
Significant Group ◽  
Age Related ◽  
Gait Features

Abstract Objective Parkinson’s disease is a common, age-related, neurodegenerative disease, affecting gait and other motor functions. Technological developments in consumer imaging are starting to provide high-quality, affordable tools for home-based diagnosis and monitoring. This pilot study aims to investigate whether a consumer depth camera can capture changes in gait features of Parkinson’s patients. The dataset consisted of 19 patients (tested in both a practically defined OFF phase and ON phase) and 8 controls, who performed the “Timed-Up-and-Go” test multiple times while being recorded with the Microsoft Kinect V2 sensor. Camera-derived features were step length, average walking speed and mediolateral sway. Motor signs were assessed clinically using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale. Results We found significant group differences between patients and controls for step length and average walking speed, showing the ability to detect Parkinson’s features. However, there were no differences between the ON and OFF medication state, so further developments are needed to allow for detection of small intra-individual changes in symptom severity.

Effects of Onabotulinum Toxin A on Gait in Parkinson’s Disease Patients with Foot Dystonia

2021 ◽  
pp. 1-6
Author(s):  
Pei Huang ◽  
Yuan-Yuan Li ◽  
Jung E. Park ◽  
Ping Huang ◽  
Qin Xiao ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Botulinum Toxin ◽  
Gait Analysis ◽  
Rating Scale ◽  
Analog Scale ◽  
Toxin A ◽  
Timed Up And Go ◽  
Balance Test ◽  
Onabotulinum Toxin A

ABSTRACT: We investigated the effects of botulinum toxin on gait in Parkinson’s disease (PD) patients with foot dystonia. Six patients underwent onabotulinum toxin A injection and were assessed by Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS), visual analog scale (VAS) of pain, Timed Up and Go (TUG), Berg Balance Test (BBT), and 3D gait analysis at baseline, 1 month, and 3 months. BFMDRS (p = 0.002), VAS (p = 0.024), TUG (p = 0.028), and BBT (p = 0.034) were improved. Foot pressures at Toe 1 (p = 0.028) and Midfoot (p = 0.018) were reduced, indicating botulinum toxin’s effects in alleviating the dystonia severity and pain and improving foot pressures during walking in PD.

scholarly journals Functional Performance and Associations between Performance Tests and Neurological Assessment Differ in Men and Women with Parkinson’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Kadri Medijainen ◽  
Mati Pääsuke ◽  
Aet Lukmann ◽  
Pille Taba
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Functional Performance ◽  
Clinical Stage ◽  
Performance Tests ◽  
Neurological Assessment ◽  
Timed Up And Go ◽  
Men And Women ◽  
Assessment Tests

Background. Neurological assessment of a patient with Parkinson’s disease (PD) is expected to reflect upon functional performance. As women are known to report more limitations even for same observed functional performance level, present study was designed to examine whether associations between neurological assessments and functional performance differ across genders.Methods. 14 men and 14 women with PD participated. Functional performance was assessed by measuring walking speeds on 10-meter walk test (10MWT) and by performing timed-up-and-go-test (TUG). Neurological assessment included Hoehn and Yahr Scale (HY), Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Schwab and England Activities of Daily Living Scale (S-E), and Mini Mental State Examination (MMSE).Results. In women with PD, Kendall’s tau-b correlation analyses revealed significant correlations between functional performance tests and neurological assessment measures, with the exception in MMSE. No corresponding associations were found for men, although they demonstrated better functional performance, as expected.Conclusion. Men in similar clinical stage of the PD perform better on functional tests than women. Disease severity reflects upon functional performance differently in men and women with PD. Results indicate that when interpreting the assessment results of both functional performance and neurological assessment tests, the gender of the patient should be taken into consideration.

scholarly journals Long-Term Multimodal Exercise Program Enhances Mobility of Patients with Parkinson’s Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Marcelo Pinto Pereira ◽  
Maria Dilailça Trigueiro de Oliveira Ferreira ◽  
Maria Joana Duarte Caetano ◽  
Rodrigo Vitório ◽  
Ellen Lirani-Silva ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Status ◽  
Exercise Program ◽  
Training Group ◽  
Berg Balance Scale ◽  
Disease Stage ◽  
Control Group ◽  
Timed Up And Go

