Gait in Benign Paroxysmal Positional Vertigo

Purpose: Patients with benign paroxysmal positional vertigo (BPPV) experience gait unsteadiness not only during the attacks but also between the spells. This study aimed to measure gait changes in BPPV and determine whether these changes are associated with the involved canal or lesion side.Methods: We recruited 33 patients with a diagnosis of unilateral BPPV. Patients with other vestibular or central nervous system disorders were excluded. Gait was assessed using the GAITRite™ system before and after canalith repositioning treatment (CRT).Results: After CRT, improvements were observed in various gait parameters including velocity (p < 0.001), cadence (p < 0.001), functional ambulation profile (p = 0.011), and the coefficient of variation of stride time (p = 0.004). Exploration of the center of pressure (COP) distribution also revealed improved stabilization during locomotion after CRT. The spatiotemporal gait variables did not differ between the patients with horizontal- and posterior-canal BPPV, or between the ipsilesional and contralesional sides before CRT.Conclusions: The gait parameters reflecting velocity and rhythmicity along with stability of COP distribution improved after the resolution of BPPV. Episodic overexcitation of semicircular canal may impair the vestibular information that is integrated with the other reference afferent systems and lead to impaired gait performance.

Spatial-Temporal Parameters of Gait Associated With Alzheimer Disease: A Longitudinal Analysis

Alzheimer’s disease (AD) is one of the biggest social and medical concerns in the aging world. A dual task of walking and talking is a particularly practical means to assess AD considering the cognitive and behavioral changes that characterize the disease. The purpose of the study was to assess the effect of the dual task of walking and talking on people with early stage AD under differing cognitive load levels of talking. Participants (9 women and 5 men, mean age (years) = 78.03, standard deviation [SD] = 12.06) with mild or moderate AD (mean Dementia Rating Scale 2 score = 88.14, SD = 7.07) completed 12 monthly walking sessions under no, low, or high cognitive load. They also completed the low and high cognitive load tasks while seated. Linear mixed-effects modeling revealed that values in the Functional Ambulation Profile, stride length, and velocity decreased as tasks became more complex and double support time increased at the same rate. The walking and seated conditions comparison indicated that participants’ performance on both low and high cognitive tasks was poor when they were walking rather than seated. The results show that people with early stage AD exhibited gait impairments that increased over time and when completing tasks with greater cognitive load.

Effect of PNF technique for knee muscles on lower limb performance in subacute stroke – an experimental study

Approximately two-thirds of stroke survivors have sequel of neurological impairments. Although all sequels have direct impact on the performance of activities of daily living, motor deficits of the lower limbs have the most important impact on an individual’s functioning. The objective was to study the effect of proprioceptive neuromuscular facilitation (PNF) technique on lower limb performance in subjects with subacute stroke.Thirteen participants with subacute strokes were recruited. Participants were treated with PNF rhythmic stabilization technique. All participants received 10 days of intervention. Treatment sessions consisted of PNF rhythmic stabilization exercises for knee that utilizes alternating isometric contractions of agonist and antagonist against resistance. Lower limb performances were measured with Modified Emory Functional Ambulation Profile, Five Time Sit To Stand Test and Postural Assessment Scale For Stroke.Lower limb performances were improved after 10 days of intervention as compared to baseline assessment in all the outcome measures.This study suggests that the rhythmic stabilization technique is an effective method to improve lower limb function that can be used as an adjunct with other therapies.

Spinal Cord Injury Functional Ambulation Profile: A Preliminary Look at Responsiveness

Background The Spinal Cord Injury Functional Ambulation Profile (SCI-FAP) is a valid, reliable measure of walking skill (eg, walking while negotiating obstacles, doors, and stairs). Objective The responsiveness of the SCI-FAP was assessed at least 7 months after spinal cord injury (SCI) and compared with that of the 10-Meter Walk Test (10MWT) and the Six-Minute Walk Test (6MWT). Design A secondary analysis of data collected during a randomized, single-blind, crossover trial was performed. Methods Participants had incomplete SCI and could walk at least 5 m without manual assistance. After 3 or 4 baseline assessments, participants completed 2 months of precision training (stepping over obstacles and onto targets on the ground) and 2 months of endurance training (treadmill training with body weight support, if needed). Walking function was assessed with the SCI-FAP, 10MWT, and 6MWT. Internal responsiveness was evaluated through change scores and standardized response means (SRMs). External responsiveness was gauged by correlating change scores on the SCI-FAP, 10MWT, and 6MWT. The minimal detectable change was calculated from the standard error of measurement from the baseline assessments. Results The SCI-FAP scores improved with both interventions. The magnitude of change was greater for participants whose pretraining self-selected speed was less than 0.5 m/s. The SCI-FAP had moderate SRMs. The 10MWT (fastest speed) and 6MWT had the largest SRMs after precision training and endurance training, respectively. The minimal detectable change in the SCI-FAP was 96 points. Limitations The convenience sample was small and all participants could ambulate independently (with devices); therefore, the generalizability of the findings is limited. Conclusions The SCI-FAP was responsive to changes in walking ability in participants who had incomplete SCI and walked at slow speeds, but overall the 10MWT and 6MWT were more responsive.