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Ataxia or Gait Instability

Francesco Paradisi, Eugenio Di Stanislao, Aurora Summa, Stefano Brunelli, M Traballesi, Giuseppe Vannozzi
BACKGROUND: The observation of upper body movement is gaining interest in the gait analysis community. Recent studies involved the use of body-worn motion sensors, allowing translation of laboratory measurements to real-life settings in the context of patient monitoring and fall prevention. OBJECTIVES: It was shown that amputee persons demonstrate altered acceleration patterns due to the presence of prosthetic components, while no information is available on how accelerations propagate upwards to the head during level walking...
August 16, 2018: Prosthetics and Orthotics International
M Gazzola, L H Dudte, A G McCormick, L Mahadevan
Soft slender structures are ubiquitous in natural and artificial systems, in active and passive settings and across scales, from polymers and flagella, to snakes and space tethers. In this paper, we demonstrate the use of a simple and practical numerical implementation based on the Cosserat rod model to simulate the dynamics of filaments that can bend, twist, stretch and shear while interacting with complex environments via muscular activity, surface contact, friction and hydrodynamics. We validate our simulations by solving a number of forward problems involving the mechanics of passive filaments and comparing them with known analytical results, and extend them to study instabilities in stretched and twisted filaments that form solenoidal and plectonemic structures...
June 2018: Royal Society Open Science
Darko Aleksovski, Dragana Miljkovic, Daniele Bravi, Angelo Antonini
INTRODUCTION: Discrete patterns of progression have been suggested for patients with Parkinson disease and presenting tremor dominant (TD) or postural instability gait disorders (PIGD). However, longitudinal prospective assessments need to take into consideration the variability in clinical manifestations and the evidence that only 40% of initially classified PIGD remain in this subtype at subsequent visits. METHODS: We analyzed clinical progression of PIGD compared to TD using longitudinal clinical data from the PPMI...
August 14, 2018: Neurological Sciences
Manuela Galli, Veronica Cimolin, Claudia Condoluci, Pier Francesco Costici, Reinald Brunner
Dynamic joint stiffness represents the resistance that a joint opposes to an applied moment. Stiffness arises in conditions of joint laxity, instability and increased co-contraction and is commonly utilized as a means to stabilize the joint. The knee joint seems to be crucial for determining the walking pattern. The aim of this study was to investigate the association between the gait pattern, globally quantified by the Gait Profile Score (GPS), which indicates the 'quality' of a particular walking strategy, and knee dynamic joint stiffness (Kk) in children with diplegia...
July 2018: Journal of Bodywork and Movement Therapies
Nico Milantoni, Natale Di Bella, Kariné Chahbazian
BACKGROUND Although rehabilitation for balance disorders is commonly undertaken following a stroke, hearing dysfunction is rarely investigated, even though hearing loss affects the ability to maintain balance. This report presents a case of restoration of balance and unilateral hearing using an alternating and filtering auditory training (AFAT) protocol in a patient with subarachnoid hemorrhage (SAH) and shunt-treated hydrocephalus. CASE REPORT A 54-year-old woman with a five-month history of SAH due to a ruptured aneurysm in the anterior communicating artery and hydrocephalus treated with a shunt was admitted to our unit for neurorehabilitation...
August 10, 2018: American Journal of Case Reports
Kareem Elzamly, Christa Nobleza, Ellen Parker, Rebecca Sugg
Context: We describe a case of unilateral posterior upper cervical spinal cord infarction and propose a pathophysiologic mechanism causing this lesion after vertebral artery endovascular intervention. Findings: A 70-year-old male presented with subacute onset of left hemibody sensory changes and gait instability following a left vertebral angioplasty procedure. MRI cervical spine revealed upper posterior cervical spinal cord infarction (PSCI). After 3 months patient had substantial improvement of his symptoms...
2018: Case Reports in Neurological Medicine
Katarzyna Pierchała, Magdalena Lachowska, Jarosław Wysocki, Krzysztof Morawski, Kazimierz Niemczyk
BACKGROUND: Among the elderly, instability leading to falls (and consequences of them) is one of the most important problems. The etiology of falls is usually complex, but balance, posture and gait problems are considered to be the most important risk factors. OBJECTIVES: The objective of this study was to assess the usefulness of the Sensory Organization Test (SOT) in differentiating multi-fallers from single-fallers. MATERIAL AND METHODS: The studied group included 92 patients aged >60 years with balance disorders and falls in their history...
