scholarly journals Assessment of Functional Activities in Individuals with Parkinson’s Disease Using a Simple and Reliable Smartphone-Based Procedure

Author(s):  
Pilar Serra-Añó ◽  
José Francisco Pedrero-Sánchez ◽  
Marta Inglés ◽  
Marta Aguilar-Rodríguez ◽  
Ismael Vargas-Villanueva ◽  
...  

Parkinson’s disease (PD) is a progressive neurodegenerative disorder leading to functional impairment. In order to monitor the progression of the disease and to implement individualized therapeutic approaches, functional assessments are paramount. The aim of this study was to determine the impact of PD on balance, gait, turn-to-sit and sit-to-stand by means of a single short-duration reliable test using a single inertial measurement unit embedded in a smartphone device. Study participants included 29 individuals with mild-to moderate PD (PG) and 31 age-matched healthy counterparts (CG). Functional assessment with FallSkip® included postural control (i.e., Medial-Lateral (ML) and Anterior-Posterior (AP) displacements), gait (Vertical (V) and Medial-Lateral (ML) ranges), turn-to-sit (time) and sit-to-stand (power) tests, total time and gait reaction time. Our results disclosed a reliable procedure (intra-class correlation coefficient (ICC) = 0.58–0.92). PG displayed significantly larger ML and AP displacements during the postural test, a decrease in ML range while walking and a longer time needed to perform the turn-to-sit task than CG (p < 0.05). No differences between groups were found for V range, sit-to-stand test, total time and reaction time (p > 0.05). In conclusion, people with mild-to-moderate PD exhibit impaired postural control, altered gait strategy and slower turn-to-sit performance than age-matched healthy people.

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 314
Author(s):  
Aida Arroyo-Ferrer ◽  
Francisco José Sánchez-Cuesta ◽  
Yeray González-Zamorano ◽  
María Dolores del Castillo ◽  
Carolina Sastre-Barrios ◽  
...  

Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder. This disease is characterized by motor symptoms, such as bradykinesia, tremor, and rigidity. Although balance impairment is characteristic of advanced stages, it can be present with less intensity since the beginning of the disease. Approximately 60% of PD patients fall once a year and 40% recurrently. On the other hand, cognitive symptoms affect up to 20% of patients with PD in early stages and can even precede the onset of motor symptoms. There are cognitive requirements for balance and can be challenged when attention is diverted or reduced, linking a worse balance and a higher probability of falls with a slower cognitive processing speed and attentional problems. Cognitive rehabilitation of attention and processing speed can lead to an improvement in postural stability in patients with Parkinson’s. Methods: We present a parallel and controlled randomized clinical trial (RCT) to assess the impact on balance of a protocol based on cognitive rehabilitation focused on sustained attention through the NeuronUP platform (Neuronup SI, La Rioja, Spain) in patients with PD. For 4 weeks, patients in the experimental group will receive cognitive therapy three days a week while the control group will not receive any therapy. The protocol has been registered at trials.gov NCT04730466. Conclusions: Cognitive therapy efficacy on balance improvement may open the possibility of new rehabilitation strategies for prevention of falls in PD, reducing morbidity, and saving costs to the health care system.


2021 ◽  
Vol 57 (2) ◽  
pp. 177-183
Author(s):  
Seong Hyun Moon ◽  
◽  
Rahul Soangra ◽  
Christopher F. Frames ◽  
Thurmon E. Lockhart ◽  
...  

Parkinson’s Disease (PD) is a neurodegenerative disorder affecting the substantia nigra, which leads to more than half of PD patients are considered to be at high risk of falling. Recently, Inertial Measurement Unit (IMU) sensors have shown great promise in the classification of activities of daily living (ADL) such as walking, standing, sitting, and laying down, considered to be normal movement in daily life. Measuring physical activity level from longitudinal ADL monitoring among PD patients could provide insights into their fall mechanisms. In this study, six PD patients (mean age=74.3±6.5 years) and six young healthy subjects (mean age=19.7±2.7 years) were recruited. All the subjects were asked to wear the single accelerometer, DynaPort MM+ (Motion Monitor+, McRoberts BV, The Hague, Netherlands), with a sampling frequency of 100 Hz located at the L5-S1 spinal area for 3 days. Subjects maintained a log of activities they performed and only removed the sensor while showering or performing other aquatic activities. The resultant acceleration was filtered using high and low pass Butterworth filters to determine dynamic and stationary activities. As a result, it was found that healthy young subjects performed significantly more dynamic activities (13.2%) when compared to PD subjects (7%), in contrast, PD subjects (92.9%) had significantly more stationary activities than young healthy subjects (86.8%).


