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 German Translation and Validation of the “Freezing of Gait Questionnaire” in Patients with Parkinson’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Anina Vogler ◽  
Jorina Janssens ◽  
Thomas Nyffeler ◽  
Stephan Bohlhalter ◽  
Tim Vanbellingen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Convergent Validity ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Divergent Validity ◽  
Timed Up And Go ◽  
Disease Rating ◽  
Disease Questionnaire ◽  
Movement Disorder Society

Background. Freezing of Gait (FOG) is a disabling parkinsonian symptom. The Freezing of Gait Questionnaire (FOG-Q) reliably detects FOG in patients with Parkinson’s disease (PD).Objectives. The aim of this study was to develop a German translated version of the FOG-Q and to assess its validity.Methods. The translation was accomplished using forward-backward-translation. The construct validity of the FOG-Q was examined in twenty-seven German native speaking PD patients. Convergent validity was assessed by correlating the FOG-Q with the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) II-III, the Parkinson Disease Questionnaire 39 (PDQ-39), and the Timed Up and Go Test (TUG). Divergent validity was assessed by correlating the FOG-Q with the MDS-UPDRS I. The internal consistency was measured using Cronbach’s alpha (Cα).Results. A good internal structure of the FOG-Q was found (Cα=0.83). Significant moderate correlations between the FOG-Q and the MDS-UPDRS item 2.13 (freezing) (rs=0.568,P=0.002) and between the FOG-Q and the PDQ-39 subscale mobility (rs=0.516,P=0.006) were found. The lack of correlation with the MDS-UPDRS I demonstrated good divergent validity.Conclusion. The German FOG-Q is a valid tool to assess FOG in German native speaking PD patients.

scholarly journals The effect of body weight-supported overground gait training for patients with Parkinson’s disease: A retrospective case-control observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254415
Author(s):  
Yasuki Koyanagi ◽  
Isato Fukushi ◽  
Masatoshi Nakamura ◽  
Kouji Suzuki ◽  
Nobuhito Oda ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Gait Training ◽  
Walk Test ◽  
Retrospective Case ◽  
Timed Up And Go ◽  
Group I ◽  
6 Minute Walk Test

Objective To evaluate the effects of body weight-supported overground gait training (BWSOGT) on motor abilities, such as gait and balance, in patients with Parkinson’s disease (PD). Design Retrospective case-controlled observational study with a 4-week follow-up. Setting Inpatient rehabilitation. Participants We selected 37 of 68 patients with PD. Inclusion criteria were (1) Hoehn & Yahr stage II–IV, (2) no medication adjustment during the study period, (3) at least 1 week since last medication adjustment, and (4) ability to walk more than 10 meters on their own. Exclusion criteria were (1) cerebrovascular disease or other complications affecting movement, (2) difficulty in measurement, (3) early discharge, (4) medication change during the study, and (5) development of complications. Interventions Patients were divided into two groups. Patients in Group I underwent 20 minutes of BWSOGT with a mobile hoist in addition to the standard exercises; Group II performed 20 minutes of gait training in place of BWSOGT. In both groups, training was performed for a total of 15 times/4 weeks. Main outcome measure(s) Participants were evaluated using the Unified Parkinson’s Disease Rating Scale total, part II, and part III; 10-m walk test; velocity; stride length; 6-minute walk test; timed up and go test; Berg Balance Scale; and freezing of gait before and after the intervention. Results There were significant decreases in the Unified Parkinson’s Disease Rating Scale total, part II, and part III in both groups; however, 6-minute walk test, timed up and go test, and freezing of gait results only improved in Group I. Conclusions BWSOGT for patients with PD improves gait ability and dynamic balance more than standard gait training.

scholarly journals Goalkeeper game: a new assessment instrument in neurology showed higher predictive power than moca for gait performance in people with parkinson’s disease

2018 ◽  
Author(s):  
Rafael B. Stern ◽  
Matheus d’Alencar ◽  
Yanina L. Uscapi ◽  
Marco D. Gubitoso ◽  
Antonio C. Roque ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Predictive Power ◽  
Assessment Instrument ◽  
Single Individual ◽  
Timed Up And Go ◽  
Gait Performance ◽  
Task Conditions ◽  
Moca Score