July 30, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Amruta Shanbhag, Helen Awai, Soham Rej, Alan J Thomas, Klajdi Puka, Akshya Vasudev
OBJECTIVES: The objective of this study was to assess the prevalence of orthostatic hypotension (OH) in a sample of late life depression (LLD) patients and to determine the validity of a standardized questionnaire, the Orthostatic Hypotension Questionnaire (OHQ). Secondarily, we wished to assess variables associated with OH. METHODS: We conducted a cross-sectional study on 82 consecutive geriatric outpatients presenting with LLD. OH was defined as a fall in systolic blood pressure of greater than 20 mm Hg and/or 10 mm Hg on diastolic blood pressure on an orthostatic stress test from sitting to standing...
July 24, 2018: International Journal of Geriatric Psychiatry
Ruben Hermann, Eugen C Ionescu, Olivier Dumas, Stephane Tringali, Eric Truy, Caroline Tilikete
Introduction: Patients suffering from bilateral vestibular hypofunction (BVH) often experience ataxia as well as visual instability. Even though progress has been made in vestibular testing, insights regarding vestibular deficit in BVH remain incomplete since no method allows evaluation of frequency ranges of vestibular sensors in a continuous way. The aim of our study was to give a detailed description of the level of vestibular deficit in different ranges of vestibular stimulation and an exhaustive evaluation of the functional impact including dynamic visual acuity (DVA) in a cohort of BVH patients in different etiologies...
2018: Frontiers in Neurology
Renu Kumari, Deepak Kumar, Samir K Brahmachari, Achal K Srivastava, Mohammed Faruq, Mitali Mukerji
Cerebellar ataxias are a group of rare progressive neurodegenerative disorders with an average prevalence ranges from 4.8 to 13.8 in 100,000 individuals. The inherited disorders affect multiple members of the families, or a community that is endogamous or consanguineous. Presence of more than 3000 mutations in different genes with overlapping clinical symptoms, genetic anticipation and pleiotropy, as well as incomplete penetrance and variable expressivity due to modifiers pose challenges in genotype-phenotype correlation...
July 2018: Journal of Genetics
José Luis Treviño González, German A Soto-Galindo, Rafael Moreno Sales, Josefina A Morales Del Ángel
The Cogan's syndrome (CS) is a very uncommon inflammatory condition that appears in young adults without a gender predisposition. It can be presented as typical, with interstitial non-syphilitic keratitis and Ménière-like audiovestibular manifestations. An atypical form of CS involves uveitis, scleritis, episcleritis, and systemic vascuitis symptoms. This is a case of a 41-year old male who reported eye redness, photophobia, and gait instability. His condition progressed to a sudden sensorineural hearing loss, tinnitus, and constant vertigo accompanied by cephalea...
June 2018: Annals of Medicine and Surgery
Dan Yu, Fu-Min Zhao, Xiao-Tang Cai, Hui Zhou, Yan Cheng
Early-onset progressive encephalopathy is a lethal encephalopathy caused by NAXE gene mutations. This paper reports the clinical and genetic features of a patient with early-onset progressive encephalopathy. A 4-year-old boy admitted to the hospital had repeated walking instability and limb weakness for 2 years. The patient and his elder brother (already dead) had clinical onset at 2 years of age. Both of them showed symptoms such as strabismus, ataxia, reduced muscle tone, delayed development, and repeated respiratory failure after infection...
July 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Richard L Doty, Michael R MacGillivray, Hussam Talab, Isabelle Tourbier, Megan Reish, Sherrie Davis, Jennifer L Cuzzocreo, Neil T Shepard, Dzung L Pham
Dizziness, postural instability, and ataxia are among the most debilitating symptoms of multiple sclerosis (MS), reflecting, in large part, dysfunctional integration of visual, somatosensory, and vestibular sensory cues. However, the role of MS-related supratentorial lesions in producing such symptoms is poorly understood. In this study, motor control test (MCT) and dynamic sensory organization test (SOT) scores of 58 MS patients were compared to those of 72 healthy controls; correlations were determined between the MS scores of 49 patients and lesion volumes within 26 brain regions...
July 17, 2018: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Xiaoxue Guan, Yuchan Wang, Qun Li, Ming Wei, Lili Chen, Oumei Cheng
OBJECTIVE: Constipation is among the most frequently delineated nonmotor symptoms (NMS) with a high occurrence in Parkinson's disease (PD). The purpose of our study was to investigate whether PD with comparatively integrated intestinal function (without constipation) in the early stage had different clinical features compared to constipated PD. METHOD: We conducted a study of 105 consecutive de novo as well as early treated (treated for shorter than 3 months), aged 50 years or older outpatients...