2020 ◽  
Vol 21 (10) ◽  
pp. 3459 ◽  
Author(s):  
Sandra Barata-Antunes ◽  
Fábio G. Teixeira ◽  
Bárbara Mendes-Pinheiro ◽  
Ana V. Domingues ◽  
Helena Vilaça-Faria ◽  
...  

Parkinson’s disease (PD) is the second most common age-related neurodegenerative disorder. The neurodegeneration leading to incapacitating motor abnormalities mainly occurs in the nigrostriatal pathway due to the loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc). Several animal models have been developed not only to better understand the mechanisms underlying neurodegeneration but also to test the potential of emerging disease-modifying therapies. However, despite aging being the main risk factor for developing idiopathic PD, most of the studies do not use aged animals. Therefore, this study aimed at assessing the effect of aging in the unilateral 6-hydroxydopamine (6-OHDA)-induced animal model of PD. For this, female young adult and aged rats received a unilateral injection of 6-OHDA into the medial forebrain bundle. Subsequently, the impact of aging on 6-OHDA-induced effects on animal welfare, motor performance, and nigrostriatal integrity were assessed. The results showed that aging had a negative impact on animal welfare after surgery. Furthermore, 6-OHDA-induced impairments on skilled motor function were significantly higher in aged rats when compared with their younger counterparts. Nigrostriatal histological analysis further revealed an increased 6-OHDA-induced dopaminergic cell loss in the SNpc of aged animals when compared to young animals. Overall, our results demonstrate a higher susceptibility of aged animals to 6-OHDA toxic insult.


Biology ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1183
Author(s):  
Sheelu Monga ◽  
Nunzio Denora ◽  
Valentino Laquintana ◽  
Rami Yashaev ◽  
Abraham Weizman ◽  
...  

Parkinson’s disease (PD) is a progressive neurodegenerative disorder which is characterized by the degeneration of dopaminergic neurons in substantia nigra (SN). Oxidative stress or reactive oxygen species (ROS) generation was suggested to play a role in this specific type of neurodegeneration. Therapeutic options which can target and counteract ROS generation may be of benefit. TSPO ligands are known to counteract with neuro-inflammation, ROS generation, apoptosis, and necrosis. In the current study, we investigated an in vitro cellular PD model by the assessment of 6-hydroxydopamine (6-OHDA, 80 µM)-induced PC12 neurotoxicity. Simultaneously to the exposure of the cells to 6-OHDA, we added the TSPO ligands CB86 and CB204 (25 µM each) and assessed the impact on several markers of cell death. The two ligands normalized significantly (57% and 52% respectively, from 44%; whereas the control was 68%) cell proliferation at different time points from 0–24 h. Additionally, we evaluated the effect of these two TSPO ligands on necrosis using propidium iodide (PI) staining and found that the ligands inhibited significantly the 6-OHDA-induced necrosis. As compared to control, the red count was increased up to 57-fold whereas CB86 and CB204 inhibited to 2.7-fold and 3.2-fold respectively. Necrosis was also analyzed by LDH assay which showed significant effect. Both assays demonstrated similar potent anti-necrotic effect of the two TSPO ligands. Reactive oxygen species (ROS) generation induced by 6-OHDA was also inhibited by the two TSPO ligand up to 1.3 and 1.5-fold respectively, as compared to 6-OHDA group. CB86 and CB204 inhibited also normalized the cell viability up to 1.8-fold after the exposure to 6-OHDA, as assessed by XTT assay. The two TSPO ligands also inhibited apoptosis significantly (1.3-fold for both) as assessed by apopxin green staining. In summary, it appears that the two TSPO ligands CB86 and CB204 can suppress cell death of PC12 induced by 6-OHDA. The results may be relevant to the use of these two TSPO ligands as therapeutic option neurodegenerative diseases like PD.


