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Comparing balance performance on force platform measures in individuals with Parkinson's Disease and healthy adults

2017
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Release : 2017
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Book Synopsis Comparing balance performance on force platform measures in individuals with Parkinson's Disease and healthy adults by : Abigail DeWitt

Download or read book Comparing balance performance on force platform measures in individuals with Parkinson's Disease and healthy adults written by Abigail DeWitt. This book was released on 2017. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Postural instability is a known contributing factor to balance dysfunction and increased fall risk in those with Parkinson’s disease (PD). The NeuroCom Force Platform System (FP) can provide objective, quantitative information regarding balance impairments in voluntary and reactive postural strategies and sensory strategies. The purpose of this study was to examine balance performance as measured by the Limits of Stability (LOS), Sensory Organization Test (SOT), and Motor Control test (MCT) utilizing the FP system in persons with PD as compared to age-matched healthy adults. Secondarily, this study will examine if these FP measures provide diagnostic and clinically meaningful information about the underlying balance impairments in the PD population. Methods: Forty two individuals for the PD cohort (H&Y stage=2.33 + 0.77) and fifty five individuals for the age-matched healthy cohort enrolled in this study. Balance measures (SOT,MCT,LOS) were assessed in both cohorts using standardized procedures on FP system. Between group comparisons of FP performance were conducted using independent t-test, as well as ANCOVA controlling for age. Within group comparisons for the PD cohort were performed using the ANCOVA for comparing disease stage and age group, and the Mann Whitney U Test for comparing PD-subtypes. Results: Significant between group differences in FP performance were found for the SOT composite equilibrium (P=0.013, CI-95% 1.286 to 10.37), SOT vestibular ratio (P=0.027, CI-95%=0.12 to 0.185), SOT number of total falls (P=0.015, CI-95%=1.527 to -0.175) and LOS average movement velocity (P=0.001, CI-95%=0.597 to 1.595). ANCOVA analysis estimated that on average the healthy cohort scored 5.28 points higher in SOT composite equilibrium that on average the healthy cohort scored 5.28 points higher in SOT composite equilibrium than the PD cohort. Within group analysis revealed significant differences in FP performance based on age, stage and PD subtypes. Discussion: Individuals in the PD cohort demonstrated greater postural instability on SOT measures and slower movement velocity on LOS than healthy cohort, suggesting that these tests were sensitive to detect sensory integration and voluntary postural control deficits in the PD cohort. The SOT differentiated between H&Y stages 1-3, supporting the use of the SOT to identify decline in sensory processing and integration with advancing disease stage. The MCT was able to detect changes in reactive postural control mainly in later disease stages. The LOS and MCT distinguished between PD subtypes with the postural instability and gait difficulty subtype demonstrating poorer balance performance than the tremor dominant. These findings support that FP measures may provide clinically meaningful, diagnostic information in the examination of balance impairments in individuals with PD. Conclusion: In response to the high fall rate and devastating sequelae of falls in individuals with PD, FP measures may inform clinicians regarding intrinsic balance deficits and guide them in designing targeted balance interventions to reduce fall risk.

Balance Dysfunction in Parkinson’s Disease

2019-09-14 Medical
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Release : 2019-09-14
Genre : Medical
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Book Rating : 750/5 ( reviews)

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Book Synopsis Balance Dysfunction in Parkinson’s Disease by : Martina Mancini

Download or read book Balance Dysfunction in Parkinson’s Disease written by Martina Mancini. This book was released on 2019-09-14. Available in PDF, EPUB and Kindle. Book excerpt: Balance Dysfunction in Parkinson’s Disease: Basic Mechanisms to Clinical Management presents the most updated information on a variety of topics. Sections help clinicians evaluate the types of balance control issues, dynamic balance dysfunction during turning, and the effects of medication, deep brain stimulation, and rehabilitation intervention on balance control. This book is the first to review the four main postural control systems and how they are affected, including balance during quiet stance, reactive postural adjustments to external perturbations, anticipatory postural adjustments in preparation for voluntary movements, and dynamic balance control during walking and turning. In addition, the book's authors summarize the effects of levodopa, deep brain stimulation, and rehabilitation intervention for each balance domain. This book is recommended for anyone interested in how and why balance control is affected by PD. Provides the first comprehensive review of research to date on balance dysfunctions in Parkinson's disease Discusses how to translate current neuroscience research into practice regarding neural control of balance Provides evidence on the effects of current interventions on balance control

