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Gait and balance

Gro Gujord Tangen, Astrid Bergland, Knut Engedal, Anne Marit Mengshoel
Parkinsonian signs are common in patients with Alzheimer's disease (AD) of mild degree and predict functional decline, but their relationship with gait speed and balance is unclear. The aims of this study were to describe characteristics of patients with parkinsonian signs among 98 patients with AD of mild degree (with no comorbid Parkinson's disease), and to examine associations between parkinsonian signs with gait speed and balance. A cross sectional study at a memory clinic was conducted. Presence of each parkinsonian sign (bradykinesia, rigidity and tremor) was derived from the UPDRS, regular gait speed was recorded over 10m and balance were assessed using the Mini-Balance Evaluation Systems Test (Mini-BESTest)...
October 14, 2016: Gait & Posture
Deanna Gray-Miceli, Sarah J Ratcliffe, Arwin Thomasson, Patricia Quigley, Kang Li, William Craelius
BACKGROUND: Patients at greatest risk for fall-related injuries are older adults with orthostatic hypotension (OH), a condition which drops blood pressure. This study sought to determine salient demographic and patient-level factors increasing risk for OH among a sample of elderly fallers. METHODS: Data analysis for this retrospective study sought to assess the relationship between various demographic and clinical risk factors and the likelihood of OH. Because fallers could experience multiple falls, generalized estimating equations were used to account for patient-level correlations...
October 20, 2016: Journal of Patient Safety
Suhitha Veeravelli, Bijan Najafi, Ivan Marin, Fernando Blumenkron, Shannon Smith, Stephen A Klotz
Approximately 1.2 million people in the United States live with HIV infection. Medical advancements have increased the life expectancy and this cohort is aging. HIV-positive individuals have a high incidence of frailty (~20%) characterized by depression and sedentary behavior. Exercise would be healthy, but due to the frail status of many HIV-positive individuals, conventional exercise is too taxing. The aim of this study was to evaluate the effectiveness and acceptability of a novel game-based training program (exergame) in ameliorating some aspects of frailty in HIV-infected individuals...
October 6, 2016: Journal of Visualized Experiments: JoVE
Mitsuru Yagi, Hideaki Ohne, Tsunehiko Konomi, Kanehiro Fujiyoshi, Shinjiro Kaneko, Masakazu Takemitsu, Masafumi Machida, Yoshiyuki Yato, Takashi Asazuma
BACKGROUND CONTEXT: Gait patterns and their relationship to demographic and radiographic data in patients with adult spinal deformity (ASD) have not been fully documented. PURPOSE: To assess gait pattern in patients with ASD and the effect of corrective spinal surgery on gait. STUDY DESIGN/SETTING: Prospective case series. PATIENT SAMPLE: The gait patterns of 33 consecutive female with ASD (age 67.1 years; body mass index (BMI) 22...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Maria I Ventura, Deborah E Barnes, Jessica M Ross, Kimberly E Lanni, Karen A Sigvardt, Elizabeth A Disbrow
Parkinson's disease (PD) is a progressive neurodegenerative disease associated with deficits in motor, cognitive, and emotion/quality of life (QOL) domains, yet most pharmacologic and behavioral interventions focus only on motor function. Our goal was to perform a pilot study of Dance for Parkinson's-a community-based program that is growing in popularity-in order to compare effect sizes across multiple outcomes and to inform selection of primary and secondary outcomes for a larger trial. Study participants were people with PD who self-enrolled in either Dance for Parkinson's classes (intervention group, N=8) or PD support groups (control group, N=7)...
October 17, 2016: Contemporary Clinical Trials
Anna Chapman, Claudia Meyer, Emma Renehan, Keith D Hill, Colette J Browning
INTRODUCTION: Falls as a complication of diabetes mellitus (DM) can have a major impact on the health of older adults. Previous reviews have demonstrated that certain exercise interventions are effective at reducing falls in older people; however, no studies have quantified the effectiveness of exercise interventions on falls-related outcomes among older adults with DM. METHODS: A systematic search for all years to September 2015 identified available literature...
