Using a Portable Gait Rhythmogram to Examine the Effect of Music Therapy on Parkinson’s Disease-Related Gait Disturbance

External cues improve walking by evoking internal rhythm formation related to gait in the brain in patients with Parkinson’s disease (PD). This study examined the usefulness of using a portable gait rhythmogram (PGR) in music therapy on PD-related gait disturbance. A total of 19 subjects with PD who exhibited gait disturbance were evaluated for gait speed and step length during a 10 m straight walking task. Moreover, acceleration, cadence, and trajectory of the center of the body were estimated using a PGR. Walking tasks were created while incorporating music intervention that gradually increased in tempo from 90 to 120 beats per minute (BPM). We then evaluated whether immediate improvement in gait could be recognized even without music after walking tasks by comparing pre- (pre-MT) and post-music therapy (post-MT) values. Post-MT gait showed significant improvement in acceleration, gait speed, cadence, and step length. During transitions throughout the walking tasks, acceleration, gait speed, cadence, and step length gradually increased in tasks with music. With regard to the trajectory of the center of the body, we recognized a reduction in post-MT medio-lateral amplitude. Music therapy immediately improved gait disturbance in patients with PD, and the effectiveness was objectively shown using PGR.

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Gait characteristics in individuals with Parkinson’s disease during 1-minute treadmill walking

PeerJ ◽

10.7717/peerj.9463 ◽

2020 ◽

Vol 8 ◽

pp. e9463

Author(s):

Byungjoo Noh ◽

Changhong Youm ◽

Myeounggon Lee ◽

Sang-Myung Cheon

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gait Speed ◽

Step Length ◽

Treadmill Walking ◽

Measurement Unit ◽

Gait Characteristics ◽

Age Related ◽

Axial Acceleration ◽

Spatiotemporal Parameters

Background No previous study has examined the age-dependent characteristics of gait in individuals between 50 and 79 years simultaneously in healthy individuals and individuals with Parkinson’s disease (PD) over continuous gait cycles. This study aimed to investigate age-related differences in gait characteristics on individuals age ranged 50–79 years, including individuals with PD, during a 1-minute treadmill walking session. Additionally, we aimed to investigate the differences associated with spatiotemporal gait parameters and PD compared in age-matched individuals. Methods This study included 26 individuals with PD and 90 participants age ranged 50–79 years. The treadmill walking test at a self-preferred speed was performed for 1 min. The embedded inertial measurement unit sensor in the left and right outsoles-based system was used to collect gait characteristics based on tri-axial acceleration and tri-axial angular velocities. Results Participants aged >60 years had a decreased gait speed and shortened stride and step, which may demonstrate a distinct shift in aging (all p < 0.005). Individuals with PD showed more of a decrease in variables with a loss of consistency, including gait asymmetry (GA), phase coordination index (PCI) and coefficient of variation (CV) of all variables, than age-matched individuals (all p < 0.001). Gait speed, stride and step length, stance phase, variability, GA and PCI were the variables that highly depended on age and PD. Discussion Older adults could be considered those older than 60 years of age when gait alterations begin, such as a decreased gait speed as well as shortened stride and step length. On the other hand, a loss of consistency in spatiotemporal parameters and a higher GA and PCI could be used to identify individuals with PD. Thus, the CV of all spatiotemporal parameters, GA and PCI during walking could play an important role and be useful in identifying individuals with PD. Conclusion This study provided the notable aging pattern characteristics of gait in individuals >50 years, including individuals with PD. Increasing age after 60 years is associated with deterioration in spatiotemporal parameters of gait during continuous 1-minute treadmill walking. Additionally, GA, PCI and the CV of all variables could be used to identify PD which would be placed after 70 years of age. It may be useful to determine the decline of gait performance in general and among individuals with PD.

