scholarly journals The Methods of Detection of Gait Disturbance and Postural Instability in Case of Parkinson’s Disease

2018 ◽  
Vol 3 (2) ◽  
pp. 37-40
Author(s):  
IE E Poverennova ◽  
VA A Kalinin ◽  
SA A Shpileva
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scales ◽  
Rating Scale ◽  
Neurological Diseases ◽  
Freezing Of Gait ◽  
Postural Instability ◽  
Motor Disorders ◽  
Medication Therapy ◽  
Disease Rating

Parkinson’s disease takes first place among neurological diseases of senior persons and its prevalence consists of 2% among people elderly than 65 years old. Disturbance of gait and postural instability are the most important motor disorders in case of Parkinson’s disease. Aim - to reveal factors which influence on the falling down of patients with Parkinson’s disease. Materials and methods. The use of unified Parkinson’s disease rating scale for examination of patients with Parkinson’s disease was performed. Results of rating scales were analyzed due to regression analysis. Results. It was revealed that the most important factor of falling down is the disturbance of gait. Freezing of gait has little influence on falling. Conclusion. The use of such diagnostic tests in the routine neurological examination allows to optimize medication therapy and to use modern non- medication methods of correction of gait.

scholarly journals Intestinal Levodopa/Carbidopa Infusion as a Therapeutic Option for Unresponsive Freezing of Gait after Deep Brain Stimulation in Parkinson’s Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Belén González-Herrero ◽  
Serge Jauma-Classen ◽  
Roser Gómez-Llopico ◽  
Gerard Plans ◽  
Matilde Calopa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Therapeutic Option ◽  
Freezing Of Gait ◽  
Disease Rating ◽  
Deep Brain

Background. Treatment of freezing of gait (FOG) is always challenging because of its unpredictable nature and multifactorial physiopathology. Intestinal levodopa infusion has been proposed in recent years as a valuable option for its improvement. FOG in Parkinson’s disease (PD) can appear after deep brain stimulation in patients who never had gait symptoms. Objective. To study the effects of intestinal levodopa/carbidopa infusion in unresponsive-FOG that appears in PD patients treated with subthalamic nucleus deep brain stimulation. Methods. We retrospectively collected and analyzed demographic, clinical, and therapeutic data from five PD patients treated with subthalamic nucleus stimulation who developed unresponsive-FOG and received intestinal levodopa/carbidopa infusion as an alternative therapy. FOG was measured based on scores in item 14 of the Unified Parkinson’s Disease Rating Scale before and after intestinal levodopa infusion. Results. Administration of intestinal levodopa caused improvement of FOG in the “ON” state in four patients (80%) by 2 or more points in item 14 of the Unified Parkinson’s Disease Rating Scale. The improvement was maintained for at least 12 months. Conclusions. Intestinal levodopa infusion may be a valuable therapeutic option for unresponsive-FOG developed after subthalamic nucleus deep brain stimulation.

scholarly journals Abnormal Olfaction in Parkinson’s Disease Is Related to Faster Disease Progression

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Sara Cavaco ◽  
Alexandra Gonçalves ◽  
Alexandre Mendes ◽  
Nuno Vila-Chã ◽  
Inês Moreira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Motor Symptom ◽  
Identification Test ◽  
Disease Rating ◽  
Abnormal Performance ◽  
Smell Identification

Introduction. A possible association between olfactory dysfunction and Parkinson’s disease (PD) severity has been a topic of contention for the past 40 years. Conflicting reports may be partially explained by procedural differences in olfactory assessment and motor symptom evaluation.Methods. One hundred and sixty-six nondemented PD patients performed the Brief-Smell Identification Test and test scores below the estimated 20th percentile as a function of sex, age, and education (i.e., 80% specificity) were considered demographically abnormal. Patients underwent motor examination after 12 h without antiparkinsonian medication.Results. Eighty-two percent of PD patients had abnormal olfaction. Abnormal performance on the Brief-Smell Identification Test was associated with higher disease severity (i.e., Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III, Freezing of Gait questionnaire, and levodopa equivalent dose), even when disease duration was taken into account.Conclusions. Abnormal olfaction in PD is associated with increased severity and faster disease progression.

