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postural stability in parkinsons disease

Kenjiro Michimoto, Yasuyuki Suzuki, Ken Kiyono, Yasushi Kobayashi, Pietro Morasso, Taishin Nomura, Kenjiro Michimoto, Yasuyuki Suzuki, Ken Kiyono, Yasushi Kobayashi, Pietro Morasso, Taishin Nomura, Ken Kiyono, Pietro Morasso, Kenjiro Michimoto, Yasushi Kobayashi, Yasuyuki Suzuki, Taishin Nomura
Intermittent feedback control for stabilizing human upright stance is a promising strategy, alternative to the standard time-continuous stiffness control. Here we show that such an intermittent controller can be established naturally through reinforcement learning. To this end, we used a single inverted pendulum model of the upright posture and a very simple reward function that gives a certain amount of punishments when the inverted pendulum falls or changes its position in the state space. We found that the acquired feedback controller exhibits hallmarks of the intermittent feedback control strategy, namely the action of the feedback controller is switched-off intermittently when the state of the pendulum is located near the stable manifold of the unstable saddle-type upright equilibrium of the inverted pendulum with no active control: this action provides an opportunity to exploit transiently converging dynamics toward the unstable upright position with no help of the active feedback control...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
David Cioncoloni, Lodovica Martelli, Deborah Rosignoli, Riccardo Mazzocchio
BACKGROUND: Postural instability may result from altered sequencing of automatic motor programs for anticipatory postural corrections and/or impaired motor learning in Parkinson Disease (PD) patients. Comorbid white matter disease is a major determinant of axial motor impairment, leading to poorer stability than nigrostriatal dopaminergic denervation per se. OBJECTIVE: To assess differences in anticipatory control of postural stability function between subjects affected by PD with comorbid leukoaraiosis (LPD), idiopathic Parkinson disease (IPD) and elderly health subjects (EHS) as control group...
February 10, 2017: NeuroRehabilitation
Arim Kim, Hye-Sun Lee, Chiang-Soon Song
[Purpose] The purpose of this study was to examine the effects of interactive metronome training on the postural stability and upper extremity function of an individual with Parkinson's disease. [Subject and Methods] The participant of this case study was a 75-year-old female with Parkinson's disease diagnosed 7 years prior. This study was a single-subject research with an A-B-A design. She received IM training during the treatment phase (B phase) for 40 minutes per session. She was assessed pretest and posttest using the Berg balance scale and Wolf motor function test, and at baseline and the treatment phase using the measured box-and-block test and a Tetrax system...
January 2017: Journal of Physical Therapy Science
Stefano Negrini, Luciano Bissolotti, Alessandro Ferraris, Fulvia Noro, Mark D Bishop, Jorge Hugo Villafañe
BACKGROUND: Impaired postural stability places individuals with Parkinson's disease (PD) at an increased risk for falls. OBJECTIVE: We evaluated the effectiveness of 10 vs. 15 sessions of Nintendo Wii Fit for balance recovery for outpatients PD. METHODS: Twenty-seven patients, 48.1% female (66 ± 8 years), with PD. Patients with PD were consecutively assigned to one of two groups receiving either 10 or 15 sessions (low dose or high dose group, respectively) with Nintendo Wii Fit in recovering balancing ability...
January 2017: Journal of Bodywork and Movement Therapies
Ali Falaki, Xuemei Huang, Mechelle M Lewis, Mark L Latash
BACKGROUND: Postural instability is one of most disabling motor symptoms in Parkinson's disease. Indices of multi-muscle synergies are new measurements of postural stability. OBJECTIVES: We explored the effects of dopamine-replacement drugs on multi-muscle synergies stabilizing center of pressure coordinate and their adjustments prior to a self-triggered perturbation in patients with Parkinson's disease. We hypothesized that both synergy indices and synergy adjustments would be improved on dopaminergic drugs...
January 11, 2017: Journal of Electromyography and Kinesiology
Michael H Cole, Matthew Sweeney, Zachary J Conway, Tim Blackmore, Peter A Silburn
OBJECTIVE: To evaluate the effect of imposed faster and slower walking speeds on postural stability in people with Parkinson disease (PD). DESIGN: Cross-sectional cohort study. SETTING: General community. PARTICIPANTS: Patients with PD (n=84; 51 with a falls history; 33 without) and age-matched controls (n=82) were invited to participate via neurology clinics and preexisting databases. Of those contacted, 99 did not respond (PD=36; controls=63) and 27 were not interested (PD=18; controls=9)...