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Plantarflexor strength, gait speed, and step length change in individuals with Parkinson’s disease

International Journal of Rehabilitation Research ◽

10.1097/mrr.0000000000000439 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Staci M. Shearin ◽

Ann Medley ◽

Elaine Trudelle-Jackson ◽

Chad Swank ◽

Ross Querry

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gait Speed ◽

Length Change ◽

Step Length

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Fractionally delineate the neuroprotective function of calbindin-D28k in Parkinson’s disease

International Journal of Biomathematics ◽

10.1142/s1793524518501036 ◽

2018 ◽

Vol 11 (08) ◽

pp. 1850103 ◽

Cited By ~ 5

Author(s):

Hardik Joshi ◽

Brajesh Kumar Jha

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dimensional Space ◽

Cytosolic Calcium ◽

The Body ◽

Dopamine Neurons ◽

Reaction Diffusion Equation ◽

Substantia Nigra Pars Compacta ◽

Brain Disorder ◽

The Brain

Neuron is a fundamental unit of the brain, which is specialized to transmit information throughout the body through electrical and chemical signals. Calcium ([Formula: see text]) ions are known as second messengers which play important roles in the movement of the neurotransmitter. Calbindin-[Formula: see text] is a [Formula: see text] binding protein which is involved in regulation of intracellular [Formula: see text] ions and maintains [Formula: see text] homeostasis level, it also alters the cytosolic calcium concentration ([[Formula: see text]]) in nerve cells to keep the cell alive. Parkinson’s disease (PD) is a chronic progressive neurodegenerative brain disorder of the nervous system. Several regions of the brain indicate the hallmark of the PD. The symptoms of PD are plainly linked with the degeneration and death of dopamine neurons in the substantia nigra pars compacta located in midbrain which is accompanied by depletion in calbindin-[Formula: see text]. In the present paper, the neuroprotective role of calbindin-[Formula: see text] in the cytoplasmic [[Formula: see text]] distribution is studied. The elicitation in [[Formula: see text]] is due to the presence of low amount of calbindin-[Formula: see text] which can be portrayed and is a hallmark of PD. A one-dimensional space time fractional reaction diffusion equation is designed by keeping in mind the physiological condition taking place inside Parkinson’s brain. Computational results are performed in MATLAB.

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Influence of Autocorrelated Rhythmic Auditory Stimulations on Parkinson’s Disease Gait Variability: Comparison With Other Auditory Rhythm Variabilities and Perspectives

Frontiers in Physiology ◽

10.3389/fphys.2020.601721 ◽

2020 ◽

Vol 11 ◽

Author(s):

Alexis Lheureux ◽

Thibault Warlop ◽

Charline Cambier ◽

Baptiste Chemin ◽

Gaëtan Stoquart ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Long Range ◽

Coefficient Of Variation ◽

Gait Speed ◽

Step Length ◽

Temporal Organization ◽

Fluctuation Analysis ◽

Gait Parameters ◽

Stride Duration

Parkinson’s Disease patients suffer from gait impairments such as reduced gait speed, shortened step length, and deterioration of the temporal organization of stride duration variability (i.e., breakdown in Long-Range Autocorrelations). The aim of this study was to compare the effects on Parkinson’s Disease patients’ gait of three Rhythmic Auditory Stimulations (RAS), each structured with a different rhythm variability (isochronous, random, and autocorrelated). Nine Parkinson’s Disease patients performed four walking conditions of 10–15 min each: Control Condition (CC), Isochronous RAS (IRAS), Random RAS (RRAS), and Autocorrelated RAS (ARAS). Accelerometers were used to assess gait speed, cadence, step length, temporal organization (i.e., Long-Range Autocorrelations computation), and magnitude (i.e., coefficient of variation) of stride duration variability on 512 gait cycles. Long-Range Autocorrelations were assessed using the evenly spaced averaged Detrended Fluctuation Analysis (α-DFA exponent). Spatiotemporal gait parameters and coefficient of variation were not modified by the RAS. Long-Range Autocorrelations were present in all patients during CC and ARAS although all RAS conditions altered them. The α-DFA exponents were significantly lower during IRAS and RRAS than during CC, exhibiting anti-correlations during IRAS in seven patients. α-DFA during ARAS was the closest to the α-DFA during CC and within normative data of healthy subjects. In conclusion, Isochronous RAS modify patients’ Long-Range Autocorrelations and the use of Autocorrelated RAS allows to maintain an acceptable level of Long-Range Autocorrelations for Parkinson’s Disease patients’ gait.

