scholarly journals A New Postural Stability-Indicator to Predict the Level of Fear of Falling in Parkinson’s Disease Patients

2020 ◽  
Author(s):  
Ehsan Pourghayoomi ◽  
Saeed Behzadipour ◽  
Mehdi Ramezani ◽  
Mohammad Taghi Joghataei ◽  
Gholamali Shahidi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Stability ◽  
Human Error ◽  
Fear Of Falling ◽  
Center Of Pressure ◽  
Threshold Level ◽  
Berg Balance Scale ◽  
Self Report ◽  
Timed Up And Go

Abstract Background: Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. Seventy percent of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error.Objectives: In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods: Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRi’s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF related behavior(s). Results: FTR1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = −0.63, P < 0.001), Pull Test (r = −0.65, p < 0.001), Timed Up and Go test (r = −0.57, p < 0.001), and Berg Balance Scale (r = 0.62, p < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions: Using the proposed assessment technique we can accurately predict the intensity of FoF in PD patients. Also, The FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

scholarly journals A New Postural Stability-Indicator to Predict the Level of Fear of Falling In Parkinson’s Disease Patients

2020 ◽  
Author(s):  
Ehsan Pourghayoomi ◽  
Saeed Behzadipour ◽  
Mehdi Ramezani ◽  
Mohammad Taghi Joghataei ◽  
Gholamali shahidi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Stability ◽  
Human Error ◽  
Fear Of Falling ◽  
Center Of Pressure ◽  
Threshold Level ◽  
Berg Balance Scale ◽  
Self Report ◽  
Timed Up And Go

Abstract Background Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. 70% of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error. Objectives In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRi’s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF related behavior(s). Results FTR 1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = − 0.63, P < 0.001), Pull Test (r = − 0.65, P < 0.001), Timed Up and Go test (r = − 0.57, P < 0.001), and Berg Balance Scale (r = 0.62, P < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions Using the proposed assessment technique we can accurately predict the intensity of FoF in PD patients. Also, The FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

scholarly journals A New Postural Stability-Indicator to Predict the Level of Fear of Falling in Parkinson’s Disease Patients

2020 ◽  
Author(s):  
Ehsan Pourghayoomi ◽  
Saeed Behzadipour ◽  
Mehdi Ramezani ◽  
Mohammad Taghi Joghataei ◽  
Gholamali Shahidi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Stability ◽  
Human Error ◽  
Fear Of Falling ◽  
Center Of Pressure ◽  
Threshold Level ◽  
Berg Balance Scale ◽  
Self Report ◽  
Timed Up And Go

Abstract Background: Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. Seventy percent of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error.Objectives: In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods: Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRi’s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF related behavior(s). Results: FTR1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = −0.63, P < 0.001), Pull Test (r = −0.65, P < 0.001), Timed Up and Go test (r = −0.57, P < 0.001), and Berg Balance Scale (r = 0.62, P < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions: Using the proposed assessment technique we can accurately predict the intensity of FoF in PD patients. Also, The FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

scholarly journals A new postural stability-indicator to predict the level of fear of falling in Parkinson’s disease patients

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Ehsan Pourghayoomi ◽  
Saeed Behzadipour ◽  
Mehdi Ramezani ◽  
Mohammad Taghi Joghataei ◽  
Gholam Ali Shahidi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Stability ◽  
Fear Of Falling

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 BODY COMPOSITION AND POSTURAL INSTABILITY IN PEOPLE WITH IDIOPATHIC PARKINSON’S DISEASE

2016 ◽  
pp. 1-6
Author(s):  
A.S. Diab ◽  
L.A. Hale ◽  
M.A. Skinner ◽  
G. Hammond-Tooke ◽  
A.L. Ward ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Body Composition ◽  
Postural Stability ◽  
Postural Instability ◽  
Composite Score ◽  
Step Test ◽  
Timed Up And Go ◽  
Composite Scores ◽  
Age And Sex