ObjectiveTo investigate the use of the Goalkeeper Game (GG) to assess gait automaticity decline under dual task conditions in people with Parkinson’s disease (PPD) and compare its predictive power with the one of the MoCA test.Materials and Methods74 PPD (H&Y stages: 23 in stage 1; 31 in stage 2; 20 in stage 3), without dementia (MoCA cut-off 23), tested in ON period with dopaminergic medication were submitted to single individual cognitive/motor evaluation sessions. The tests applied were: MoCA, GG, dynamic gait index (DGI) task and timed up and go test (TUG) under single and dual-task (DT) conditions. GG test resulted in 9 measures extracted via a statistical model. The predictive power of the GG measures and the MoCA score with respect to gait performance, as assessed by DGI and DT-TUG, were compared.ResultsThe predictive models based on GG measures and MoCA score obtained, respectively, sensitivities of 65% and 56% for DGI scores and 59% and 57% for DT-TUG cost at a 50% specificity. GG application proved to be feasible and aroused more motivation in PPDs than MoCa.ConclusionGG, a friendly and ludic game, was able to reach a good power of gait performance prediction in people at initial and intermediate stages of PD evolution.

scholarly journals B-11 Cognitive Performance in Depressed and Non-Depressed Patients with de novo Parkinson’s disease

2019 ◽  
Vol 34 (6) ◽  
pp. 955-955
Author(s):  
B Honsey ◽  
K WymanChick
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Rating Scale ◽  
Early Stage ◽  
Depression Scale ◽  
Cutoff Score ◽  
Depressed Group ◽  
Significant Difference ◽  
Category Fluency

Abstract Objective Compare cognitive performance in early-stage Parkinson Disease (PD) participants with and without depression. Method Data from the Parkinson’s Progression Marker Initiative were utilized. We examined data from 422 participants diagnosed with PD within the previous two years (age = 61.7±9.7 years, education = 15.6±3.0 years). Depressive symptoms were assessed using the Geriatric Depression Scale (GDS-15) using a cutoff score of ≤5 to indicate the absence of clinical depression. Cognitive tests included Hopkins Verbal Memory Test-Revised (HVLT-R), Judgment of Line Orientation (JLO), Letter-Number Sequencing (LNS), Symbol Digit Modalities Test (SDMT), and Category Fluency. Motor scores were measured by the Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part III. Demographic and clinical variables for the two groups were compared using independent samples t-tests and chi-square analyses. Results The non-depressed group (n = 280) was significantly older; t(246.08) = 2.25, p = .026 and had higher education; t(420) = 2.35, p = .019; and duration of PD symptoms; t(170.58) = -2.13, p = .035 than the depressed group (n = 142). The groups did not differ in terms of race, gender, handedness, side of onset, or severity of motor symptoms. There was no significant differences in performance on HVLT, JLO, SDMT, or Category Fluency; however, the non-depressed group performed better on LNS than the depressed group, t(420) = 2.05, p = .041. Conclusion(s) There is no significant difference in cognitive performance between early-stage PD participants with and without depression, with the exception of significantly lower working memory performance in the depressed group.

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.

Dance Rhythms Improve Motor Symptoms in Individuals with Parkinson’s Disease: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Jéssica A. Moratelli ◽  
Kettlyn H. Alexandre ◽  
Leonessa Boing ◽  
Alessandra Swarowsky ◽  
Clynton L. Corrêa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Clinical Trial ◽  
Parkinson's Disease ◽  
Randomized Clinical Trial ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Motor Symptoms ◽  
Score Change ◽  
Significant Difference ◽  
Binary Group