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TLR2 and TLR4 in Parkinson’s disease pathogenesis: the environment takes a toll on the gut

Translational Neurodegeneration ◽

10.1186/s40035-021-00271-0 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Anastazja M. Gorecki ◽

Chidozie C. Anyaegbu ◽

Ryan S. Anderton

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Nervous System ◽

Intestinal Barrier ◽

The Body ◽

Enteric Neurons ◽

Gut Dysfunction ◽

Gut Homeostasis ◽

The Brain

AbstractParkinson’s disease (PD) is an incurable, devastating disorder that is characterized by pathological protein aggregation and neurodegeneration in the substantia nigra. In recent years, growing evidence has implicated the gut environment and the gut-brain axis in the pathogenesis and progression of PD, especially in a subset of people who exhibit prodromal gastrointestinal dysfunction. Specifically, perturbations of gut homeostasis are hypothesized to contribute to α-synuclein aggregation in enteric neurons, which may spread to the brain over decades and eventually result in the characteristic central nervous system manifestations of PD, including neurodegeneration and motor impairments. However, the mechanisms linking gut disturbances and α-synuclein aggregation are still unclear. A plethora of research indicates that toll-like receptors (TLRs), especially TLR2 and TLR4, are critical mediators of gut homeostasis. Alongside their established role in innate immunity throughout the body, studies are increasingly demonstrating that TLR2 and TLR4 signalling shapes the development and function of the gut and the enteric nervous system. Notably, TLR2 and TLR4 are dysregulated in patients with PD, and may thus be central to early gut dysfunction in PD. To better understand the putative contribution of intestinal TLR2 and TLR4 dysfunction to early α-synuclein aggregation and PD, we critically discuss the role of TLR2 and TLR4 in normal gut function as well as evidence for altered TLR2 and TLR4 signalling in PD, by reviewing clinical, animal model and in vitro research. Growing evidence on the immunological aetiology of α-synuclein aggregation is also discussed, with a focus on the interactions of α-synuclein with TLR2 and TLR4. We propose a conceptual model of PD pathogenesis in which microbial dysbiosis alters the permeability of the intestinal barrier as well as TLR2 and TLR4 signalling, ultimately leading to a positive feedback loop of chronic gut dysfunction promoting α-synuclein aggregation in enteric and vagal neurons. In turn, α-synuclein aggregates may then migrate to the brain via peripheral nerves, such as the vagal nerve, to contribute to neuroinflammation and neurodegeneration typically associated with PD.

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MICROBIOTA INTESTINAL RELACIONADA A DOENÇA DE PARKINSON

Revista Ensaios Pioneiros ◽

10.24933/rep.v5i1.235 ◽

2021 ◽

Vol 5 (1) ◽

pp. 49-60

Author(s):

Caroline Felix da Silva ◽

Graziele Estevo Azevedo ◽

Natália Franco Taketani

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gastrointestinal Tract ◽

Intestinal Microbiota ◽

Direct Relationship ◽

Progressive Disease ◽

Signs And Symptoms ◽

The Body ◽

Early Age ◽

The Brain

RESUMO. A Doença de Parkinson é uma doença crônica, neurodegenerativa e progressiva onde não tem cura. Ainda há muitas investigações para se descobrir a causa da patologia. Em estudos recentes descobriram que pode ter uma relação direta com intestino, com a possibilidade de origem na microbiota intestinal e espalhando-se até o cérebro, com relação a uma desregulação no trato gastrointestinal. É reconhecido que, antes de aparecer os sinais e sintomas motores da doença, o organismo começa a sofrer alterações desde cedo, como a constipação intestinal, com o fortalecimento da hipótese de que a doença de Parkinson tenha início no trato gastrointestinal, e chegue até o cérebro através do nervo vago. Este trabalho pretende abordar sobre a microbiota intestinal e a sua conexão com a doença de Parkinson fazendo revisão de estudos e evidência de como sua composição no hospedeiro pode influenciar o seu metabolismo. A modulação da microbiota intestinal poderá, então, ser uma estratégia para o desenvolvimento de novas opções terapêuticas para o tratamento de doenças neurodegenerativas. ABSTRACT. Parkinson's Disease is a chronic, neurodegenerative and progressive disease that has no cure. There are still many investigations to discover the cause of the pathology. In recent studies they found that it may have a direct relationship with the intestine, with the possibility of originating in the intestinal microbiota and spreading to the brain, with respect to dysregulation in the gastrointestinal tract. It is recognized that, before the appearance of the motor signs and symptoms of the disease, the body begins to undergo changes from an early age, such as intestinal constipation, with the strengthening of the hypothesis that Parkinson's disease starts in the gastrointestinal tract and reaches the brain through the vagus nerve. This work intends to approach the intestinal microbiota and its connection with Parkinson's disease, reviewing studies and evidence on how its composition in the host can influence its metabolism. The modulation of the intestinal microbiota could then be a strategy for the development of new therapeutic options for the treatment of neurodegenerative diseases.