Objectives: Idopathic Parkinson’s disease (PD) is the second most common neurodegenerative disorder. Our objective was to investigate the relationship between body composition and postural instability in people with PD, and age- and sex-matched controls. Design: Cross-sectional study among PD sufferers and age- and sex-matched controls. Setting: University of Otago’s Balance Clinic, School of Physiotherapy. Participants: Forty-seven people with PD and 58 age- and sex-matched controls. Measurements: Postural stability was assessed with the Sensory Organization Test, Motor Control Test, Timed Up and Go Test, and Step Test. Body composition was measured by dual energy x-ray absorptiometry (DXA). Movement Disorders Society-Unified Parkinson’s Disease Rating Scale was applied to assess PD severity. Results: Mean group differences between PD and controls for the equilibrium composite score, Timed Up and Go Tests, and Step Test were statistically significant (p<0.05); strategy and latency composite scores and body composition variables were not (p>0.05). Three PD participants were sarcopenic; 15 PD and 24 controls were obese. In PD participants, total body lean mass and age predicted latency composite scores. Disease, age, and leg fat mass predicted the Timed Up and Go Test results (p<0.05). Sex and disease predicted the equilibrium composite score (p<0.01). Conclusion: The prevalence of obesity was high and sarcopenia low in the PD group, which is a novel finding. Not surprisingly, participants with PD had reduced postural stability compared to controls. Disease status, age and sex were influential factors in the weak relationships found between postural stability and body composition. These findings may have clinical relevance for the treatment of the physical symptoms of those suffering from PD.

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.

scholarly journals Effect of Group-Based Rehabilitation Combining Action Observation with Physiotherapy on Freezing of Gait in Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Elisa Pelosin ◽  
Roberta Barella ◽  
Cristina Bet ◽  
Elisabetta Magioncalda ◽  
Martina Putzolu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Outcome Measures ◽  
Physical Training ◽  
Action Observation ◽  
Freezing Of Gait ◽  
Berg Balance Scale ◽  
Control Group ◽  
Timed Up And Go ◽  
Balance Scale

Freezing of gait (FoG) is among the most disabling symptoms of Parkinson’s disease (PD) patients. Recent studies showed that action observation training (AOT) with repetitive practice of the observed actions represents a strategy to induce longer-lasting effects compared with standard physiotherapy. We investigated whether AOT may improve FoG and mobility in PD, when AOT is applied in a group-based setting. Sixty-four participants with PD and FoG were assigned to the experimental (AO) or control groups and underwent a 45-minute training session, twice a week, for 5 weeks. AOT consisted in physical training combined with action observation whereas the control group executed the same physical training combined with landscape-videos observation. Outcome measures (FoG questionnaire, Timed Up and Go test, 10-meter walking test, and Berg balance scale) were evaluated before training, at the end of training, and 4 weeks later (FU-4w). Both groups showed positive changes in all outcome measures at posttraining assessment. Improvements in FoG questionnaire, Timed Up and Go test, and Berg balance scale were retained at FU-4w evaluation only in the AOT group. AOT group-based training is feasible and effective on FoG and motor performance in PD patients and may be introduced as an adjunctive option in PD rehabilitation program.

scholarly journals Validation of the German Version of the New Freezing of Gait Questionnaire for People with Parkinson‘s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Jana Seuthe ◽  
Kristina Kuball ◽  
Ann-Kristin Hoffmann ◽  
Burkhard Weisser ◽  
Günther Deuschl ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Internal Consistency ◽  
Fear Of Falling ◽  
Freezing Of Gait ◽  
Cognitive State ◽  
German Version ◽  
Divergent Validity ◽  
Timed Up And Go ◽  
Convergent And Divergent Validity

Freezing of gait (FOG) in Parkinson’s disease (PD) is a highly disabling symptom which impacts quality of life. The New FOG Questionnaire (NFOG-Q) is the most commonly used tool worldwide to characterize FOG severity in PD. This study aims to provide a German translation of the NFOG-Q and to assess its validity in people with PD. The questionnaire was translated using forward-backward translation. Validity was tested in 57 PD patients with FOG via Cronbach’s alpha for internal consistency and Spearman correlations with several clinical measures to quantify disease severity, mobility, fall risk, and cognitive state for convergent and divergent validity. The German version of the NFOG-Q shows good internal consistency (Cα = 0.84). Furthermore, the NFOG-Q score was significantly correlated with the MDS-UPDRS III, H&Y stage, Timed Up and Go test, and the subjective fear of falling (FES-I). The lack of correlation with cognition (MoCA) points towards good divergent validity. This study provides a German version of the NFOG-Q which proved to be valid for the assessment of FOG severity in individuals with PD.