July 17, 2018: Neurological Sciences
Paulo H S Pelicioni, Matthew A Brodie, Mark D Latt, Jasmine C Menant, Hylton B Menz, Victor S C Fung, Stephen R Lord
INTRODUCTION: People with Parkinson's disease (PD) can be classified into tremor dominant (TD) and postural instability and gait difficulty (PIGD) subtypes; the latter group having more impaired gait and increased fall risk. While there is some evidence that anti-parkinsonian medication, levodopa, might not improve balance and gait control or reduce fall risk in the PIGD subtype, it is unclear whether the levodopa dosage intake affects gait stability. To address these issues, this study used accelerometry to compare gait stability: (i) during before and after levodopa intake between non-PIGD and PIGD subtypes; (ii) between individuals who took less or >750 mg of levodopa/day...
July 3, 2018: Experimental Gerontology
Maryse Feron, Annabelle Couillandre, Eya Mseddi, Nicolas Termoz, Malek Abidi, Eric Bardinet, Daniel Delgadillo, Timothée Lenglet, Giorgia Querin, Marie-Laure Welter, Nadine Le Forestier, François Salachas, Gaelle Bruneteau, Maria Del Mar Amador, Rabab Debs, Lucette Lacomblez, Vincent Meininger, Mélanie Pélégrini-Issac, Peter Bede, Pierre-François Pradat, Giovanni de Marco
INTRODUCTION: Extrapyramidal deficits are poorly characterised in amyotrophic lateral sclerosis (ALS) despite their contribution to functional disability, increased fall risk and their quality-of-life implications. Given the concomitant pyramidal and cerebellar degeneration in ALS, the clinical assessment of extrapyramidal features is particularly challenging. OBJECTIVE: The comprehensive characterisation of postural instability in ALS using standardised clinical assessments, gait analyses and computational neuroimaging tools in a prospective study design...
July 11, 2018: Journal of Neurology
Saviour Kweku Adjenti, Graham Jacob Louw, Jennifer Jelsma, Marianne Unger
Background: Abdominal muscles have stiffer appearance in individuals with spastic type cerebral palsy (STCP) than in their typically developing (TD) peers. This apparent stiffness has been implicated in pelvic instability, mal-rotation, poor gait and locomotion. This study was aimed at investigating whether abdominal muscles activation patterns from rest to activity differ in the two groups. Method: From ultrasound images, abdominal muscles thickness during the resting and active stages was measured in 63 STCP and 82 TD children...
2018: Archives of Physiotherapy
Theodoros Varakliotis, Federico Maspes, Vittoria Di Rubbo, Sara Cisternino, Maria Lauriello, Elisa Vitti, Alberto Eibenstein
We report a case of a 54-year old female patient, complaining for chronic dizziness, hearing loss, tension headaches without aura, postural instability and gait dysfunction. The patient referred having these symptoms from 1992, but the last few months she experienced a noticeable aggravation of the symptoms. A magnetic resonance imaging test revealed a triventricular hydrocephalus, not associated with signs of intracranial hypertension decompensation. The ENT-Audiology evaluation revealed a bilateral sensorineural hearing loss with a conductive component, video-nystagmography resulted in an areflexia of the right ear and a reduced vestibular activity for the left ear...
March 6, 2018: Audiology Research
Teresa Frisan, Noemi Nagy, Dimitrios Chioureas, Marie Terol, Francesca Grasso, Maria G Masucci
We have addressed the role of bacterial co-infection in viral oncogenesis using as model Epstein-Barr virus (EBV), a human herpesvirus that causes lymphoid malignancies and epithelial cancers. Infection of EBV carrying epithelial cells with the common oral pathogenic Gram-negative bacterium Aggregatibacter actinomycetemcomitans (Aa) triggered reactivation of the productive virus cycle. Using isogenic Aa strains that differ in the production of the cytolethal distending toxin (CDT) and purified catalytically active or inactive toxin, we found that the CDT acts via induction of DNA double strand breaks and activation of the Ataxia Telangectasia Mutated (ATM) kinase...
July 6, 2018: International Journal of Cancer. Journal International du Cancer
Yasutaka Nikaido, Toshihiro Akisue, Hideyuki Urakami, Yoshinaga Kajimoto, Kenji Kuroda, Yuki Kawami, Hisatomo Sato, Yoshiyuki Ohta, Tetsuya Hinoshita, Yuka Iwai, Tadayuki Nishiguchi, Hiroshi Ohno, Ryuichi Saura
OBJECTIVES: This study aimed to confirm whether cerebrospinal fluid (CSF) shunting for idiopathic normal-pressure hydrocephalus (iNPH) improves postural instability, and to investigate the relationship between postural control and gait ability. PATIENTS AND METHODS: Twenty-three iNPH patients and 18 age-matched healthy controls (HC) were examined using the timed up and go (TUG) test and a force platform for calculating the center of pressure (COP) trajectory during voluntary multidirectional leaning and quiescent standing...
June 30, 2018: Clinical Neurology and Neurosurgery
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