scholarly journals Gait Analyses of Parkinson’s Disease Patients Using Multiscale Entropy

Electronics ◽  
2021 ◽  
Vol 10 (21) ◽  
pp. 2604
Author(s):  
Yuan-Lun Hsieh ◽  
Maysam F. Abbod
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Ground Reaction Force ◽  
Reaction Force ◽  
Pressure Sensors ◽  
Step Length ◽  
Multiscale Entropy ◽  
Vertical Ground Reaction Force ◽  
Sensor Signals

Parkinson’s disease (PD) is a type of neurodegenerative diseases. PD influences gait in many aspects: reduced gait speed and step length, increased axial rigidity, and impaired rhythmicity. Gait-related data used in this study are from PhysioNet. Twenty-one PD patients and five healthy controls (CO) were sorted into four groups: PD without task (PDw), PD with dual task (PDd), control without task (COw), and control with dual task (COd). Since dual task actions are attention demanding, either gait or cognitive function may be affected. To quantify the used walking data, eight pressure sensors installed in each insole are used to measure the vertical ground reaction force. Thus, quantitative measurement analysis is performed utilizing multiscale entropy (MSE) and complexity index (CI) to analyze and differentiate between the ground reaction force of the four different groups. Results show that the CI of patients with PD is higher than that of CO and 11 of the sensor signals are statistically significant (p < 0.05). The COd group has larger CI values at the beginning (p = 0.021) but they get lower at the end of the test (p = 0.000) compared to that in the COw group. The end-of-test CI for the PDw group is lower in one of the feet sensor signals, and in the right total ground reaction force compared to the PDd group counterparts. In conclusion, when people start to adjust their gait due to pathology or stress, CI may increase first and reach a peak, but it decreases afterward when stress or pathology is further increased.

scholarly journals Vertical ground reaction force marker for Parkinson’s disease

PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0175951 ◽  
Author(s):  
Md Nafiul Alam ◽  
Amanmeet Garg ◽  
Tamanna Tabassum Khan Munia ◽  
Reza Fazel-Rezai ◽  
Kouhyar Tavakolian
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Ground Reaction Force ◽  
Reaction Force ◽  
Vertical Ground Reaction Force ◽  
Vertical Ground

scholarly journals Effects of dance on gait and dual-task gait in Parkinson’s disease

2019 ◽  
Author(s):  
Nadeesha Kalyani Hewa Haputhanthirige ◽  
Karen Sullivan ◽  
Gene Moyle ◽  
Sandy Brauer ◽  
Erica Rose Jeffrey ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Verbal Fluency ◽  
Large Scale ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Step Length ◽  
Gait Velocity ◽  
Control Group

Abstract Background Gait impairments in Parkinson’s disease (PD) limit independence and quality of life. While dance based interventions could improve gait, further studies are needed to determine if the benefits generalise to different terrains and when dual-tasking. The aim was to perform a feasibility study of the effects of a dance intervention, based on the Dance for PD®(DfPD®) program, on gait under different dual-tasks (verbal fluency, serial subtraction) and surfaces (even, uneven), and to determine if a larger scale follow-up RCT is warranted.Methods A dance group (DG; n = 17; age = 65.8 ± 11.7 years) and a control group (CG: n = 16; age = 67.0 ± 7.7 years) comprised of non-cognitively impaired (Addenbrooke’s score: DG = 93.2 ± 3.6, CG = 92.6 ± 4.3) independently locomoting people with PD (Hoehn & Yahr I-III) participated in the study. The DG undertook a one-hour DfPD®based class, twice weekly for 12 weeks. The CG had treatment as usual. Gait analysis was performed at baseline and post-intervention while walking on two surfaces (even, uneven) under three conditions (regular walking; dual-task: verbal-fluency, serial-subtraction). The data was analysed by means of a linear mixed model. ResultsThe DG improved significantly compared to the CG in gait velocity, cadence, step-length, and stride-length when even surface walking, with and without a dual-task. On the uneven surface the DG walked more cautiously during regular walking but had improved gait velocity, cadence and step-length when performing serial-subtractions. Conclusions DfPD®-based classes produced clinically significant improvement on spatiotemporal gait parameters under dual-task conditions and on uneven surfaces. This could arise from improved movement confidence and coordination; emotional expression; cognitive skills (planning, multitasking), and; utilisation of external movement cues. A large-scale RCT of this program is warranted.Trial registration A protocol for this study has been registered retrospectively at Australian New Zealand Clinical Trials Registry on 12.11.2018. Identifier: ACTRN12618001834246.

