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Gait instability

Kingsley O Abode-Iyamah, Stephanus V Viljoen, Colleen L McHenry, Michael A Petrie, Kirsten E Stoner, Nader S Dahdaleh, Nicole M Grosland, Matthew A Howard, Richard K Shields
BACKGROUND: Cervical spondylotic myelopathy (CSM) is a common disease of aging that leads to gait instability resulting from loss of leg sensory and motor functions. The results of surgical intervention have been studied using a variety of methods, but no test has been reported that objectively measures integrative leg motor sensory functions in CSM patients. OBJECTIVE: To determine the feasibility of using a novel single leg squat (SLS) test to measure integrative motor sensory functions in patients with CSM before and after surgery...
November 2016: Neurosurgery
Rainer von Coelln, Lisa M Shulman
PURPOSE OF REVIEW: Recent studies on clinical, genetic and pathological heterogeneity of Parkinson disease have renewed the old debate whether we should think of Parkinson disease as one disease with variations, or as a group of independent diseases that happen to present with similar phenotypes. Here, we provide an overview of where the debate is coming from, and how recent findings in clinical subtyping, genetics and clinico-pathological correlation have shaped this controversy over the last few years...
October 5, 2016: Current Opinion in Neurology
Thibault Warlop, Christine Detrembleur, Benjamin Bollens, Gaëtan Stoquart, Frédéric Crevecoeur, Anne Jeanjean, Thierry M Lejeune
OBJECTIVE: Gait instability and fall risk are major concerns in Parkinson's disease. This study shows that the temporal organization of gait variability can represent a marker of gait instability that complements standard assessment of motor deficits in Parkinson's disease. METHODS: Temporal organization (long-range autocorrelation; LRA) of stride duration variability, collected from 20 persons with Parkinson's disease walking overground at a comfortable speed, was studied...
October 13, 2016: Journal of Rehabilitation Medicine
L Wu, N Mu, F Yang, J Zang, J-P Zheng
OBJECTIVE: The aim of this study is to determine characteristics of non-motor symptoms (NMS) in early Parkinson's disease (PD) with olfactory deficits and to analyze the feasibility of diagnosing PD based on olfactory deficits. PATIENTS AND METHODS: 62 patients without olfactory deficits in early PD (PD group), 58 patients with olfactory deficits in early PD (olfactory deficits group) and 60 healthy examined people (control group) were selected successively. RESULTS: It was found that there was no statistical significance in the difference in ages and courses of disease among the three groups (p > 0...
September 2016: European Review for Medical and Pharmacological Sciences
Humberto G Rosas
Although rare, posterolateral corner (PLC) injuries can result in sustained instability and failed cruciate ligament reconstruction if they are not diagnosed. The anatomy of the PLC was once thought to be perplexing and esoteric-in part because of the varying nomenclature applied to this region in the literature, which added unnecessary complexity. More recently, three major structures have been described as the primary stabilizers of the PLC on the basis of biomechanical study findings: the lateral collateral ligament, popliteus tendon, and popliteofibular ligament...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
S V Vasichkin, O S Levin
AIM: To study gait disorders and postural instability in patients with essential tremor (ET). MATERIAL AND METHODS: Forty patients with ET, aged from 29 to 82 years, (mean 64.2±13.0) were examined. Tandem walk, tremor, stability and stabilometry were studied. RESULTS AND CONCLUSION: A half of the patients had gait disorders and postural instability. Though these disorders were mild to moderate, they caused significant subjective discomfort and influenced quality of life...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
N A Trusova, O S Levin, A V Arablinsky
AIM: To study clinical/neuropsychological and neuroimaging characteristics of Alzheimer's disease in the combination with cerebrovascular disease (CVD). MATERIAL AND METHODS: Ninety patients with dementia, including 35 patients with AD, 35 patients with mixed dementia (MD) and 20 patients with vascular dementia, were examined. The character of dementia was established according to NINCDS-ADRDA and NINDS-AIREN criteria. The neuropsychological battery included Addenbrooke's Cognitive Examination (ACE-R), Montreal Cognitive Assessment scale (MoCA), fluency test and the visual memory test (SCT)...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Michael P O'Malley, Ayoosh Pareek, Patrick J Reardon, Michael J Stuart, Aaron J Krych
Coronal limb malalignment is a significant contributor to asymmetric joint wear, gait abnormalities, and the development and progression of degenerative joint disease. Osteotomies about the knee were developed to realign the mechanical axis of the limb to unload the affected compartment. Valgus malalignment is less common than varus malalignment, but can contribute to a variety of clinical conditions, including lateral compartment cartilage defects and arthritis, lateral patellofemoral instability, and medial collateral ligament laxity...
