Pull test performance and correlation with falls risk in Parkinson?s disease

Munhoz, Renato P.; Teive, Hélio Afonso Ghizoni

doi:10.1590/0004-282x20140082

Cited by 19 publications

(13 citation statements)

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“…The quantitative tests used routinely are kinematic gait analysis, global mobility task, phase coordination index, ambulatory gait assessment, ambulatory freezing assessment, and the GAITRite system [47]. The pull test (PT), is reported to have the highest specificity and sensitivity when rightly performed and interpreted [48]. However, many studies have concluded that multiple balance tests assessing the different types of postural stress provide an optimal assessment of PI [48,49].…”

Section: Pathophysiologymentioning

confidence: 99%

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Postural Instability in Parkinson’s Disease: A Review

Palakurthi

Burugupally

2019

Brain Sciences

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Parkinson’s disease (PD) is a heterogeneous progressive neurodegenerative disorder, which typically affects older adults; it is predicted that by 2030 about 3% of the world population above 65 years of age is likely to be affected. At present, the diagnosis of PD is clinical, subjective, nonspecific, and often inadequate. There is a need to quantify the PD factors for an objective disease assessment. Among the various factors, postural instability (PI) is unresponsive to the existing treatment strategies resulting in morbidity. In this work, we review the physiology and pathophysiology of postural balance that is essential to treat PI among PD patients. Specifically, we discuss some of the reported factors for an early PI diagnosis, including age, nervous system lesions, genetic mutations, abnormal proprioception, impaired reflexes, and altered biomechanics. Though the contributing factors to PI have been identified, how their quantification to grade PI severity in a patient can help in treatment is not fully understood. By contextualizing the contributing factors, we aim to assist the future research efforts that underpin posturographical and histopathological studies to measure PI in PD. Once the pathology of PI is established, effective diagnostic tools and treatment strategies could be developed to curtail patient falls.

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Section: Pathophysiologymentioning

confidence: 99%

“…The pull test (PT), is reported to have the highest specificity and sensitivity when rightly performed and interpreted [48]. However, many studies have concluded that multiple balance tests assessing the different types of postural stress provide an optimal assessment of PI [48,49].…”

Section: Pathophysiologymentioning

confidence: 99%

Postural Instability in Parkinson’s Disease: A Review

Palakurthi

Burugupally

2019

Brain Sciences

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“…Matinollia et al analyzed mobility and balance in PD and noted that advanced age and severity of disease are related to mobility and impaired balance in patients with PD (23) . Munhoz and Tieve rated balance by retropulsion using the UPDRS test and found that age and severity of PD increase the level of difficulty for completion of the task (24) . We also analyzed the relationship between freezing of gait and mobility / performance of DT, and we observed that the low performance of DT and functional activities could be due to gait freezing.…”

Section: Discussionmentioning

confidence: 99%

Analysis of functional profile and mobility in Parkinson’s disease: a cross sectional study

Gomes¹,

Miranda²,

Silva³

et al. 2020

mtprehabjournal

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Background: Idiopathic Parkinson’s disease (PD) is a progressive neurodegenerative disease that has a prevalence of 18–328 per 100,000 in habitants in developing countries, with an estimated 3.3% of the Brazilian elderly population affected by PD throughout life. The classic symptoms include a resting tremor, muscular rigidity, bradykinesia and postural instability, which are all motor symptoms. The mobility of the subjects is compromised early, thus impairing their balance and limiting their ability to perform simple tasks. The restricted movement prevents dissociation between the head and trunk during walking, and freezing occurs as advanced disease reduces the progression of movements during walking. Objective: To analyze mobility and functionality profiles in subjects with Parkinson’s disease and compare them with healthy subjects. Method: A sample was consisted of 10 subjects with PD and 10 healthy elderly subjects. Assessment tools were used to quantify the severity of PD the scale Hoehn and Yah (HY), for mobility were used the Dynamic Parkinson’s Gait Scale (DYPAGS) and Modified Parkinson Activity Scale (PAS modified), for functionality were used the Unified Parkinson’s Disease Rating Scale (UPDRS) and dual task (DT) performance. Results: The subjects with PD showed worse performance in mobility and DT as determined by the modified PAS (p=0.0001) and DYPAGS (p=0.0001). Correlations were found between the UPDRS, the Gait Freezing Questionnaire (FOG), the PAS modified score, left-hand grip strength and the HY values (p<0.05). There were no differences in prehensile muscle strength between PD and healthy subjects. Conclusions: Subjects with PD showed decreased mobility and functionality for activities related to ADLs, gait and DT compared to healthy elderly subjects. Disease severity, muscle strength and freezing were correlated with the mobility and DT performance in subjects with PD.

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“…This is important because poor reactive postural control is associated with increased fall risk. 50 Furthermore, the FAB Scale and Mini-BESTest measure postural stability while performing a secondary task. It has been shown that patients with PD worsen in balance performance when focusing on a secondary task.…”

Section: Discussionmentioning

confidence: 99%