September 30, 2016: Journal of Diabetes and its Complications
Martin Alfuth
The aim of this systematic review with meta-analysis was to investigate if using textured or other types of stimulating insoles improve gait characteristics and balance/postural control in patients with multiple sclerosis and Parkinson's disease. Primary outcomes for balance were the center of pressure (CoP) displacement and CoP velocity/sway rate. Primary outcomes for gait were the cadence, velocity, and step length. Standardized mean differences (SMD) were used to verify the efficacy of wearing the insoles on gait and balance outcome measures...
October 11, 2016: Gait & Posture
Michiel S Oerbekke, Mirelle J Stukstette, Kurt Schütte, Rob A de Bie, Martijn F Pisters, Benedicte Vanwanseele
BACKGROUND: The OpenGo seems promising to take gait analysis out of laboratory settings due to its capability of long-term measurements and mobility. However, the OpenGo's concurrent validity and reliability need to be assessed to determine if the instrument is suitable for validation in patient samples. METHODS: Twenty healthy volunteers participated. Center of pressure data were collected under eyes open and closed conditions with participants performing unilateral stance trials on the gold standard (AMTI OR6-7 force plate) while wearing the OpenGo...
October 6, 2016: Gait & Posture
Hsuan-Lun Lu, Tung-Wu Lu, Hsiu-Chen Lin, Hong-Jung Hsieh, Wing P Chan
Treadmills are often used in clinical settings to improve walking balance control in patients with gait impairments. However, knowledge of the effects of belt speed on balance control remains incomplete. The current study determined such effects in terms of inclination angles (IA) and the rate of change (RCIA) of the center of mass (COM) motion relative to the center of pressure (COP) in twelve healthy adults at five belt speeds, including the subjects' preferred walking speed (PWS), as measured using a motion capture system and an instrumented treadmill...
September 29, 2016: Gait & Posture
Nima Toosizadeh, Homayoon Harati, Tzu-Chuan Yen, Cindy Fastje, Jane Mohler, Bijan Najafi, Michael Dohm
BACKGROUND: This study examined short- and long-term improvements in motor performance, quantified using wearable sensors, in response to facet spine injection in degenerative facet osteoarthropathy patients. METHODS: Adults with confirmed degenerative facet osteoarthropathy were recruited and were treated with medial or intermediate branch block injection. Self-report pain, health condition, and disability (Oswestry), as well as objective motor performance measures (gait, balance, and timed-up-and-go) were obtained in five sessions: pre-surgery (baseline), immediately after the injection, one-month, three-month, and 12-month follow-ups...
October 11, 2016: Clinical Biomechanics
Eun Young Han, Sang Hee Im, Bo Ryun Kim, Min Ji Seo, Myeong Ok Kim
OBJECTIVE: Brachial-ankle pulse wave velocity (baPWV) evaluates arterial stiffness and also predicts early outcome in stroke patients. The objectives of this study were to investigate arterial stiffness of subacute nonfunctional ambulatory stroke patients and to compare the effects of robot-assisted gait therapy (RAGT) combined with rehabilitation therapy (RT) on arterial stiffness and functional recovery with those of RT alone. METHOD: The RAGT group (N = 30) received 30 minutes of robot-assisted gait therapy and 30 minutes of conventional RT, and the control group (N = 26) received 60 minutes of RT, 5 times a week for 4 weeks...
October 2016: Medicine (Baltimore)
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
Christopher McCrum, Katrin Eysel-Gosepath, Gaspar Epro, Kenneth Meijer, Hans H C M Savelberg, Gert-Peter Brüggemann, Kiros Karamanidis
Posturography is used to assess balance in clinical settings, but its relationship to gait stability is unclear. We assessed if dynamic gait stability is associated with standing balance in 12 patients with unilateral vestibulopathy. Participants were unexpectedly tripped during treadmill walking and the change in the margin of stability (MoSchange) and base of support (BoSchange) relative to non-perturbed walking was calculated for the perturbed and first recovery steps. The centre of pressure (COP) path during 30s stance with eyes open and closed, and the distance between the most anterior point of the COP and the anterior BoS boundary during forward leaning (ADist) were assessed using a force plate...
October 13, 2016: Journal of Applied Biomechanics
Emily I McIntosh, John L Zettel, Lori Ann Vallis
The objective of this work was to investigate the influence perturbation direction has on postural responses during overground gait, and whether these responses are age related. Differences in stepping patterns following perturbations of the support surface were examined in the frontal and sagittal planes during forward walking. Eleven young and 10 older adults completed Mini BESTest, hip strength tests, and 45 perturbed walking trials, triggered on heel contact. Lateral perturbations were more challenging to postural stability for both groups...