August 2016: Arthroscopy Techniques
Laura Comber, Rose Galvin, Susan Coote
BACKGROUND: Multiple Sclerosis (MS) results in postural instability and gait abnormalities which are associated with accidental falls. OBJECTIVE: This systematic review and meta-analysis aims to quantify the effect of MS on gait to inform the development of falls prevention interventions. METHODS: A systematic literature search identified case-control studies investigating differences in gait variables between people with MS and healthy controls...
September 26, 2016: Gait & Posture
Charlotte Apps, Thorsten Sterzing, Thomas O'Brien, Mark Lake
Unstable shoes (US) continually perturb gait which can train the lower limb musculature, but muscle co-contraction and potential joint stiffness strategies are not well understood. A shoe with a randomly perturbing midsole (IM) may enhance these adaptations. This study compares ankle and knee joint stiffness, and ankle muscle co-contraction during walking and running in US, IM and a control shoe in 18 healthy females. Ground reaction forces, three-dimensional kinematics and electromyography of the gastrocnemius medialis and tibialis anterior were recorded...
September 20, 2016: Journal of Electromyography and Kinesiology
Daniel Brian Scherman, Prashanth J Rao, Winny Varikatt, Gordon Dandie
BACKGROUND: The spinal cord intramedullary cavernoma (SCIC) is a rare form of hemangioma that typically behaves as a space-occupying lesion resulting in neurological symptoms, including bladder and bowel dysfunction. To date, there have been few reports characterizing the clinical presentations and surgical outcomes of cavernomas at the C2 spinal level or the potential for resolution of bladder and bowel symptoms postoperatively. This case details the clinical course of a patient with a C2 cavernoma with an atypical neurological presentation and rapid improvement in both bladder and bowel function postoperatively...
June 2016: J Spine Surg
Bernard Auvinet, Claude Touzard, Vincent Goëb
OBJECTIVE: Gait disorders are associated with increased fall risk, dementia and loss of autonomy. Gait analysis has previously been validated in the identification of motor phenotypes in mild cognitive impairment [1]. We hypothesized that gait analysis under dual-task conditions in elderly patients with gait disorders might allow the identification of motor phenotypes linked to specific brain abnormalities. MATERIAL/PATIENTS AND METHODS: An observational study was instructed for elderly patients with gait disorders or memory impairment...
September 2016: Annals of Physical and Rehabilitation Medicine
Juliette Ropars, Mathieu Lempereur, Sylvain Brochard, Carole Vuillerot, Vincent Tiffreau, Jean-Marie Cuisset, Yann Péréon, Fabien Leboeuf, Raphaël Gross, Ludovic Delporte, Yannick Delpierre
OBJECTIVE: The aim of this prospective study was to investigate changes in muscle activity during gait in children with Duchenne muscular Dystrophy (DMD). MATERIALS/PATIENTS AND METHODS: Dynamic surface electromyography recordings (EMGs) of 16 children with DMD and pathological gait were compared with those of 15 control children. The activity of the rectus femoris (RF), vastus lateralis (VL), medial hamstrings (HS), tibialis anterior (TA) and gastrocnemius soleus (GAS) muscles was recorded and analyzed quantitatively and qualitatively...
September 2016: Annals of Physical and Rehabilitation Medicine
Jeanne Montastruc, David Amarantini, Valérie Lambert, Evelyne Castel-Lacanal, Philippe Marque, David Gasq
OBJECTIVE: Weight-bearing asymmetry (WBA) at the expense of the paretic side concerns 60% of stroke patients. WBA is associated with poor functional prognosis especially in terms of gait performance [1,2]. The primary objective was to assess the determinants of WBA in stroke patients from clinical and instrumental data. MATERIAL/PATIENTS AND METHODS: The sensitivity (EmNSA), motricity (Fugl-Meyer motor), spatial neglect and visual perception of verticality (VPV) were evaluated in 20 stroke patients (age: 53...