scholarly journals Virtual Reality Telerehabilitation for Postural Instability in Parkinson’s Disease: A Multicenter, Single-Blind, Randomized, Controlled Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Marialuisa Gandolfi ◽  
Christian Geroin ◽  
Eleonora Dimitrova ◽  
Paolo Boldrini ◽  
Andreas Waldner ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Virtual Reality ◽  
Postural Stability ◽  
Controlled Trial ◽  
Balance Training ◽  
Berg Balance Scale ◽  
Postural Instability ◽  
Cost Comparison ◽  
Group Differences

Introduction. Telerehabilitation enables patients to access remote rehabilitation services for patient-physiotherapist videoconferencing in their own homes. Home-based virtual reality (VR) balance training has been shown to reduce postural instability in patients with Parkinson’s disease (PD). The primary aim was to compare improvements in postural stability after remotely supervised in-home VR balance training and in-clinic sensory integration balance training (SIBT). Methods. In this multicenter study, 76 PD patients (modified Hoehn and Yahr stages 2.5–3) were randomly assigned to receive either in-home VR telerehabilitation (n=38) or in-clinic SIBT (n=38) in 21 sessions of 50 minutes each, 3 days/week for 7 consecutive weeks. VR telerehabilitation consisted of graded exergames using the Nintendo Wii Fit system; SIBT included exercises to improve postural stability. Patients were evaluated before treatment, after treatment, and at 1-month follow-up. Results. Analysis revealed significant between-group differences in improvement on the Berg Balance Scale for the VR telerehabilitation group (p=0.04) and significant Time × Group interactions in the Dynamic Gait Index (p=0.04) for the in-clinic group. Both groups showed differences in all outcome measures over time, except for fall frequency. Cost comparison yielded between-group differences in treatment and equipment costs. Conclusions. VR is a feasible alternative to in-clinic SIBT for reducing postural instability in PD patients having a caregiver.

163 Thai Traditional Game-Based Exercise for Gait and Balance of People with Parkinson's Disease

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv34-iv39
Author(s):  
Surasa Khongprasert ◽  
Keerati Sooksai
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Planning ◽  
Computer Game ◽  
Berg Balance Scale ◽  
Gait Velocity ◽  
Control Group ◽  
Timed Up And Go ◽  
Eyes Open ◽  
Traditional Game

Abstract Falls and recurrent falls are serious complications for people with PD. Poor standing balance, impaired ambulation, impaired lower-limb motor planning, postural instability and falling in previous year are associated with falling in PD. Exercise based computer game (Exergaming) have been used for motor rehabilitation to promote gait and balance and can encourage therapeutic activity. However, many commercially available games are not affordable for some people with Parkinson’s Disease. The aim of this study was to evaluate the effectiveness of Thai Traditional game (TTG) based exercise on gait and balance in people with Parkinson’s Disease. A total of 22 participants with PD (mild –moderate severity) were randomly assigned to either a TTG group or a control group. Participants in TTG completed 1 hour, 3 sessions a week for 10 weeks. The TTG comprises 10 games involved instruction in sit to standing, slow and fast walking speed, turning, weight shifting, reaching, obstacle stepping, cognition, clapping and singing. Gait and balance were assessed before and after the training sessions. Measures included the Berg Balance Scale (BBS), Balance platform, Timed Up and Go (TUG) and The GaitRite walkway. Participants in TTG groups showed significantly improved BBS, TUG, gait velocity and sagittal mean sway with eyes open (p &lt;0.05). Thai Traditional Game based exercise incorporated therapeutic movement could lead improvement in gait and balance and participants seem to enjoy playing as an activity while maintaining their functionality. Future studies should incorporate larger groups and focus on long-term compliance and follow-up.

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