The Reliability and Validity of the rapid step up test (RST) in individuals with Parkinson's Disease and Health Adults

2016
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Release : 2016
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Book Synopsis The Reliability and Validity of the rapid step up test (RST) in individuals with Parkinson's Disease and Health Adults by : Kelly Conley

Download or read book The Reliability and Validity of the rapid step up test (RST) in individuals with Parkinson's Disease and Health Adults written by Kelly Conley. This book was released on 2016. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Parkinson’s disease is a common neurodegenerative disorder with clinical manifestations including postural instability, bradykinesia, gait disturbances and strength decline, leading to functional limitations and a high incidence of falls. A clinically feasible outcome measure that is valid, reliable and sensitive for assessing balance and functional mobility in the PD population is needed to add to the current battery of criterion gait and balance measures. The Rapid Step Up test (RST) is a salient functional performance measure with embedded strength and dynamic balance demands. The purpose of this study is to examine the test psychometric properties of the RST in community dwelling individuals with Parkinson’s disease and healthy adults. Methods: Two distinct groups participated in this study: 1) Forty individuals with idiopathic Parkinson’s disease (PD) on stable PD medication regimen (Hoehn & Yahr stage I-IV, mean age= 66.30 (8.07)) and 2) fifty-five age and gender-matched healthy adults (mean age=64.75 (8.50)). All participants passed the screening process and met functional mobility criteria for inclusion in the study. Test-retest reliability was examined by administering the RST twice over a 10-day period. Interrater reliability was examined by having three raters simultaneously time RST performance. Intraclass correlation coefficients for RST were calculated, as well as standard error of measurement and minimal detectable change for both cohorts. Concurrent validity was examined using Pearson correlation coefficients by comparing RST times with criterion gait measures [Functional Gait Assessment(FGA) and MiniBest] and force platform balance impairment measures [Limits of Stability test (LOS), Motor Control Test (MCT), and Sensory Organization Test (SOT)]. Discriminative validity was assessed using Independent t Tests to determine if there was a significant difference in RST between the PD and health groups. Stepwise multiple linear regression analyses examined if there was an association between RST time and age and PD-related variables. An alpha of .05 was utilized in data analysis. Results: A significant difference in RST performance was found between PD and healthy adult cohorts (p

Force platform measures of balance impairment

2015
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Release : 2015
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Book Synopsis Force platform measures of balance impairment by : Chris Burdis

Download or read book Force platform measures of balance impairment written by Chris Burdis. This book was released on 2015. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Parkinson’s Disease (PD) is a highly prevalent neurodegenerative disorder with incidence increasing annually in the growing elderly population in the United States. Complex movement and balance impairments in PD contribute to high fall risk and devastating consequences of all-related injuries in this population. Therefore, comprehensive balance assessment is warranted to identify intrinsic fall risk factors and direct intervention for fall prevention. The purpose of this study was to examine the test psychometric properties of three balance measures on the NeuroCom Force Platform (FP) system in persons with PD. Methods: Forty-two community dwelling individuals with Idiopathic PD (mean age 66.21 years, Hoehn & Yahr stage I-IV) were included in the study. Participants were included if they met the functional mobility criteria for the study and were excluded if they had other neurologic disorders, dementia, peripheral neuropathy, or deep brain stimulation. Test retest reliability was assessed for the Limits of Stability (LOS), Motor Control Test (MCT) and Sensory Organization test (SOT) by administering the FP tests twice within 10 days during on time of PD medications. Intraclass correlation coefficients (ICC) were calculated to determine test-retest reliability of the FP measures. Minimal detectable change (MDC) was calculated using standard error of mean from ICC values. Concurrent validity was assessed by comparing the FP measures with criterion gait (10 meter walk test [10MWT], six minute walk test [6MWT]), and clinical balance measures (Functional Gait Assessment [FGA], Mini balance Evaluation Systems test [MiniBEST], Rapid Step Up test [RST] using Pearson Product Moment correlations. Convergent validity of FP measures and PD characteristics was analyzed using both multiple linear regression and correlation values. Results: All FP variables demonstrated excellent test-retest reliability (ICC range 0.78-0.92), with the exception of LOS average reaction time and LOS falls, which were moderately reliable (ICC0.69,0.62). The strongest reliability was found for the MCT variables (average latency ICC=0.92, average amplitude ICC=0.92). The MDC values for FP measures were as follows: SOT composite equilibrium (11.64), LOS average end-point excursion (13.79), and MCT average latency (7.43). SOT and LOS demonstrated fair to good correlations with gait and clinical balance measures. The strongest correlations were found between SOT composite equilibrium score and the balance measures, MiniBEST (r=0.69), FGA (r=0.60 ) and RST (r=0.55). Convergent validity findings demonstrated significant relationships of both SOT composite equilibrium and MCT average latency with disease severity. Discussion: FP measures are reliable and valid measures of balance impairment in persons with PD and are able to detect balance deficits in this population, One third of this studies sample had SOT composite equilibrium scores below normative values, reflecting impairment in sensory integration for balance. Additionally, the SOT composite equilibrium and MCT average latency differentiated individuals based on disease severity, perhaps reflecting that these tests are sensitive indicators of decline in postural control with disease progression. Conclusion: A battery of balance measures is needed to accurately assess balance deficits at both the functional and impairment levels in PD. Force platform measures may provide valuable quantitative information about underlying balance impairments in PD to guide therapeutic interventions for fall risk reduction.