scholarly journals Acupuncture Alleviated the Nonmotor Symptoms of Parkinson’s Disease including Pain, Depression, and Autonomic Symptoms

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Chifumi Iseki ◽  
Taiga Furuta ◽  
Masao Suzuki ◽  
Shingo Koyama ◽  
Keiji Suzuki ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scales ◽  
Rating Scale ◽  
Hot Flashes ◽  
Leg Pain ◽  
Intractable Pain ◽  
Nonmotor Symptoms ◽  
Autonomic Symptoms ◽  
Disease Rating

A woman started to feel intractable pain on her lower legs when she was 76. At the age of 78, she was diagnosed as having Parkinson’s disease (PD). The leg pain was suspected to be a symptom of PD after eliminating other causes. The patient also suffered from nonmotor symptoms, depression, anxiety, hot flashes, and paroxysmal sweating. Though the patient had received pharmacotherapy including levodopa for 5 years, she still suffered from the nonmotor symptoms and was referred to our department. We treated her with acupuncture based on the Chinese traditional medicine and electroacupuncture five times per week. After the 2-week treatment, the assessment for the symptoms was as follows; visual analogue scale (VAS) score of the leg pain was 16 mm (70 mm, before), Hamilton’s rating scales for depression (HAM-D) score was 9 (18, before), timed 3 m Up and Go took 20 steps in 30 sec (24 steps in 38 sec, before), and the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part 1 score was 13 (21, before). Autonomic symptoms, hot flashes and paroxysmal sweating, were also alleviated. Acupuncture may be a good treatment modality for nonmotor symptoms in PD.

scholarly journals Feasibility of Home-Based Automated Assessment of Postural Instability and Lower Limb Impairments in Parkinson’s Disease

Sensors ◽  
2019 ◽  
Vol 19 (5) ◽  
pp. 1129 ◽  
Author(s):  
Claudia Ferraris ◽  
Roberto Nerino ◽  
Antonio Chimienti ◽  
Giuseppe Pettiti ◽  
Nicola Cau ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Lower Limb ◽  
Rating Scale ◽  
Postural Instability ◽  
Motor Tasks ◽  
Automated Assessment ◽  
Home Based ◽  
Supervised Classifiers ◽  
Disease Rating

A self-managed, home-based system for the automated assessment of a selected set of Parkinson’s disease motor symptoms is presented. The system makes use of an optical RGB-Depth device both to implement its gesture-based human computer interface and for the characterization and the evaluation of posture and motor tasks, which are specified according to the Unified Parkinson’s Disease Rating Scale (UPDRS). Posture, lower limb movements and postural instability are characterized by kinematic parameters of the patient movement. During an experimental campaign, the performances of patients affected by Parkinson’s disease were simultaneously scored by neurologists and analyzed by the system. The sets of parameters which best correlated with the UPDRS scores of subjects’ performances were then used to train supervised classifiers for the automated assessment of new instances of the tasks. Results on the system usability and the assessment accuracy, as compared to clinical evaluations, indicate that the system is feasible for an objective and automated assessment of Parkinson’s disease at home, and it could be the basis for the development of neuromonitoring and neurorehabilitation applications in a telemedicine framework.