Objective. This study aimed to evaluate the effect of a long-period multimodal exercise program on balance, mobility and clinical status of patients with Parkinson’s disease (PD). Methods. Thirty-three PD patients were assigned into two groups: a training group (TG—n=22; aged 67.23±8.39 years) and a control group (CG—n=9; aged 71.56±8.50 years). The TG patients were enrolled in a 6-month multimodal exercise program. This program was designed to improve physical capacity components and to reduce PD impairments. Balance and mobility were assessed immediately before and after the training protocol using the Berg Balance Scale (BBS), the “Timed up and go” (TUG), and the Posture Locomotion Test (PLM). Also, clinical variables were assessed (disease stage and impairments). Results. The TG showed an improvement in the TUG (P=0.006) while CG were not influenced by the 6-months period. Both groups showed no differences for BBS and PLM and for their disease impairments—assessed through the Unified Parkinson’s disease Scale. Conclusions. Long-term multimodal exercise programs are able to improve mobility of patients with Parkinson’s disease and therefore should be used on clinical day life.

scholarly journals Measurement and correlation of fatigue and sleep quality in Parkinson’s disease: a cross sectional study

2020 ◽  
pp. 1-4
Author(s):  
Wildja de Lima Gomes ◽  
Laize Gabriele Castro Silva ◽  
Neildja Maria da Silva ◽  
Robison Carlos Silva Costa ◽  
Roberta de Oliveira Cacho ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Cross Sectional Study ◽  
Daily Activities ◽  
Motor Symptom ◽  
Disease Stage ◽  
Measuring Instruments ◽  
Cross Sectional ◽  
High Prevalence

Background: Fatigue corresponds to a non-motor symptom of high prevalence in Parkinson’s disease (PD) affecting about one thirdof patients with the disease. This symptom negatively affects daily activities, contributing to the deterioration of the quality of life ofthese subjects. Objectives: To estimate fatigue in PD and to correlate with demographic characteristics, sleep, disease stage, motorfunction and daily activities. Methods: The sample consisted of patients with PD. The following measuring instruments were used for thestudy:Hoehn and Yahr scale, Fatigue Rating Scale, Unified Parkinson’s Disease Rating Scale, Parkinson’s Disease Sleep Scale. Results: Thisstudy highlights the high prevalence of fatigue in subjects with PD, and the screening and treatment of this symptom is extremelyrelevant in clinical practice. There were no significant correlations between fatigue and other variables analyzed. Conclusions: Mostparticipants reported fatigue as a relevant problem, so it is important the use of instruments for fatigue screening in clinical practiceand the need to develop therapies related to this symptom in the PD.

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.

scholarly journals CLOCK 3111T/C Variant Correlates with Motor Fluctuation and Sleep Disorders in Chinese Patients with Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Fan Lou ◽  
Ming Li ◽  
Xiaoguang Luo ◽  
Yan Ren
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Rating Scale ◽  
Clock Genes ◽  
Motor Fluctuation ◽  
Binary Logistic Regression ◽  
Chinese Patients ◽  
Binary Logistic Regression Analysis

Background. The clock genes controlling biological rhythm play an important role in the pathophysiology of aging. The purpose of this study was to determine whether there is an association between a variant of the circadian locomotor output cycles kaput (CLOCK) gene and circadian dysfunction of Parkinson’s disease (PD). Methods. Six hundred and forty-six cases of Parkinson’s disease from consecutive outpatients and inpatients ward from our hospital were included in this study. Kompetitive allele-specific PCR was used to determine the frequency distribution of genotypes and alleles. The examinations for the PD group were assessed in person in order to evaluate motor symptoms, cognitive function, sleep, and depression, including the Unified Parkinson’s Disease Rating Scale (UPDRS), Mini-Mental State Examination (MMSE), Pittsburgh Sleep Quality Index (PSQI), and 17-item Hamilton Rating Scale for Depression (HAMD-17). Results. Motor fluctuation (P<0.001) and sleep disorders (P=0.007) were significantly different between the two groups. These correlations persisted after adjusting for confounding risk factors by further binary logistic regression analysis, suggesting that the CLOCK 3111T/C variant was associated with motor fluctuation (OR = 1.080, P<0.001) and a subjective sleep disorder (OR = 1.130, P=0.037). Conclusion. The CLOCK 3111T/C variant can be an independent risk factor for motor fluctuation and sleep disorder in Parkinson’s disease.

scholarly journals Comparison of three physical therapy interventions with an emphasis on the gait of individuals with Parkinson’s disease

2017 ◽  
Vol 30 (4) ◽  
pp. 691-701
Author(s):  
Maria Eduarda Brandão Bueno ◽  
Ana Carolina dos Reis Andrello ◽  
Marcelle Brandão Terra ◽  
Hevely Beatriz Celestino dos Santos ◽  
Júlia Marson Marquioli ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Physical Therapy ◽  
Rating Scale ◽  
Post Intervention ◽  
Timed Up And Go ◽  
Intervention Protocol ◽  
Before And After ◽  
Yahr Scale ◽  
Therapy Interventions