Dynamic balance during preferred and fast-paced walking in individuals with and without Parkinson's Disease

2017
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Release : 2017
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Book Synopsis Dynamic balance during preferred and fast-paced walking in individuals with and without Parkinson's Disease by : Ashley Rodriquez

Download or read book Dynamic balance during preferred and fast-paced walking in individuals with and without Parkinson's Disease written by Ashley Rodriquez. This book was released on 2017. Available in PDF, EPUB and Kindle. Book excerpt: INTRODUCTION: Falls are a frequent problem for individuals with Parkinson’s disease (PD). Functional implications associated with these falls suggest a need for further research in the area of gait and dynamic balance associated with PD. To date, few studies have investigated dynamic balance with variables such as the margin of stability and center of mass (COM) velocity, much less in individuals with PD. Therefore, the purpose of this study was to compare dynamic balance during normal and fast-paced walking between individuals with PD and healthy controls. METHODS: Prospective cohort study. Subjects: Fourteen subjects with PD (5 females, 9 males; mean age, 68.1 + 7.8 years) were included in this study as well as age-and gender-matched control subjects (CS) (5 females,9 males; mean age, 66.1 + 9.7 years). Methods/Procedures: Participants walked across a 10-m level walkway using normal- and fast-paced walking speeds. Eight MX-T40 cameras (120 Hz), Nexus motion capture software (Vicon Motion System Ltd., Oxford Metrics, UK), three AMTI (Advanced Mechanical Technology Inc., Watertown, MA) force plates, and Vicon Nexus 2.5 software were used to collect kinetic and kinematic data. The full body Plug-In Gait (PIG) model marker set was used. The mediolateral (M/L) extrapolated COM to center of pressure (COP) distance (XCOM_COP M/L), the M/L inclination angle (COM_COP M/L angle), and M/L extrapolated COM to margin of stability distance (MoS M/L) were used to determine whether a difference in dynamic balance exists between the PD group and CS at loading response (LR) and mid-stance (MS). Statistical analysis: A repeated measures ANOVA was performed to test for group condition main effects on dependent variables. Significance was set at a=0.05. RESULTS: Condition main effects were found for XCOM_COP M/L and COM_COP M/L angle at LR and MS for pace, with a greater mean distance and angle, respectively, during fast pace compared to normal pace. A condition main effect was found for MoS M/L at MS for pace, with a greater mean distance during fast paced walking. A between groups main effect was found for COM_COP M/L angle at MS, with the CS demonstrating a larger mean angle than the PD group. DISCUSSION: The current results indicate that high functioning individuals with PD do not display many significant differences in dynamic balance variables when compared to a matched CS. This could be a result of gait compensations that have developed over time to improve the perceived stability of those with PD, such as maintaining the COM close to the COP. Previous research on these variables is conflicting and not definitive in this population. CONCLUSION: Mild differences in these variables between groups suggest even minimally involved individuals with PD could benefit from early exercise intervention to improve balance. Further research should focus on individuals with more advanced PD and analysis of the current variables with more challenging dynamic balance tasks.

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