BILATERAL ELECTRICAL STIMULATION OF PRELEMNISCAL RADIATIONS IN THE TREATMENT OF ADVANCED PARKINSON'S DISEASE

Neurosurgery ◽  
2008 ◽  
Vol 62 (2) ◽  
pp. 347-359 ◽  
Author(s):  
Josè D. Carrillo-Ruiz ◽  
Francisco Velasco ◽  
Fiacro Jimènez ◽  
Guillermo Castro ◽  
Ana L. Velasco ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Electrical Stimulation ◽  
Rating Scales ◽  
Rating Scale ◽  
Zona Incerta ◽  
Yahr Scale ◽  
Disease Rating ◽  
Chronic Electrical Stimulation ◽  
Stimulation Of

Abstract OBJECTIVE Tremor and rigidity have been efficiently controlled by electrical stimulation of contralateral prelemniscal radiations (Raprl) in patients with unilateral Parkinson's disease. The present study determines the effect of bilateral Raprl electrical stimulation in a group of patients with severe bilateral tremor, rigidity, and bradykinesia. METHODS Five patients with Parkinson's disease (Hoehn and Yahr scale, Stage V) underwent bilateral stereotactic electrode implantation. Postoperative magnetic resonance imaging studies confirmed their position. Bipolar chronic electrical stimulation was performed through contiguous contacts of each electrode, which were selected by means of a screening test that explored multiple combinations. Preoperative and 3-, 6-, 9-, and 12-month postoperative evaluations were performed using international rating scales. Postoperative evaluations were performed with 24 hours off medication-on stimulation. RESULTS Contralateral tremor and rigidity were significantly decreased by simple insertion of electrodes in Raprl and returned hours to days later. Contacts for chronic stimulation were located in the area between the red and subthalamic nuclei, including Raprl, zona incerta, and substantia Q. Efficient stimulation had at least one contact in Raprl and in four cases, both contacts were only in Raprl. Stimulation parameters were 90 to 130 Hz, 90 to 330 μs, and 1.5 to 3.5 V. Unified Parkinson's Disease Rating Scale (motor, Part III) scores decreased 65% (P < 0.001), with improvements of 90% in tremor (P < 0.001), 94% in rigidity (P < 0.001), 75% in bradykinesia (P < 0.001), 40% in gait, and 35% in postural stability (P < 0.05) at 1 year. CONCLUSION Raprl electrical stimulation is safe and efficient to treat patients with the Parkinson's disease symptomatic triad. By use of Raprl stereotactic coordinates, electrodes were placed behind the subthalamic nucleus.

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.

Clinical Study of Fetal Mesencephalic Intracerebral Transplants for the Treatment of Parkinson's Disease

1996 ◽  
Vol 5 (2) ◽  
pp. 327-337 ◽  
Author(s):  
Oleg V. Kopyov ◽  
Deane “Skip” Jacques ◽  
Abraham Lieberman ◽  
Christopher M. Duma ◽  
Robert L. Rogers
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daily Living ◽  
Rating Scales ◽  
Rating Scale ◽  
Motor Tasks ◽  
Patients Âgés ◽  
Foot Tapping ◽  
Disease Rating ◽  
Ventral Mesencephalic

This study reports our findings from 22 patients (ages ranging from 42 to 73 yr; mean = 55.2) with recalcitrant idiopathic Parkinson's disease (PD) who received implants of fetal ventral mesencephalic tissue using an MRI-guided stereotactic procedure and who have been followed for at least 6 mo postoperatively, employing the guidelines established by the Core Assessment Program for Intracerebral Transplantations. Evaluations were videotaped and were performed both on and off levodopa medications. To date, we have seven patients with 24 mo, three with 18 mo, three with 12 mo, and nine with 6 mo of postsurgical assessments. Comparing surgical outcomes to levels prior to fetal transplants we found: 1) mean levodopa levels were reduced 46% at 6 mo, 12% at 12 mo, 20% at 18 mo, and 54% at 24 mo; 2) Unified Parkinson's Disease Rating Scale (UPDRS) scores with patients on levodopa were improved by an average of 38% (6 mo), 50.2% (12 mo), 69.3% (18 mo), and 73.9% (24 mo), while off medication scores showed reductions ranging from 24.7% at 6 mo to 55.1% at 24 mo. Other measures, including Hoehn-Yahr staging, Activities of Daily Living, and dyskinesia rating scales, were also significantly improved following fetal transplants. Timed motor tasks (finger dexterity, supination-pronation, foot tapping, and Stand-Walk-Sit) performance also demonstrated highly significant improvements. Patient's self-rating scores indicated that the patients typically perceived substantial improvements in their condition. However, substantial variability in the improvements following surgery still persists and range from nominal improvements in performance to significant changes that can be classified as altering the overall lifestyle of the patients. To date, 4 of the 22 subjects were considered by the physicians to be nonresponders; that is, there were no clinically relevant improvements in these patients' conditions.