December 16, 2016: Archives of Physical Medicine and Rehabilitation
Eric N Beck, Quincy J Almeida
BACKGROUND: Parkinson disease (PD) impairs control of well-learned movements. Movement control improvements are found when individuals complete tasks while focusing attention externally on manipulating an object, which is argued to occur due to automatic processing associated with well-learned movements. Focusing attention internally (on movements of one's limbs) is believed to involve conscious control networks and hinders movement performance. Previous work has shown that an external focus of attention (EFA) improved postural stability in individuals with PD (compared with an internal focus of attention [IFA]), but this improvement occurred when patients were taking dopamine medication, which modulates basal ganglia functioning responsible for well-learned movements...
October 6, 2016: Physical Therapy
Sarah J Ozinga, Susan M Linder, Jay L Alberts
OBJECTIVE: To determine the accuracy of inertial measurement unit data from a mobile device using the mobile device relative to posturography to quantify postural stability in individuals with Parkinson disease (PD). DESIGN: Criterion standard. SETTING: Motor control laboratory at a clinic. PARTICIPANTS: A sample (N=28) of individuals with mild to moderate PD (n=14) and age-matched community-dwelling individuals without PD (n=14) completed the study...
September 23, 2016: Archives of Physical Medicine and Rehabilitation
Marcos Rossi-Izquierdo, Andrés Soto-Varela, Arne Ernst, Juan Pedro Rubio-Rodríguez, Sofía Santos-Pérez, Ángel Sesar, Miguel Alberte-Woodward, Mónica Guijarro-Del Amo, Elena San Román-Rodríguez, Ana Faraldo-García, Alfonso Zubizarreta-Gutiérrez, Dietmar Basta
OBJECTIVE: Impaired balance in patients with Parkinson's disease (PD) leads to loss of balance and frequent falls. Computerized dynamic posturography allows the assessment of stance tasks whereas mobile posturography analyzes the balance in free-field conditions, where falls among PD patients commonly occur (e.g. sitting down or standing up). The aim of the present study is to assess postural stability in PD patients with both techniques. STUDY DESIGN: Prospective study...
October 2016: Otology & Neurotology
Meng-Che Shih, Ray-Yau Wang, Shih-Jung Cheng, Yea-Ru Yang
BACKGROUND: The present study examined the effects of a balance-based exergaming intervention using the Kinect sensor on postural stability and balance in people with Parkinson's disease (PD). METHODS: We conducted a subject-blinded, randomized controlled study. Twenty people with PD (Hoehn and Yahr stages I through III) were recruited and randomly assigned to either a balance-based exergaming group (N = 10) or a balance training group (N = 10) for an 8-week balance training period...
August 27, 2016: Journal of Neuroengineering and Rehabilitation
D S Peterson, F B Horak
Protective postural responses, including stepping, to recover equilibrium are critical for fall prevention and are impaired in people with Parkinson's disease (PD) with freezing of gait (FoG). Improving protective postural responses through training may reduce falls in this population. However, motor learning, the basis of neurorehabilitation, is also impaired in people with PD and, in particular, people with PD who experience freezing. It is unknown whether people with PD who freeze can improve protective postural responses, and whether these improvements are similar to nonfreezers...
October 15, 2016: Neuroscience
Katrijn Smulders, Marian L Dale, Patricia Carlson-Kuhta, John G Nutt, Fay B Horak
Gait impairments are a hallmark of Parkinson's disease (PD), both as early symptom and an important cause of disability later in the disease course. Although levodopa has been shown to improve gait speed and step length, the effect of dopamine replacement therapy on other aspects of gait is less well understood. In fact, falls are not reduced and some aspects of postural instability during gait are unresponsive to dopaminergic treatment. Moreover, many medications other than dopaminergic agents, can benefit or impair gait in people with PD...
October 2016: Parkinsonism & related Disorders
Cathy C Harro, Alicia Marquis, Natasha Piper, Chris Burdis
BACKGROUND: Complex movement and balance impairments in people with Parkinson disease (PD) contribute to high fall risk. Comprehensive balance assessment is warranted to identify intrinsic fall risk factors and direct interventions. OBJECTIVE: The purpose of this study was to examine the psychometric properties of 3 balance measures of a force platform (FP) system in people with PD. METHODS: Forty-two community-dwelling individuals with idiopathic PD completed the testing protocol...