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Which Drug for Parkinsonism? Walking, Stiffness, Tremor, and Slowness

Dementia with Lewy Body and Parkinson's Disease Patients ◽

10.1093/oso/9780199977567.003.0011 ◽

2013 ◽

Author(s):

J. Eric Ahlskog

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Basal Ganglia ◽

Substantia Nigra ◽

The Body ◽

Brain Dopamine ◽

Arm Swing ◽

Repetitive Movements ◽

The Brain ◽

Repetitive Motor

In Chapters 1 and 4, we briefly summarized the symptoms of parkinsonism. Parkinsonism implies movement problems that are typical of Parkinson’s disease. They remain treatment issues during the lifetime of people with Parkinson’s disease, even if dementia develops. Similarly, parkinsonism also typically occurs in DLB, although to variable degrees. In these disorders parkinsonism primarily reflects low brain dopamine levels and improves with dopamine replacement therapy, often markedly. Parkinsonism occurs when a region of the brain called the basal ganglia ceases to work properly (see Figure 4.2 in Chapter 4). As discussed in Chapter 4, the substantia nigra is a crucial regulator of basal ganglia activity, which is mediated by dopamine release in the striatum. The substantia nigra degenerates in these Lewy disorders and, as a result, brain dopamine declines. With a decline in dopamine, movement slows. Bradykinesia is the medical term for such slowness. This manifests as not only slowed movement but also less movement and smaller than normal movements. Unconscious automatic movements, such as blinking or arm swing, diminish. A unique tremor of the hands (sometimes legs) often develops when these limbs are in a relaxed position (rest tremor). For unknown reasons, the brain is not affected symmetrically, hence, neither is the body. Typically, one side of the body is much more impaired than the other. The extent to which these symptoms develop differs from person to person and includes various combinations of the following components. The slowness may be apparent on one or both sides of the body. For example, one leg may lag behind when walking. The overall appearance is characterized by moving much slower than expected for one’s age. The person feels as if they are moving in molasses—everything slows down. Many of our daily activities involve repeated small movements, such as writing or brushing teeth. In the Lewy conditions of DLB and PDD, the size (amplitude) of repetitive movements diminishes, impairing the activity. This is exemplified by the small handwriting of someone with parkinsonism, termed micrographia. Clinicians assess repetitive motor function by asking the patient to repetitively tap the thumb and index finger.

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Effects of a Multidisciplinary Intervention on Daily-Living Gait Among Older Adults With Parkinson’s Disease

Innovation in Aging ◽

10.1093/geroni/igaa057.746 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 231-231

Author(s):

Jeffrey Hausdorff ◽

Moriya Cohen ◽

Natalie Ganz ◽

Yitchak Green ◽

Inbal Badichi ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gait Speed ◽

Daily Living ◽

Step Length ◽

Rehabilitation Program ◽

Adverse Outcomes ◽

Time Variability ◽

Walking Gait ◽

Gait Quality

Abstract Multidisciplinary interventions can improve gait and balance in patients with Parkinson’s disease (PD). However, it is not yet known if these interventions also positively impact the quality of daily-living walking. We, therefore, examined the effects of a multidisciplinary, intensive out-patient rehabilitation program (MIOR) as delivered by the rehabilitation center of EZRA–LEMARPE organization on gait and balance as measured in the clinic and on every-day walking, as measured during 1-week of continuous measurement. 46 PD patients (age: 70.05±7.71; gender: 31.3% women; disease duration: 8.85±6.27 yrs) were evaluated before and after participating in 8-weeks of physical, occupational, and hydro-therapy, boxing, and dance (3 days/week; 5 hrs/day). After the intervention, clinical measures of balance (MiniBest Test of Balance delta: 1.82±3.30 points, p=0.001), mobility (TUG delta: -1.78±6.15sec; p=0.001), and usual-walking speed (delta 19±16cm/s; p<0.001) improved. Daily-living step counts and daily-living gait quality did not change (p>0.5). In exploratory analyses, subjects were categorized as responders (Rs) and non-responders (NRs) based on changes in their daily-living walking gait speed. Rs increased their daily-living gait speed (delta: 10±14cm/s; p<0.001); NRs did not. Rs (n=21) also improved their daily-living gait quality measures (e.g. stride regularity, step length, stride time variability). At baseline, disease severity (MDS-UPDRSIII) was lower (p=0.02) in Rs (25.33±11.47), compared to the NRs (34.38±14.27). These results demonstrate that improvements in the clinic do not necessarily transfer to improvements in daily-living gait. Further, in select patients, MIOR can ameliorate daily-living walking quality, potentially reducing the risk of falls and other adverse outcomes associated with impaired mobility.