2019 ◽  
Vol 24 (5) ◽  
pp. 317-327 ◽  
Author(s):  
Ayu Dekawaty ◽  
Hema Malini ◽  
Feri Fernandes

Background Parkinson's disease is a chronic progressive neurodegenerative disorder with unpredictable symptoms, which leads to stress for individuals caring for their family members. Most patients with Parkinson's disease in Indonesia are cared for by family members. Their treatment requires continuous supervision and a great deal of attention. Aims Accordingly, this research explores caregivers' experiences in caring for family members with Parkinson's disease. Methods This study is qualitative with a phenomenological design. Participants, selected via a purposive sampling technique, were individuals caring for and living with family members suffering from Parkinson's disease. The data were analysed using the Colaizzi approach. Results This research identified four themes: the ways in which members of the family adapt; the impact of the patient's condition on the caregiver; support received in providing care; and the cultural and spiritual meanings the caregiver obtained when providing care. Conclusion This study uncovered several aspects that contribute to the understanding of the life of family members as caregivers for Parkinson's disease patients. This research also found there is still limited psychosocial support from health workers, so it is necessary for them to be more proactive in providing support for family members who care for patients with Parkinson's disease.


Author(s):  
Yoan Espinoza-Valdés ◽  
Rocio Córdova-Arellano ◽  
Maiter Espinoza-Espinoza ◽  
Diego Méndez-Alfaro ◽  
Juan Pablo Bustamante-Aguirre ◽  
...  

Parkinson’s disease (PD) is a neurodegenerative disorder that affects postural and cardiac autonomic control. However, since it is unknown whether these changes are associated, the objective of this study was to determine whether such a relationship exists. Twenty-three patients with PD participated. The RR intervals were recorded in different positions and heart rate variability (HRV) was analyzed. Postural sway was analyzed based on the center of pressure. No significant differences on HRV indices were induced by postural change. A correlation was found between these indices and postural control, high frequency (HF), and anterior-posterior (AP) root mean square (RMS-AP) (r = 0.422, p = 0.045), low frequency (LF)/HF, and AP mean velocity (r = 0.478, p = 0.021). A correlation was found between HRV induced by postural change and postural control, Δ LF/HF and RMS-AP (r = 0.448, p = 0.032), Δ LF/HF and ellipse area (r = 0.505, p = 0.014), Δ LF/HF and AP mean velocity (r = −0.531; p = 0.009), and Δ LF and AP mean velocity (r = −0.424, p = 0.044). There is an association between the autonomic and postural systems, such that PD patients with blunted cardiac autonomic function in both the supine and orthostatic positions have worse postural control.


Author(s):  
Giuseppe Cosentino ◽  
Micol Avenali ◽  
Antonio Schindler ◽  
Nicole Pizzorni ◽  
Cristina Montomoli ◽  
...  

Abstract Background Parkinson’s disease (PD) is a neurodegenerative disorder characterized by a combination of motor and non-motor dysfunction. Dysphagia is a common symptom in PD, though it is still too frequently underdiagnosed. Consensus is lacking on screening, diagnosis, and prognosis of dysphagia in PD. Objective To systematically review the literature and to define consensus statements on the screening and the diagnosis of dysphagia in PD, as well as on the impact of dysphagia on the prognosis and quality of life (QoL) of PD patients. Methods A multinational group of experts in the field of neurogenic dysphagia and/or PD conducted a systematic revision of the literature published since January 1990 to February 2021 and reported the results according to PRISMA guidelines. The output of the research was then analyzed and discussed in a consensus conference convened in Pavia, Italy, where the consensus statements were drafted. The final version of statements was subsequently achieved by e-mail consensus. Results Eighty-five papers were used to inform the Panel’s statements even though most of them were of Class IV quality. The statements tackled four main areas: (1) screening of dysphagia: timing and tools; (2) diagnosis of dysphagia: clinical and instrumental detection, severity assessment; (3) dysphagia and QoL: impact and assessment; (4) prognostic value of dysphagia; impact on the outcome and role of associated conditions. Conclusions The statements elaborated by the Consensus Panel provide a framework to guide the neurologist in the timely detection and accurate diagnosis of dysphagia in PD.


2021 ◽  
Author(s):  
Eftychia Vasili ◽  
Antonio Dominguez-Meijide ◽  
Manuel Flores-León ◽  
Mohammed Al-Azzani ◽  
Angeliki Kanellidi ◽  
...  