December 2016: Physical Therapy
Preeti Umarao, Samrat Bose, Supti Bhattacharyya, Anil Kumar, Suman Jain
Parkinson's disease (PD) is a progressive neurodegenerative disorder affecting mainly the dopaminergic neurons of the substantia nigra leading to various motor and non-motor deficits. We explored the neuroprotective potential of superparamagnetic iron oxide nanoparticles (IONPs) along with exposure to EMF in 6-OHDA rat model of PD. IONPs were implanted at the site of lesion and 24 h thereafter the rats were exposed to magnetic fields 2 h/day for one week. Bilateral lesions of the striatum were made with 6-OHDA...
January 2016: Journal of Nanoscience and Nanotechnology
Michael H Cole, Geraldine A Naughton, Peter A Silburn
Background The trunk plays a critical role in attenuating movement-related forces that threaten to challenge the body's postural control system. For people with Parkinson's disease (PD), disease progression often leads to dopamine-resistant axial symptoms, which impair trunk control and increase falls risk. Objective This prospective study aimed to evaluate the relationship between impaired trunk muscle function, segmental coordination, and future falls in people with PD. Methods Seventy-nine PD patients and 82 age-matched controls completed clinical assessments and questionnaires to establish their medical history, symptom severity, balance confidence, and falls history...
January 2017: Neurorehabilitation and Neural Repair
Asako Yoritaka, Hideo Mori, Nobutaka Hattori
BACKGROUND: Camptocormia in Parkinson's disease (PD) is unresponsive to various therapies and induced difficulties in their day-to-day life. OBJECTIVE: This study, an open trial, was aimed at assessing the efficacy of selegiline in the treatment of mild camptocormia in PD patients. METHODS: Participants were administered 5 mg of selegiline for the first 8 weeks and 7.5 mg for the second 8 weeks. RESULTS: As primary endpoints, the degree of thoracolumbar anteflexion decreased from 23...
2016: European Neurology
Ryan P Hubble, Peter A Silburn, Geraldine A Naughton, Michael H Cole
This cross-sectional study aimed to investigate the relationship between accelerometer-derived measures of movement rhythmicity and clinical measures of mobility, balance confidence and gait difficulty in people with Parkinson's disease (PD). Twenty-nine independently-living PD patients (Hoehn & Yahr Stages 1-3) with no history of significant injury or orthopaedic/deep brain stimulation surgery were recruited from a database of patients who had expressed an interest to participate in research. Participants completed clinical assessments of mobility, postural stability, balance confidence and symptom severity, while head and trunk rhythmicity was evaluated during gait using accelerometers...
September 2016: Gait & Posture
Daniel S Peterson, Bauke W Dijkstra, Fay B Horak
Protective postural responses to external perturbations are hypokinetic in people with Parkinson's disease (PD), and improving these responses may reduce falls. However, the ability of people with PD to improve postural responses with practice is poorly understood. Our objective was to determine whether people with PD can improve protective postural responses similarly to healthy adults through repeated perturbations, and whether improvements are retained or generalize to untrained perturbations. Twelve healthy adults and 15 people with PD underwent 25 forward and 25 backward translations of the support surface, eliciting backward, and forward protective steps, respectively...
August 2016: Journal of Neurology
Daniel S Peterson, Fay B Horak
Background The effect of levodopa on postural motor learning in people with Parkinson's disease is poorly understood. In particular, it is unknown whether levodopa affects improvement in protective postural responses after external perturbations such as a slip or trip, a critical aspect of fall prevention. Objective Determine the effect of levodopa on postural motor learning in people with Parkinson's disease. Methods We assessed improvement in protective postural responses in people with Parkinson's disease over short-term (1 day) perturbation training on and off levodopa...
November 2016: Neurorehabilitation and Neural Repair
Tanya Simuni, Chelsea Caspell-Garcia, Christopher Coffey, Shirley Lasch, Caroline Tanner, Ken Marek
OBJECTIVE: To determine the frequency and stability over time of the subgroup characterization of the tremor dominant (TD) versus postural instability gait disorder dominant (PIGD) Parkinson's disease (PD) in de novo patients. BACKGROUND: There is a substantial body of literature on the clinical sub classification of PD into TD versus PIGD subtype. However, there are limited data on the stability of this classification especially in early disease. METHODS: Parkinson's Progression Markers Initiative (PPMI) is a longitudinal case control study of de novo, untreated PD participants at enrollment...
July 2016: Parkinsonism & related Disorders
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