Single- Versus Dual-Task Functional Movement Paradigms: A Biomechanical Analysis

2020 ◽  
pp. 1-12
Author(s):  
Landon B. Lempke ◽  
Jeonghoon Oh ◽  
Rachel S. Johnson ◽  
Julianne D. Schmidt ◽  
Robert C. Lynall
Keyword(s):  
Dual Task ◽  
Ground Reaction Force ◽  
Injury Risk ◽  
Reaction Force ◽  
Mean Difference ◽  
Biomechanical Analysis ◽  
Vertical Ground Reaction Force ◽  
Functional Movement ◽  
Single Task ◽  
Vertical Ground

Context: Laboratory-based movement assessments are commonly performed without cognitive stimuli (ie, single-task) despite the simultaneous cognitive processing and movement (ie, dual task) demands required during sport. Cognitive loading may critically alter human movement and be an important consideration for truly assessing functional movement and understanding injury risk in the laboratory, but limited investigations exist. Objective: To comprehensively examine and compare kinematics and kinetics between single- and dual-task functional movement among healthy participants while controlling for sex. Design: Cross-sectional study. Setting: Laboratory. Patients (or Other Participants): Forty-one healthy, physically active participants (49% female; 22.5 ± 2.1 y; 172.5 ± 11.9 cm; 71.0 ± 13.7 kg) enrolled in and completed the study. Intervention(s): All participants completed the functional movement protocol under single- and dual-task (subtracting by 6s or 7s) conditions in a randomized order. Participants jumped forward from a 30-cm tall box and performed (1) maximum vertical jump landings and (2) dominant and (3) nondominant leg, single-leg 45° cuts after landing. Main Outcome Measures: The authors used mixed-model analysis of variances (α = .05) to compare peak hip, knee, and ankle joint angles (degrees) and moments (N·m/BW) in the sagittal and frontal planes, and peak vertical ground reaction force (N/BW) and vertical impulse (Ns/BW) between cognitive conditions and sex. Results: Dual-task resulted in greater peak vertical ground reaction force compared with single-task during jump landing (mean difference = 0.06 N/BW; 95% confidence interval [CI], 0.01 to 0.12; P = .025) but less force during dominant leg cutting (mean difference = −0.08 N/BW; 95% CI, −0.14 to −0.02; P = .015). Less hip-flexion torque occurred during dual task than single task (mean difference = −0.09 N/BW; 95% CI, −0.17 to −0.02). No other outcomes were different between single and dual task (P ≥ .053). Conclusions: Slight, but potentially important, kinematic and kinetic differences were observed between single- and dual-task that may have implications for functional movement assessments and injury risk research. More research examining how various cognitive and movement tasks interact to alter functional movement among pathological populations is warranted before clinical implementation.

scholarly journals Comparison of Shod and Unshod Gait in Patients With Parkinson's Disease With Subthalamic and Nigral Stimulation

2022 ◽  
Vol 15 ◽  
Author(s):  
Martin A. Horn ◽  
Alessandro Gulberti ◽  
Ute Hidding ◽  
Christian Gerloff ◽  
Wolfgang Hamel ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Load ◽  
Dual Task ◽  
Step Length ◽  
Gait Disorder ◽  
Double Blind ◽  
Gait Characteristics ◽  
Stn Dbs ◽  
Stimulation Of

Background: The Parkinsonian [i.e., Parkinson's disease (PD)] gait disorder represents a therapeutical challenge with residual symptoms despite the use of deep brain stimulation of the subthalamic nucleus (STN DBS) and medical and rehabilitative strategies. The aim of this study was to assess the effect of different DBS modes as combined stimulation of the STN and substantia nigra (STN+SN DBS) and environmental rehabilitative factors as footwear on gait kinematics.Methods: This single-center, randomized, double-blind, crossover clinical trial assessed shod and unshod gait in patients with PD with medication in different DBS conditions (i.e., STIM OFF, STN DBS, and STN+SN DBS) during different gait tasks (i.e., normal gait, fast gait, and gait during dual task) and compared gait characteristics to healthy controls. Notably, 15 patients participated in the study, and 11 patients were analyzed after a dropout of four patients due to DBS-induced side effects.Results: Gait was modulated by both factors, namely, footwear and DBS mode, in patients with PD. Footwear impacted gait characteristics in patients with PD similarly to controls with longer step length, lower cadence, and shorter single-support time. Interestingly, DBS exerted specific effects depending on gait tasks with increased cognitive load. STN+SN DBS was the most efficient DBS mode compared to STIM OFF and STN DBS with intense effects as step length increment during dual task.Conclusion: The PD gait disorder is a multifactorial symptom, impacted by environmental factors as footwear and modulated by DBS. DBS effects on gait were specific depending on the gait task, with the most obvious effects with STN+SN DBS during gait with increased cognitive load.

scholarly journals A feasibility study of dual-task strategy training to improve gait performance in patients with Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bettina Wollesen ◽  
Silvan Rudnik ◽  
Alessandro Gulberti ◽  
Thomas Cordes ◽  
Christian Gerloff ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Step Length ◽  
Strategy Training ◽  
Walking Distance ◽  
Gait Velocity ◽  
Special Focus ◽  
Gait Performance ◽  
Gait Quality