Abstract Introduction: Gait impairments are one of the earliest signs reported by patients with Parkinson’s disease (PD) and cause an increased number of falls and decreased quality of life among these patients. Objective: To compare the effectiveness of three physical therapy interventions using Rhythmic Cues (RC), Swiss Ball (SB) and Dual Task (DT), with an emphasis on gait treatment (step and stride length, duration and velocity), in individuals with PD. Methods: Quasi-randomized clinical trial addressing a sample composed of 45 individuals assigned to three groups. The individuals were assessed before and after the intervention protocol using the following: Modified Hoehn and Yahr Scale (HY), Unified Parkinson’s Disease Rating Scale (UPDRS), Footprint analysis, Video Gait analysis, and Timed Up and Go Test (TUG). The groups were homogeneous concerning age, HY and UPDRS. Statistical analysis was performed using SPSS, version 20.0. Results: Statistically significant differences were found in all the variables analyzed in the RC and SB groups when compared in the pre- and post-intervention. With the exception of the TUG variable, the DT group presented statistically significant differences in all the remaining variables. Conclusion: The three interventions were effective for the outcomes under study, but the SB group presented the greatest magnitude of change (effect size), while the RC group presented the greatest improvement in the temporal gait variables (duration and velocity) and TUG.

The Relationships Between the Unified Parkinson’s Disease Rating Scale and Lower Extremity Functional Performance in Persons With Early-Stage Parkinson’s Disease

2009 ◽  
Vol 23 (7) ◽  
pp. 657-661 ◽  
Author(s):  
Jooeun Song ◽  
Beth E. Fisher ◽  
Giselle Petzinger ◽  
Allan Wu ◽  
James Gordon ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Lower Extremity ◽  
Rating Scale ◽  
Functional Performance ◽  
Early Stage ◽  
Motor Fluctuation ◽  
Stair Climbing ◽  
Functional Capabilities ◽  
Disease Rating

Background. The Unified Parkinson’s Disease Rating Scale (UPDRS) is the “gold standard” assessment tool for characterizing impairments in persons with Parkinson’s disease (PD); however, this scale’s ability to predict functional capabilities across different functional tasks has not been adequately assessed in persons with early-stage PD. Methods. Thirty persons with PD within 3 years of diagnosis and without motor fluctuation performed self-selected walking, fast walking, and sit-to-stand and stair-climbing tasks. Pearson’s correlation coefficients were used to calculate correlations with a standard UPDRS examination ( P < .05). Simple linear regression models were used to fit each functional performance outcome measure with the UPDRS total predictor scores. Results. The correlations between the UPDRS motor (section III), UPDRS total scores, and all timed functional performance measures were fair to good (range, 0.45-0.57). Conversely, only greater self-selected time to walk 50 ft correlated with a higher UPDRS activities of daily living (II) score ( r = .386; P < .05). Conclusions. The UPDRS motor (III) and total scores may be good predictors of overall lower extremity function in persons with early-stage PD. Understanding the relationships between UPDRS scores and functional capabilities may allow clinicians to better quantify early physical functioning, longitudinally assess disease progression, and assess the efficacy of interventions.

scholarly journals Recurrent Falls in People with Parkinson’s Disease without Cognitive Impairment: Focusing on Modifiable Risk Factors

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Lorena R. S. Almeida ◽  
Guilherme T. Valença ◽  
Nádja N. Negreiros ◽  
Elen B. Pinto ◽  
Jamary Oliveira-Filho
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Roc Curves ◽  
Berg Balance Scale ◽  
Modifiable Risk Factors ◽  
Timed Up And Go ◽  
Recurrent Falls ◽  
Yahr Scale

Falls can be considered a disabling feature in Parkinson’s disease. We aimed to identify risk factors for falling, testing simultaneously the ability of disease-specific and balance-related measures. We evaluated 171 patients, collecting demographic and clinical data, including standardized assessments with the Unified Parkinson’s Disease Rating Scale (UPDRS), activities of daily living (ADL) and motor sections, modified Hoehn and Yahr Scale, Schwab and England, eight-item Parkinson’s Disease Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale-International (FES-I), Berg Balance Scale, Dynamic Gait Index, Functional Reach, and Timed Up and Go. ROC curves were constructed to determine the cutoff scores for all measures. Variables withP<0.1entered a logistic regression model. The prevalence of recurrent falls was 30% (95% CI 24%–38%). In multivariate analysis, independent risk factors for recurrent falls were (P<0.05) levodopa equivalent dose (OR = 1.283 per 100 mg increase; 95% CI = 1.092–1.507), UPDRS-ADL > 16 points (OR = 10.0; 95% CI = 3.6–28.3), FES-I > 30 points (OR = 6.0; 95% CI = 1.6–22.6), and Berg ≤ 48 points (OR = 3.9; 95% CI = 1.2–12.7).We encourage the utilization of these modifiable risk factors in the screening of fall risk.

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