scholarly journals Gait Difficulties and Postural Instability in Adrenoleukodystrophy

2021 ◽  
Vol 12 ◽  
Author(s):  
Neha P. Godbole ◽  
Reza Sadjadi ◽  
Madeline A. DeBono ◽  
Natalie R. Grant ◽  
Daniel C. Kelly ◽  
...  
Keyword(s):  
Postural Control ◽  
Fall Risk ◽  
Postural Instability ◽  
Walk Test ◽  
Expanded Disability Status Scale ◽  
Dynamic Posturography ◽  
Computerized Dynamic Posturography ◽  
Disability Status ◽  
Males And Females ◽  
Functional Gait

Background: Gait and balance difficulties are among the most common clinical manifestations in adults with X-linked adrenoleukodystrophy, but little is known about the contributions of sensory loss, motor dysfunction, and postural control to gait dysfunction and fall risk.Objective: To quantify gait and balance deficits in both males and females with adrenoleukodystrophy and evaluate how environmental perturbations (moving surfaces and visual surrounds) affect balance and fall risk.Methods: We assessed sensory and motor contributions to gait and postural instability in 44 adult patients with adrenoleukodystrophy and 17 healthy controls using three different functional gait assessments (25 Foot Walk test, Timed Up and Go, and 6 Minute Walk test) and computerized dynamic posturography.Results: The median Expanded Disability Status Scale score for the patient cohort was 3.0 (range 0.0–6.5). Both males and females with adrenoleukodystrophy showed impairments on all three functional gait assessments relative to controls (P < 0.001). Performance on walking tests and Expanded Disability Status Scale scores correlated with incidence of falls on computerized dynamic posturography, with the 25 Foot Walk being a moderately reliable predictor of fall risk (area under the ROC curve = 0.7675, P = 0.0038).Conclusion: We demonstrate that gait difficulties and postural control deficits occur in patients with adrenoleukodystrophy, albeit at an older age in females. Postural deficits were aggravated by eyes closed and dynamic conditions that rely on vestibular input, revealing challenges to the interplay of motor, sensory and vestibular circuitry in adrenoleukodystrophy.

The development of postural control among children: Repeatability and normative data for computerized dynamic posturography system

2020 ◽  
Vol 78 ◽  
pp. 40-47 ◽  
Author(s):  
Amir Shams ◽  
Roshanak Vameghi ◽  
Parvaneh Shamsipour Dehkordi ◽  
Nahid Allafan ◽  
Mahdi Bayati
Keyword(s):  
Postural Control ◽  
Normative Data ◽  
Dynamic Posturography ◽  
Computerized Dynamic Posturography

Effects of lifetime ethanol consumption on postural control: A computerized dynamic posturography study

2002 ◽  
Vol 12 (1) ◽  
pp. 53-64
Author(s):  
Saad Ahmad ◽  
John W. Rohrbaugh ◽  
Andrey P. Anokhin ◽  
Erik J. Sirevaag ◽  
Joel A. Goebel
Keyword(s):  
Alcohol Consumption ◽  
Postural Control ◽  
Spectral Power ◽  
Support Surface ◽  
Dependent Manner ◽  
Dynamic Posturography ◽  
Eyes Closed ◽  
Sensory Organization ◽  
Computerized Dynamic Posturography ◽  
Eyes Open

The relationship between lifetime alcohol consumption and postural control was investigated in 35 subjects with no clinically-detectable neurologic abnormalities, using computerized dynamic posturography (CDP) procedures. The estimated total number of lifetime alcoholic drinks was positively correlated with anteroposterior sway spectral power within the 2–4 Hz and 4–6 Hz frequency bands, in three Sensory Organization Test (SOT) conditions: eyes closed with stable support surface (SOT 2), eyes open with sway-referenced support (SOT 4), and eyes closed with sway-referenced support (SOT 5). All correlations remained significant after controlling for subject age, and were increased after excluding nine drug-abusing subjects. In contrast to the strong findings for frequency-based measures, no correlation was observed using conventional amplitude-based sway measures. These results suggest that 1) alcohol consumption compromises postural control in an exposure-dependent manner, and 2) sway frequency analysis reveals pathological processes not manifested in conventional CDP measures of sway amplitude.