Abstract Background Parkinson's disease is a progressive neurodegenerative disorder characterized by the accumulation of misfolded alpha-synuclein in intraneuronal inclusions known as Lewy bodies and Lewy neurites. Multiple studies strongly implicate the levels of alpha-synuclein as a major risk factor for the onset and progression of Parkinson’s disease. alpha-Synuclein pathology spreads progressively throughout interconnected brain regions but the precise molecular mechanisms underlying alpha-synuclein spreading and accumulation remain obscure. Methods Here, using stable cell lines expressing alpha-synuclein, we examined the correlation between endogenous alpha-synuclein levels and the seeding propensity by exogenous alpha-synuclein pre-formed fibrils. We applied biochemical approaches and imaging methods in stable cell lines expressing alpha-synuclein and in primary neurons to determine the impact of alpha-synuclein expression levels on seeding and aggregation. Results Our results indicate that alpha-synuclein levels define the pattern and severity of aggregation and the extent of p-alpha-synuclein deposition, likely explaining the selective vulnerability of different cell types in synucleinopathies. Conclusions The elucidation of the cellular processes involved in the pathological aggregation of alpha-synuclein will enable the identification of novel targets and the development of therapeutic strategies for Parkinson's disease and other synucleinopathies.


Geriatrics ◽  
2021 ◽  
Vol 6 (4) ◽  
pp. 105
Author(s):  
Mathieu Dallaire ◽  
Guillaume Gagnon ◽  
Émilie Fortin ◽  
Josée Nepton ◽  
Anne-France Severn ◽  
...  

Introduction: Parkinson’s disease is most prevalent among elderly people, 65 years and over, and leads to an alteration in motor control associated with postural instability. Current evidence shows that postural control decreases with the aging process. In addition, postural control is more altered in healthy aged men than in women. Until today, few studies have evaluated the combined impact of Parkinson’s disease and sex on postural control. This review has allowed to evaluate the impact of Parkinson’s disease and sex on postural control measurements in elderly people. Methodology: Studies have been selected from two main databases: PubMed and EBSCO using the keywords “Parkinson”, “postural control OR balance” and “sex”. Articles related to the evaluation of postural control, including men and women with Parkinson’s aged over 65 years old, regardless of stage, were included (n = 179). Articles were excluded if not written in French or English or not presenting original content. Results: Ten (10) studies out of 179 that fulfilled inclusion and exclusion criteria were reported in the final analysis, which cumulates a total of 944 individuals with Parkinson’s (410 women). In general, results show greater postural instability among people with Parkinson’s compared to healthy subjects, and this according to different objective measurements using stabilographic parameters from force platforms. Only two studies out of ten evaluated postural control while briefly considering distinctions between sex, but without showing a significant difference between men and women with Parkinson’s. Parkinson’s severity, length of time of Parkinson’s disease and cognitive state of the person are the three variables with a negative impact on postural control. Conclusion: Older people with Parkinson’s disease have greater postural instability. Sex does not seem to influence the postural control of elderly people with Parkinson’s, although more studies are necessary.


2021 ◽  
Vol 18 (5) ◽  
pp. 6995-7009
Author(s):  
Leandro Donisi ◽  
◽  
Giuseppe Cesarelli ◽  
Pietro Balbi ◽  
Vincenzo Provitera ◽  
...  

<abstract> <p>Parkinson's disease is the second most common neurodegenerative disorder in the world. Assumed that gait dysfunctions represent a major motor symptom for the pathology, gait analysis can provide clinicians quantitative information about the rehabilitation outcome of patients. In this scenario, wearable inertial systems for gait analysis can be a valid tool to assess the functional recovery of patients in an automatic and quantitative way, helping clinicians in decision making. Aim of the study is to evaluate the impact of the short-term rehabilitation on gait and balance of patients with Parkinson's disease. A cohort of 12 patients with Idiopathic Parkinson's disease performed a gait analysis session instrumented by a wearable inertial system for gait analysis: Opal System, by APDM Inc., with spatial and temporal parameters being analyzed through a statistic and machine learning approach. Six out of fourteen motion parameters exhibited a statistically significant difference between the measurements at admission and at discharge of the patients, while the machine learning analysis confirmed the separability of the two phases in terms of Accuracy and Area under the Receiving Operating Characteristic Curve. The rehabilitation treatment especially improved the motion parameters related to the gait. The study shows the positive impact on the gait of a short-term rehabilitation in patients with Parkinson's disease and the feasibility of the wearable inertial devices, that are increasingly spreading in clinical practice, to quantitatively assess the gait improvement.</p> </abstract>


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