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Physical therapy of the early non-motorized violations to slow the progression of Parkinson's disease

Likarska sprava ◽

10.31640/jvd.1-2.2019(17) ◽

2019 ◽

pp. 117-120

Author(s):

А. I. Labinskiy ◽

G. B. Labinska

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Physical Therapy ◽

The Body ◽

Motor Symptoms ◽

Physical Treatment ◽

Treatment Regimens ◽

Objective State ◽

Non Motor Symptoms ◽

The Brain

The authors developed and applied the original complex of innovative combined physical therapy of non-motor manifestations of the early stages of Parkinson's disease to slow its progression. Applied concomitant treatments affect some parts of the etiology and pathogenesis of non-motor manifestations of Parkinson's disease. In particular, hirudotherapy restores the rheological properties of blood without side effects characteristic of known anticoagulants; helps to restore tissue trophism, in particular the brain. Nutritional correction prevents the development of digestive disorders. The main principles of such nutrition were: 1. The role of antioxidant saturation of the diet for the correction of metabolism. 2. The value of increasing the number of "ballasts" in the diet. 3. "Free mode" of food intake (at the request of the organism), taking into account the human biorhythms (daily, seasonal and psychological). 4. The need for periodic short-term fasting - as a method of cleansing the body. 5. The need for separate power. Manual therapy in the variant proposed by the authors prevents the vertebral component of the destructive processes in the brain. After the use of combined physical therapy, an improvement in the objective state of patients with Parkinson's disease was noted. According to the study, non-motor symptoms on the scale of autonomic disorders and non-motor symptoms (NMSS) were statistically significantly less pronounced in all patients examined in the group of patients using the developed complex of physical therapy compared to the group of patients without using the developed complex of physical therapy. Considering the improvement of the objective state of patients after the applied physical treatment, we can recommend the indicated therapeutic technique for the complex treatment of early non-motor manifestations of Parkinson's disease, slowing its progression and improving the effectiveness of existing modern treatment regimens of the studied pathology.

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The Effects of Metronome Frequency Differentially Affects Gait on a Treadmill and Overground in People with Parkinson’s Disease

10.1101/19003251 ◽

2019 ◽

Author(s):

Madelon Wygand ◽

Guneet Chawla ◽

Nina Browner ◽

Michael D Lewek

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gait Speed ◽

Repeated Measures ◽

Step Length ◽

Yahr Stage ◽

Gait Parameters ◽

Walking Environment ◽

Stage 1 ◽

Walking Speeds

AbstractObjectiveTo determine the effect of different metronome cue frequencies on spatiotemporal gait parameters when walking overground compared to walking on a treadmill in people with Parkinson’s diseaseDesignRepeated-measures, within-subject designSettingResearch laboratoryParticipantsTwenty-one people with Parkinson’s disease (Hoehn & Yahr stage 1-3)InterventionsParticipants walked overground and on a treadmill with and without metronome cues of 85%, 100%, and 115% of their baseline cadence for one minute each.Main Outcome MeasuresGait speed, step length, and cadenceResultsAn interaction effect between cue frequency and walking environment revealed that participants took longer steps during the 85% condition on the treadmill only. When walking overground, metronome cues of 85% and 115% of baseline cadence yielded decreases and increases, respectively, in both cadence and gait speed with no concomitant change in step length.ConclusionsThese data suggest that people with PD are able to alter spatiotemporal gait parameters immediately when provided the appropriate metronome cue and walking environment. We propose to target shortened step lengths by stepping to the beat of slow frequency auditory cues while walking on a treadmill, whereas the use of fast frequency cues during overground walking can facilitate faster walking speeds.

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