scholarly journals Predicting Falls in People with Multiple Sclerosis: Fall History Is as Accurate as More Complex Measures

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Michelle H. Cameron ◽  
Emily Thielman ◽  
Rajarshi Mazumder ◽  
Dennis Bourdette
Keyword(s):  
Multiple Sclerosis ◽  
Fall Risk ◽  
Area Under The Curve ◽  
Dynamic Posturography ◽  
Balance Confidence ◽  
The Past ◽  
Injurious Falls ◽  
Fall Prediction ◽  
Disability Status ◽  
Physical Tests

Background.Many people with MS fall, but the best method for identifying those at increased fall risk is not known.Objective.To compare how accurately fall history, questionnaires, and physical tests predict future falls and injurious falls in people with MS.Methods.52 people with MS were asked if they had fallen in the past 2 months and the past year. Subjects were also assessed with the Activities-specific Balance Confidence, Falls Efficacy Scale-International, and Multiple Sclerosis Walking Scale-12 questionnaires, the Expanded Disability Status Scale, Timed 25-Foot Walk, and computerized dynamic posturography and recorded their falls daily for the following 6 months with calendars. The ability of baseline assessments to predict future falls was compared using receiver operator curves and logistic regression.Results.All tests individually provided similar fall prediction (area under the curve (AUC) 0.60–0.75). A fall in the past year was the best predictor of falls (AUC 0.75, sensitivity 0.89, specificity 0.56) or injurious falls (AUC 0.69, sensitivity 0.96, specificity 0.41) in the following 6 months.Conclusion.Simply asking people with MS if they have fallen in the past year predicts future falls and injurious falls as well as more complex, expensive, or time-consuming approaches.

Effect of time of day on walking capacity and self-reported fatigue in persons with multiple sclerosis: a multi-center trial

2011 ◽  
Vol 18 (3) ◽  
pp. 351-357 ◽  
Author(s):  
P Feys ◽  
D Gijbels ◽  
A Romberg ◽  
C Santoyo ◽  
B Gebara ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Time Of Day ◽  
Diurnal Change ◽  
Walk Test ◽  
Expanded Disability Status Scale ◽  
Time Points ◽  
Walking Capacity ◽  
Disability Status ◽  
6 Minute Walk Test ◽  
Minute Walk

Background: Many persons with multiple sclerosis (PwMS) report increased fatigue in the afternoon and evening compared with the morning. It is commonly accepted that physical capacity also decreases as time of day progresses, potentially influencing the outcomes of testing. Objective: The objective of this article was to determine whether self-reported fatigue level and walking capacity are influenced by time of day in PwMS. Methods: A total of 102 PwMS from 8 centers in 5 countries, with a diverse level of ambulatory dysfunction (Expanded Disability Status Scale [EDSS] <6.5), participated. Patients performed walking capacity tests and reported fatigue level at three different time points (morning, noon, afternoon) during 1 day. Walking capacity was measured with the 6-Minute Walk Test (6MWT) and the 10-m walk test performed at usual and fastest speed. Self-reported fatigue was measured by the Rochester Fatigue Diary (RFD). Subgroups with mild (EDSS 1.5–4.0, n = 53) and moderate (EDSS 4.5–6.5, n = 49) ambulatory dysfunction were formed, as changes during the day were hypothesized to depend on disability status. Results: Subgroups had different degree of ambulatory dysfunction ( p < 0.001) but reported similar fatigue levels. Although RFD scores were affected by time of day with significant differences between morning and noon/afternoon ( p < 0.0001), no changes in walking capacity were found in any subgroup. Additional analyses on subgroups distinguished by diurnal change in self-reported fatigue failed to reveal analogous changes in walking capacity. Conclusions: Testing of walking capacity is unaffected by time of day, despite changes in subjective fatigue.

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