Background: Evidence-based practices involving dance modalities found in binary (two-beat rhythm) or quaternary (four-beat rhythm) show that dance positively influences the motor aspects of disease.Aim: This randomized clinical trial aimed to analyze the effect of two dance rhythm (binary and quaternary) on the balance, gait, and mobility in individuals with Parkinson’s disease (PD). Methods: Thirty-one individuals with PD were randomized into the binary group (n = 18) and the quaternary group (n = 13). Both groups participated in different dance rhythms lasting 12 weeks, twice a week, for 45 minutes. Results: The binary group showed a significant difference in balance (p = 0.003), freezing of gait (p = 0.007), as well as in the motor aspects of MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), with emphasis on the total values with a score change of 3.23. In the quaternary group, significant differences were found in balance (p = 0.021) with a score change of -2.54 and in the motor aspects of the MDS-UPDRS Part III where the total values stood out with a change of 3.54. Discussion: When comparing the possible effects of binary and quaternary rhythms on the motor symptoms of individuals with PD, it was demonstrated that binary rhythm improved balance, freezing gait, and UPDRSIII. As for the quaternary rhythm, the benefits were in balance and the UPDRSIII. Conclusion: The binary and the quaternary rhythm dance protocols positively influenced the motor symptoms of individuals with PD after 12 weeks of intervention.

scholarly journals Stability of MDS-UPDRS Motor Subtypes Over Three Years in Early Parkinson's Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Abhijeet K. Kohat ◽  
Samuel Y. E. Ng ◽  
Aidan S. Y. Wong ◽  
Nicole S. Y. Chia ◽  
Xinyi Choi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Area Under The Curve ◽  
Baseline Factors ◽  
Prospective Cohorts ◽  
The Mean ◽  
The Stability ◽  
Early Parkinson’S Disease ◽  
Levodopa Equivalent Daily Dose

Background: Various classifications have been proposed to subtype Parkinson's disease (PD) based on their motor phenotypes. However, the stability of these subtypes has not been properly evaluated.Objective: The goal of this study was to understand the distribution of PD motor subtypes, their stability over time, and baseline factors that predicted subtype stability.Methods: Participants (n = 170) from two prospective cohorts were included: the Early PD Longitudinal Singapore (PALS) study and the National Neuroscience Institute Movement Disorders Database. Early PD patients were classified into tremor-dominant (TD), postural instability and gait difficulty (PIGD), and indeterminate subtypes according to the Movement Disorder Society's Unified PD Rating Scale (MDS-UPDRS) criteria and clinically evaluated for three consecutive years.Results: At baseline, 60.6% patients were TD, 12.4% patients were indeterminate, and 27.1% patients were PIGD subtypes (p < 0.05). After 3 years, only 62% of patients in TD and 50% of patients in PIGD subtypes remained stable. The mean levodopa equivalent daily dose (LEDD) was higher in the PIGD subtype (276.92 ± 232.91 mg; p = 0.01). Lower LEDD [p < 0.05, odds ratio (OR) 0.99, 95% confidence interval (CI): 0.98–0.99] and higher TD/PIGD ratios (p < 0.05, OR 1.77, 95% CI: 1.29–2.43) were independent predictors of stability of TD subtype with an area under the curve (AUC) of 0.787 (95%CI: 0.669–0.876), sensitivity = 57.8%, and specificity = 89.7%.Conclusion: Only 50–62% of PD motor subtypes as defined by MDS-UPDRS remained stable over 3 years. TD/PIGD ratio and baseline LEDD were independent predictors for TD subtype stability over 3 years.

scholarly journals Central Pain in Parkinson’s Disease: Behavioral and Cognitive Characteristics

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
N. Vila-Chã ◽  
S. Cavaco ◽  
A. Mendes ◽  
A. Gonçalves ◽  
I. Moreira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Rating Scale ◽  
Short Form ◽  
Structured Interview ◽  
Smoking Habits ◽  
Addictive Behaviors ◽  
Study Results ◽  
Compulsive Behaviors