AbstractGait disorders in patients with Parkinson’s disease (PD) impact their mobility and self-dependence. Gait training and dual-task (DT)-training improve gait quality. This study aims to assess the feasibility of a specific, gradually intensified DT-training for PD patients with a special focus on gait performance under single task (ST) and DT conditions. Correlations to Freezing of Gait (FoG) were examined. 17 PD patients (70.1 ± 7.4 years, H&Y Stadium 2–3, FoG-Q 9.0 ± 5.5) participated in a four-week DT-training (1x/week, 60 min) with progressively increasing task difficulty and number of tasks. Gait performance (spatiotemporal parameters) was assessed during ST and DT conditions. The training improved DT gait performance, especially gait velocity + 0.11 m/s; (F(2,16) = 7.163; p = .0171; η2part = .309) and step length (+ 5.73 cm). Also, physical well-being and absolved walking distance improved significantly. Correlation analyses of the FoG score at baseline with relative change of gait metrics post-training revealed significant correlations with training-induced changes of step length and improvement of gait velocity. Overall, the developed DT-training was feasible and effective. Further studies should examine the long-term benefits and the optimal setting to achieve the highest impact. The study was registered in the DRKS (ID DRKS00018084, 23.1.20).

Effect of osteopathic manipulation on gait asymmetry

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Cherice N. Hill ◽  
M’Lindsey Romero ◽  
Mark Rogers ◽  
Robin M. Queen ◽  
Per Gunnar Brolinson
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Step Length ◽  
Vertical Ground Reaction Force ◽  
Osteopathic Manipulation ◽  
Somatic Dysfunction ◽  
Peak Knee ◽  
Gait Asymmetry ◽  
Stance Time ◽  
Vertical Ground

Abstract Context Movement and loading asymmetry are associated with an increased risk of musculoskeletal injury, disease progression, and suboptimal recovery. Osteopathic structural screening can be utilized to determine areas of somatic dysfunction that could contribute to movement and loading asymmetry. Osteopathic manipulation treatments (OMTs) targeting identified somatic dysfunctions can correct structural asymmetries and malalignment, restoring the ability for proper compensation of stresses throughout the body. Little is currently known about the ability for OMTs to reduce gait asymmetries, thereby reducing the risk of injury, accelerated disease progression, and suboptimal recovery. Objectives To demonstrate whether osteopathic screening and treatment could alter movement and loading asymmetry during treadmill walking. Methods Forty-two healthy adults (20 males, 22 females) between the ages of 18 and 35 were recruited for this prospective intervention. Standardized osteopathic screening exams were completed by a single physician for each participant, and osteopathic manipulation was performed targeting somatic dysfunctions identified in the screening exam. Three-dimensional (3-D) biomechanical assessments, including the collection of motion capture and force plate data, were performed prior to and following osteopathic manipulation to quantify gait mechanics. Motion capture and loading data were processed utilizing Qualisys Track Manager and Visual 3D software, respectively. Asymmetry in the following temporal, kinetic, and kinematic measures was quantified utilizing a limb symmetry index (LSI): peak vertical ground reaction force, the impulse of the vertical ground reaction force, peak knee flexion angle, step length, stride length, and stance time. A 2-way repeated-measures analysis of variance model was utilized to evaluate the effects of time (pre/post manipulation) and sex (male/female) on each measure of gait asymmetry. Results Gait asymmetry in the peak vertical ground reaction force (−0.6%, p=0.025) and the impulse of the vertical ground reaction force (−0.3%, p=0.026) was reduced in males following osteopathic manipulation. There was no difference in gait asymmetry between time points in females. Osteopathic manipulation did not impact asymmetry in peak knee flexion angle, step length, stride length, or stance time. Among the participants, 59.5% (25) followed the common compensatory pattern, whereas 40.5% (17) followed the uncommon compensatory pattern. One third (33.3%, 14) of the participants showed decompensation at the occipitoatlantal (OA) junction, whereas 26.2% (11), one third (33.3%, 14), and 26.2% (11) showed decompensation at the cervicothoracic (CT), thoracolumbar (TL), and lumbosacral (LS) junctions, respectively. Somatic dysfunction at the sacrum, L5, right innominate, and left innominate occurred in 88.1% (37), 69.0% (29), 97.6% (41), and 97.6% (41) of the participants, respectively. Conclusions Correcting somatic dysfunction can influence gait asymmetry in males; the sex-specificity of the observed effects of osteopathic manipulation on gait asymmetry is worthy of further investigation. Osteopathic structural examinations and treatment of somatic dysfunctions may improve gait symmetry even in asymptomatic individuals. These findings encourage larger-scale investigations on the use of OMT to optimize gait, prevent injury and the progression of disease, and aid in recovery after surgery.

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