September 2016: Annals of Physical and Rehabilitation Medicine
Marie Lumeau, Mathieu Lempereur, Emmanuel Sonnet, Olivier Remy Neris
OBJECTIVE: Distal sensorimotor polyneuropathy (DPN) is a leading risk factor of developing ulcer, including increased pressures at the forefoot. The rocker sole shoes are prescribed to decrease pressures but could induce instability [1]. The aim of this study was to compare the postural stability between normal shoes (NS) and rocker sole shoes (RSS) in patients with type 2 diabetes and DPN. MATERIAL/PATIENTS AND METHODS: In this preliminary, randomized, controlled study, NS and RSS were compared during static standing and gait...
September 2016: Annals of Physical and Rehabilitation Medicine
Andrew A Fanous, Nathan P Olszewski, Lindsay J Lipinski, Jingxin Qiu, Andrew J Fabiano
The differential diagnoses for spinal cord lesions include spinal tumors and inflammatory processes. The distinction between these pathologies can be difficult if solely based on imaging. We report for the first time to our knowledge a case of idiopathic transverse myelitis (ITM) mimicking a discrete cervical spinal lesion in a 66-year-old man who presented with gait instability and neck pain. The patient's symptoms failed to resolve after an initial course of steroid therapy. Surgical biopsy confirmed the diagnosis of ITM...
2016: Case Reports in Pathology
Gregory M Freisinger, Erin E Hutter, Jacqueline Lewis, Jeffrey F Granger, Andrew H Glassman, Matthew D Beal, Xueliang Pan, Laura C Schmitt, Robert A Siston, Ajit M W Chaudhari
Increased varus-valgus laxity has been reported in individuals with knee osteoarthritis (OA) compared to controls. However, the majority of previous investigations may not report truly passive joint laxity, as their tests have been performed on conscious participants who could be guarding against motion with muscle contraction during laxity evaluation. The purpose of this study was to investigate how a measure of passive knee laxity, recorded when the participant is under anesthesia, is related to varus-valgus excursion during gait, clinical measures of performance, perceived instability, and self-reported function in participants with severe knee OA...
September 24, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Nicholas F Matlovich, Brent A Lanting, Edward M Vasarhelyi, Douglas D Naudie, Richard W McCalden, James L Howard
BACKGROUND: Fracture location is an important consideration in managing supracondylar periprosthetic femur fractures. The outcomes of locked plating and intramedullary (IM) nail fixation were therefore compared based on fracture location, being above or at/below the total knee arthroplasty (TKA) flange. METHODS: Fifty-seven patients were identified from surgical records as being treated for supracondylar periprosthetic femur fracture with either a locking plate (n = 38) or IM nail (n = 19)...
August 3, 2016: Journal of Arthroplasty
Joseph W Maricelli, Qi L Lu, David C Lin, Buel D Rodgers
Limb-girdle muscular dystrophy type 2i (LGMD2i) affects thousands of lives with shortened life expectancy mainly due to cardiac and respiratory problems and difficulty with ambulation significantly compromising quality of life. Limited studies have noted impaired gait in patients and animal models of different muscular dystrophies, but not in animal models of LGMD2i. Our goal, therefore, was to quantify gait metrics in the fukutin-related protein P448L mutant (P448L) mouse, a recently developed model for LGMD2i...
2016: PloS One
Telassin da Silva Homem, Fernando Silva Guimarães, Maurício Dos Santos Soares, Leandro Kasuki Jomori de Pinho, Monica Roberto Gadelha, Agnaldo José Lopes
Advances in the knowledge of acromegaly are leading to an increase in the survival rate of acromegalic subjects. This study was conducted to evaluate balance control, risk of falls, and peripheral muscle function in the acromegalic elderly. Seventeen elderly subjects with acromegaly (67 (63-73) years) and twenty paired control subjects were evaluated with balance scales, force platform, and knee isokinetic dynamometry tests. There were significant differences between the groups on several balance and gait scales, with a worse performance and risk of falls in the acromegalic elderly...
September 6, 2016: Journal of Aging and Physical Activity
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