Introduction. Pain is a major nonmotor symptom of Parkinson’s disease (PD), and central parkinsonian pain is the core feature of the putative Park pain subtype of PD. This study aimed to explore the cognitive and behavioral profile of PD patients with central parkinsonian pain. Material and Methods. A structured interview was used to identify and characterize pain in a cohort of 260 consecutive PD patients. The Ford classification of pain was applied. The Dementia Rating Scale-2 (DRS-2) and the Impulse Control Disorders in Parkinson’s Disease Short Form (QUIP-S) were administered, and patients’ smoking habits were recorded. The Unified Parkinson’s Disease Rating Scale (UPDRS) was used to assess motor and nonmotor symptoms in off and on conditions. Results. One hundred and eighty-eight patients (68%) reported pain; and in 41 (22%) of them, the pain was classified as central parkinsonian pain. PD patients with central parkinsonian pain had better cognitive performance in DRS-2 Initiation/Perseveration and Conceptualization subscales but reported more other compulsive behaviors (e.g., hobbyism, punding, and walkabout) and had more current smoking habits than those without pain or with non-central parkinsonian pain. Multiple logistic regression analyses revealed that the DRS-2 Conceptualization subscale, other compulsive behaviors, and smoking habits remained statistically associated with central parkinsonian pain even when other significant covariates were considered. Only patients with pain, regardless of type, had a gambling disorder. Discussion. The study results provide further evidence that pain revealed that patients with central parkinsonian pain are more likely to present compulsive or addictive behaviors, despite having more preserved cognitive performance. Patients with central parkinsonian pain appear to have a distinct phenotype of PD.

scholarly journals Temporal Characteristics of High-Frequency Lower-Limb Oscillation during Freezing of Gait in Parkinson’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Don A. Yungher ◽  
Tiffany R. Morris ◽  
Valentina Dilda ◽  
James M. Shine ◽  
Sharon L. Naismith ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
High Frequency ◽  
Freezing Of Gait ◽  
Body Motion ◽  
High Frequency Oscillation ◽  
Frequency Oscillation ◽  
Timed Up And Go ◽  
Clinical Onset ◽  
Acceleration Data

A cardinal feature of freezing of gait (FOG) is high frequency (3–8 Hz) oscillation of the legs, and this study aimed to quantify the temporal pattern of lower-body motion prior to and during FOG. Acceleration data was obtained from sensors attached to the back, thighs, shanks, and feet in 14 Parkinson’s disease patients performing timed-up-and-go tasks, and clinical assessment of FOG was performed by two experienced raters from video. A total of 23 isolated FOG events, defined as occurring at least 5 s after gait initiation and with no preceding FOG, were identified from the clinical ratings. The corresponding accelerometer records were analyzed within a 4 s window centered at the clinical onset of freezing. FOG-related high-frequency oscillation (an increase in power in the 3–8 Hz band >3 SD from baseline) followed a distal to proximal onset pattern, appearing at the feet, shanks, thighs, and then back over a period of 250 ms. Peak power tended to decrease as the focus of oscillation moved from feet to back. There was a consistent delay (mean 872 ms) between the onset of high frequency oscillation at the feet and clinical onset of FOG. We infer that FOG is characterized by high frequency oscillation at the feet, which progresses proximally and is mechanically damped at the torso.

Retinal Morphological Changes during the Two Years of Follow-Up in Parkinson's Disease

2020 ◽  
Author(s):  
Mahmut Atum ◽  
Bekir Enes Demiryurek
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Early Stage ◽  
Morphological Changes ◽  
Fiber Layer ◽  
Significant Difference ◽  
Yahr Scale ◽  
And Control

Abstract Background: The study aims to investigate the relationship between the progression of idiopathic Parkinson's disease (IPD) and retinal morphology. Methods: The study was carried out with 23 patients diagnosed with early-stage IPD (phases 1 and 2 of the Hoehn and Yahr scale) and 30 age-matched healthy controls. All patients were followed up at least two years, with 6-month intervals (initial, 6th month, 12th month, 18th month, and 24th month), and detailed neurological and ophthalmic examinations were performed at each follow-up. Unified Parkinson's Disease Rating Scale part III (UPDRS Part III) scores, Hoehn and Yahr (H&Y) scores, best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were analyzed at each visit. Results: The average age of the IPD and control groups was 43.96 ± 4.88 years, 44.53 ± 0.83 years, respectively. The mean duration of the disease in the IPD group was 7.48 ± 5.10 months at the start of the study (range 0-16). There was no statistically significant difference in BCVA and IOP values between the two groups during the two-year follow-up period (p> 0.05, p> 0.05, respectively). Average and superior quadrant RNFL thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p = 0.025, p=0.034, p> 0.05, respectively). There was no statistically significant difference in CMT between the two groups during the follow-up period (p> 0.05). Conclusion: Average and superior quadrant RNFL thicknesses were significantly thinning with the progression of IPD.

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