scholarly journals Postural instability and falls are more frequent in Parkinson’s disease patients with worse trunk mobility

2016 ◽  
Vol 74 (7) ◽  
pp. 519-523 ◽  
Author(s):  
Nathalie Ribeiro Artigas ◽  
Clarissa Franco ◽  
Paula Leão ◽  
Carlos R. M. Rieder
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daily Living ◽  
Rating Scale ◽  
Cross Sectional Study ◽  
Postural Instability ◽  
Cross Sectional ◽  
Risk Of Falls ◽  
History Of ◽  
Disease Rating

ABSTRACT Postural instability and axial rigidity are frequent symptoms of the Parkinson’s disease (PD). Objective Correlate the occurrence of falls and the activity of rolling over in bed with performance on the Trunk Mobility Scale (TMS) in patients with PD, and determine whether this instrument score can predict the risk of falls. Method This is a cross-sectional study. Assessed patients reported the frequency of falls in the previous year and whether they had difficulties rolling over in bed. Then, the following scales were applied: TMS, Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III and Schwab and England Activities of Daily Living. Results Eighty-five patients were analyzed. Patients with a history of falling showed worse performance in the TMS (p < 0.01). There is a significant correlation between TMS and the activity of rolling over in bed (p < 0.01). Conclusion PD fallers present worse scores in TMS, and there is a significant correlation between difficulty rolling over in bed and TMS score.

scholarly journals Focal Vibration Training (Equistasi®) to Improve Posture Stability. A Retrospective Study in Parkinson’s Disease

Sensors ◽  
2019 ◽  
Vol 19 (9) ◽  
pp. 2101 ◽  
Author(s):  
Francesco Serio ◽  
Cosimo Minosa ◽  
Matteo De Luca ◽  
Pierguido Conte ◽  
Giovanni Albani ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scales ◽  
Rating Scale ◽  
Berg Balance Scale ◽  
Timed Up And Go ◽  
Risk Of Falls ◽  
Disease Rating ◽  
Vibration Training ◽  
Posture Stability

Background: For people with Parkinson’s disease (PD), falls are a critical point. Focal vibration training (FVT) may represent a valid tool to improve postural performances and reduce the risk of falls. The aim of this study was to evaluate the efficacy of FVT to improve the postural stability in PD patients. Methods: Since October 2015, 55 consecutive PD patients have been selected (T0) for an approach including FVT associated with a rehabilitative protocol (RP); after eight weeks (T1), those patients showing a relevant improvement in the clinical rating scales ((Timed Up and Go (TUG), Tinetti, Unified Parkinson’s disease rating scale (UPDRS) Part III, Berg Balance scale (BBS) and falls rate scale), continued with the FVT protocol (FVTRP group). The remaining patients continued with only the RP (RP group). In July 2018, we have extrapolated the data of the last clinical visit (T2) to observe any differences in the rate of falls. Results: The FVTRP group shows a decrement in the rate of falls from 2.1 to 1.25 (p 0.036) and a stability of the levodopa equivalent daily dosage (LEDD). The RP group shows an increment of LEDD and stability in falls. Conclusions: FVT has been confirmed as a valid tool to enhance the effect of the rehabilitation protocol aimed at postural training.

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