Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Turning whilst walking was investigated by gait analysis in a group of Parkinson's Disease (PD) patients with mild clinical impairment and no significant abnormalities in stride parameters and kinematics of steady-state, linear walking. Comparison with age-matched controls demonstrated that patients approached turns with a slower step and completed turning with a greater number of steps. Moreover, the normal cranio-caudal sequence, whereby rotation of the head toward the intended direction of travel is followed by rotation of the trunk, was replaced by nearly simultaneous rotation of head and trunk and decreased relative head excursion after the second turning step. The evidence of abnormal inter-segmental coordination during turning in mildly affected, normally walking patients suggests that task-specific pathophysiological mechanisms, not necessary related to basic locomotor deficits, underlie disturbed directional changes in PD. Furthermore, turning-related neural systems may be more vulnerable to functional impairments associated with PD, as compared with linear walking. Hierarchically higher control levels involved in the turning ability may explain the observed unexpected association.
Gait Posture 2007 Jul
PMID:The association between impaired turning and normal straight walking in Parkinson's disease. 1753 36

The Vitaport Activity Monitor (VAM) is an ambulatory monitoring device that uses accelerometer signals to assess the quality and quantity of walking and mobility related activities in home and community. The objective of this study was to investigate the concurrent validity of the VAM and GAITRite((R)) to measure gait speed, step length and step frequency during a test of functional gait that included single, dual and multiple task components for 12 people with Parkinsons Disease (PD) and 11 comparisons participating. For PD participants, ICCs were excellent for all gait variables (ICC (2, 2)=0.92-0.99, p< or =0.0001). For control participants, ICCs were good to excellent for all gait variables (ICC (2, 2)=0.74-0.94, p< or =0.05). Mean score differences between the two instruments were greatest for step frequency for both PD and comparisons. The VAM is useful for objective gait measurement in the home and community.
Gait Posture 2008 Feb
PMID:Concurrent validity of accelerometry to measure gait in Parkinsons Disease. 1760 30

The aims of the present study are twofold: (1) to compare the postural control mechanisms of young and elderly people as well as in Parkinson's disease (PD) patients during quiet standing and (2) to assess the impact of a stooped posture on these mechanisms. All subjects were required to maintain both a side-by-side and a 45 degrees foot position. Elderly subjects performed a third condition where they were requested to mimic the stooped posture as adopted by PD subjects. The net centre of pressure (COP(net)) and centre of mass (COM) profiles in the anterior/posterior (A/P) and medial/lateral (M/L) planes were analyzed. The COP(net) signal was recorded from two force plates and was categorized in two mechanisms: an ankle mechanism (COP(c)) and a load/unload hip mechanism (COP(v)). The results showed similar postural control mechanisms in young, elderly and PD subjects. When the feet were side-by-side, the COP(net) was controlled by the ankle plantar/dorsiflexors (COP(c)) in the A/P direction, while by the hip abductor/adductors (COP(v)) controlled in the M/L direction. When the feet were in the 45 degrees position, both the ankle and hip mechanisms contributed to the COP(net). However, the PD subjects showed significant smaller RMS amplitudes compared to the elderly people in the 45 degrees foot position and in the stooped posture. These findings suggest that PD subjects resort to a stiffening strategy to control their balance in postural tasks that imply a mixed control (ankle and hip mechanisms) but have adapted to their stooped posture.
Gait Posture 2008 Apr
PMID:The control of upright stance in young, elderly and persons with Parkinson's disease. 1764 37

This study examined the relationships between gait and dynamic balance in people with early-stage Parkinson's disease (PD). We assessed 18 participants diagnosed with stage I-II idiopathic PD and 17 healthy age-matched volunteers. Temporo-spatial gait variables were analyzed using the GAITRite system and participants were asked to walk at a comfortable walking speed. Dynamic balance was assessed using the Balance Master. Movement velocity (MV), maximal excursion (ME), and directional control (DC), obtained through the limits of stability test, quantified dynamic balance. People with early stage PD exhibited significantly slower walking speed, shorter stride length, and smaller forward MV than the comparison group. In the PD group, stride length and speed significantly correlated with forward MV, forward ME, and forward DC. Thus, in people with early PD, gait speed and stride length are correlated with dynamic balance, particularly in the forward direction in standing.
Gait Posture 2008 May
PMID:Relationships between gait and dynamic balance in early Parkinson's disease. 1789 91

This pilot study examines the effects of Tai Chi on balance, gait and mobility in people with Parkinson disease (PD). Thirty-three people with PD were randomly assigned to either a Tai Chi group or a control group. The Tai Chi group participated in 20 1-h long training sessions completed within 10-13 weeks; whereas, the control group had two testing sessions between 10 and 13 weeks apart without interposed training. The Tai Chi group improved more than the control group on the Berg Balance Scale, UPDRS, Timed Up and Go, tandem stance test, six-minute walk, and backward walking. Neither group improved in forward walking or the one leg stance test. All Tai Chi participants reported satisfaction with the program and improvements in well-being. Tai Chi appears to be an appropriate, safe and effective form of exercise for some individuals with mild-moderately severe PD.
Gait Posture 2008 Oct
PMID:Tai Chi improves balance and mobility in people with Parkinson disease. 1837 56