October 10, 2016: Journal of Motor Behavior
Oanh Tran Thi Hoang, Pornchai Jullamate, Naiyana Piphatvanitcha, Edwin Rosenberg
AIMS AND OBJECTIVES: To investigate the relationship between age, gender, history of falls, balance and gait status, general health perception, activities of daily living and depression to fear of falling in community-dwelling older people in Danang, Vietnam. BACKGROUND: Fear of falling is a common and consequential psychosocial problem for older people and can lead to decreased quality of life. There is only limited research on fear of falling in Vietnam. DESIGN: This is a cross-sectional descriptive study...
October 9, 2016: Journal of Clinical Nursing
V S C Fung
Gait disorder is a common accompaniment of functional neurologic disorders. The diagnosis of a functional or psychogenic gait is complex. It requires a sound knowledge of the range of phenomenology observed in organic movement disorders, the ability to evaluate and diagnose nonmovement disorder neurologic symptoms and signs, but additionally knowledge of potential musculoskeletal causes of gait disturbance. A stepwise approach to the analysis of the phenomenology and separation into four (sometimes overlapping) psychogenic gait syndromes is suggested to aid diagnosis: (1) movement disorder mimics; (2) neurologic (nonmovement disorder) mimics; (3) musculoskeletal or biomechanical mimics; and (4) isolated disequilibrium or balance disorders...
2017: Handbook of Clinical Neurology
Terry Trinh, Christine T Shiner, Angelica G Thompson-Butel, Penelope A McNulty
PURPOSE: Post-stroke hemiparesis may manifest as asymmetric gait, poor balance, and inefficient movement patterns. We investigated improvements in lower-limb muscle activation and function during Wii-based Movement Therapy (WMT), a rehabilitation program specifically targeting upper-limb motor-function. METHODS: Electromyography (EMG) was recorded bilaterally from tibialis anterior (TA) in 20 stroke patients during a 14-day WMT program. EMG amplitude and burst duration were analyzed during stereotypical movement sequences of WMT activities...
October 9, 2016: Disability and Rehabilitation
Ece Çınar, Yeşim Akkoç, Hale Karapolat, Raika Durusoy, Gökhan Keser
OBJECTIVE: This study aimed to assess the impact of postural deformities caused by ankylosing spondylitis (AS) on balance problems. MATERIAL AND METHODS: This study included 29 patients with AS and 21 healthy controls. For assessing exercise capacity and dynamic balance, timed up and go test, five times sit-to-stand test, gait speed, and 6-min walk test were performed. Romberg tests were used to evaluate static balance and proprioception, whereas Dynamic Gait Index (DGI), Functional Gait Assessment (FGA), Berg Balance Scale (BBS), Activity Specific Balance Confidence Scale (ABC), Dizziness Handicap Inventory (DHI), and functional reach test were used to assess dynamic balance and the risk of falling...
March 2016: Eur J Rheumatol
Hyun-Ju Park, Duck-Won Oh, Jong-Duk Choi, Jong-Man Kim, Suhn-Yeop Kim, Yong-Jun Cha, Su-Jin Jeon
PURPOSE: To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke. DESIGN: Randomized, controlled pilot study. SETTING: Inpatient rehabilitation hospital. SUBJECTS: A total of 25 inpatients with post-stroke hemiparesis were randomly assigned to either the experimental group (n = 12) or control group (n = 13). INTERVENTION: Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes, three times a week for four weeks...
October 5, 2016: Clinical Rehabilitation
Hwang-Jae Lee, Won Hyuk Chang, Sun Hee Hwang, Byung-Ok Choi, Gyu-Ha Ryu, Yun-Hee Kim
The purpose of this study was to examine age-related gait characteristics and their associations with balance function in older adults. A total of 51 adult volunteers participated. All subjects underwent locomotion analysis using a 3D motion analysis and 12-channel dynamic electromyography system. Dynamic balance function was assessed by the Berg Balance Scale. Older adults showed a higher level of muscle activation than young adults, and there were significant positive correlations between increased age and activation of the trunk and thigh muscles in the stance and swing phase of the gait cycle...
October 5, 2016: Journal of Aging and Physical Activity
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