The Dynamic Gait Index (DGI) was developed as a clinical tool to assess gait, balance and fall risk. Because the DGI evaluates not only usual steady-state walking, but also walking during more challenging tasks, it may be an especially sensitive test. The present investigation evaluated the DGI and its association with falls, fear of falling, depression, anxiety and other measures of balance and mobility in 278 healthy elderly individuals. Measures included the DGI, the Berg Balance Test (BBT), the Timed Up and Go (TUAG), the Mini-Mental State Exam (MMSE), the Unified Parkinson's Disease Rating Scale (UPDRS) motor part, the Activities-specific Balance Confidence (ABC) scale and the number of annual falls. The DGI was moderately correlated with the BBT (r=0.53; p<0.001), the TUAG (r=-0.42; p<0.001) and the ABC (r=0.49; p<0.001). Fallers performed worse on the DGI compared to non-fallers (p=0.029). Scores on the DGI were near perfect in men (23.3+/-1.2), but among women, there was a small, but significant (p<0.001) decrease (22.5+/-1.6). The reduction in the DGI score in women was due to stair climbing performance, with many women (65%) choosing to walk while holding a handrail, compared to only 39% of men. Scores on the BBT, the TUAG, the UPDRS and the MMSE were similar in men and women. Conversely, ABC scores and fall history were different. These findings suggest that the DGI, although susceptible to ceiling effects, appears to be an appropriate tool for assessing function in healthy older adults.
Gait Posture 2009 Feb
PMID:The Dynamic Gait Index in healthy older adults: the role of stair climbing, fear of falling and gender. 1884 39

Posture is often affected in Parkinson's disease. Postural abnormalities belong to the motor axial involvement. Generally, postural dysfunction induces clinical impairment at the latest stages of the disease, except in late-onset idiopathic Parkinson's disease and in atypical parkinsonian syndromes. Posture may be affected in its orientation component (stooped posture, camptocormia, Pisa syndrome) or in its balance component (loss of postural reflexes). Overall, postural impairment is poorly improved by levodopa, which implies that it is unlikely due to the nigrostriatal dopaminergic denervation. Several methods of investigation have been proposed but are generally not available in clinical practice. Medical treatment and deep brain stimulation (DBS) of the subthalamic nucleus or globus pallidus pars interna are less efficient on axial than on distal motor signs. The pedonculopontine nucleus seems promising as a new target for DBS in combination with the subthalamic nucleus. Physical therapy is, in most cases, the best way to improve postural dysfunction.
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PMID:Postural disorders in Parkinson's disease. 1902 65

Freezing of gait (FOG) is difficult to measure due to its unpredictable occurrence. This study investigated: (1) whether the new freezing of gait questionnaire (NFOG-Q) is a reliable measure of freezing by comparing patients' ratings with those of carers' and (2) whether adding a video improved its reliability. Non-demented people with Parkinson's disease (PD) (N=102) and their carers of similar age and cognitive status were recruited from movement disorders clinics in three countries. The NFOG-Q was administered to carers and patients independently before and after watching a video showing several examples of FOG. Patients had very high agreement between their pre- and post-video detection of FOG (Kappa=0.91). However, this was less than in carers (Kappa=0.79). The video had a significant influence (p=0.01) on the rating of FOG severity (duration) but not on the estimation of its functional impact. Post-video freezing severity scores in the 69 freezers showed high agreement with carers' scores (ICC=0.78 [0.65;0.87]). We conclude that the NFOG-Q is a reliable tool to detect and evaluate the impact and severity of FOG. Adding a video does not add to the sensitivity and specificity of FOG detection but influences the estimation of FOG severity.
Gait Posture 2009 Nov
PMID:Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson's disease and their carers. 1966 Sep 49

Current clinical assessments do not adequately detect the onset of postural instability in the early stages of Parkinson's disease (PD). The aim of this study was to identify biomechanical variables that are sensitive to the effects of early Parkinson's disease on the ability to recovery from a balance disturbance. Ten adults diagnosed with idiopathic PD and no clinically detectable postural instability, and ten healthy age-range matched controls (HC) completed the study. The first step in the response to a backwards waist pull was quantified in terms of strategy, temporal, kinematic, kinetic, and center of pressure (COP) variables. People with PD, compared to HC, tended to be less consistent in the choice of stepping limb, utilized more time for weight shift, used a modified ankle joint motion prior to liftoff, and the COP was further posterior at landing. The study results demonstrate that PD changes the response to a balance disturbance which can be quantified using biomechanical variables even before the presence of clinically detectable postural instability. Further studies are required to determine if these variables are sensitive and specific to postural instability.
Gait Posture 2009 Nov
PMID:Early biomechanical markers of postural instability in Parkinson's disease. 1974 71

The aim of this study was to compare the locomotor behavior of people with Parkinson's disease (PD) and healthy older adults during obstacle negotiation, both in the approaching and crossing phases. Twelve people with idiopathic PD, with mild to moderate disease, and 12 healthy individuals (CG) walked across an 8m pathway for three obstacle conditions: no obstacle, low obstacle and high obstacle. Each performed five trials for each obstacle condition. Performance was more disturbed for the high obstacle than the low obstacle. During the approach phase, people with PD demonstrated shorter stride length (F(1,22)=8.55, P=0.008) and greater stride duration (F(1,22)=7.371, P=0.013) than controls. Those with PD also increased their stance phase durations (F(1,22)=7.426, P=0.012) for both obstacle conditions, while the CG maintained comparable step durations for all conditions. For the crossing phase, people with PD demonstrated shorter step length (F(1,22)=9.699, P=0.005) over the obstacle. Leading limbs were closer to the obstacle, before and after crossing. Thus PD hypokinesia compromises the approach and crossing phases of obstacle negotiation.
Gait Posture 2010 Jan
PMID:Effects of obstacle height on obstacle crossing in mild Parkinson's disease. 1985 57


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