Fall Risk Factors in Parkinsonʼs Disease

Gray, Peggy; Hildebrand, Kathleen

doi:10.1097/01376517-200008000-00006

Cited by 308 publications

(274 citation statements)

References 0 publications

Supporting

Mentioning

240

Contrasting

Unclassified

Order By: Relevance

“…Patients with more advanced disease showed greater benefit after using the device, as greater baseline disability would provide the opportunity for a proportionally larger magnitude of benefit whereas small baseline disability makes it harder for the intervention to show any beneficial effects. The reduction in at-home freezing severity noted in the FOGQ, although small in magnitude, is particularly relevant because of the pharmacoresistance of freezing and its association with an increased rate of falls [18]. A possible mechanism for the reduction in freezing, we speculate, is the generation of cortical reorganization or neuroplasticity, which may alter or circumvent the neuronal pathways responsible for this phenomenon.…”

Section: Discussionmentioning

confidence: 99%

At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease

Espay¹,

Baram²,

Dwivedi³

et al. 2010

JRRD

132

View full text Add to dashboard Cite

Abstract-Shuffling and freezing while walking can impair function in patients with Parkinson disease (PD). Open-loop devices that provide fixed-velocity visual or auditory cues can improve gait but may be unreliable or exacerbate freezing of gait in some patients. We examined the efficacy of a closedloop, accelerometer-driven, wearable, visual-auditory cueing device in 13 patients with PD with off-state gait impairment at baseline and after 2 weeks of twice daily (30 minute duration) at-home use. We measured gait velocity, stride length, and cadence using a validated electronic gait-analysis system. Subjects underwent standard motor assessment and completed a self-administered Freezing of Gait Questionnaire (FOGQ) (range 0-24; lower is better). After training, device use enhanced walking velocity (61.6 ± 20.1 cm/s to 72.6 ± 26.5 cm/s, p = 0.006) and stride length (74.3 ± 16.4 cm to 84.0 ± 18.5 cm, p = 0.004). Upon device removal, walking velocity (64.5 ± 21.4 cm/s to 75.4 ± 21.5 cm/s, p < 0.001) and stride length (79.0 ± 20.3 cm to 88.8 ± 17.7 cm, p = 0.003) exhibited a greater magnitude of change, suggesting immediate residual benefits. Also upon device removal, nearly 70 percent of subjects improved by at least 20 percent in either walking velocity, stride length, or both. An overall improvement in gait was measured by the FOGQ (14.2 ±1.9 to 12.4 ± 2.5, p = 0.02). Although issues related to compliance and response variability render a definitive interpretation of study outcome difficult, devices using closed-loop sensory feedback appear to be effective and desirable nonpharmacologic interventions to improve walking in selected individuals with PD.

show abstract

Section: Discussionmentioning

confidence: 99%

At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease

Espay¹,

Baram²,

Dwivedi³

et al. 2010

JRRD

132

View full text Add to dashboard Cite

show abstract

“…A feeling of being glued to the floor is typically expressed. FOG can be quite disabling, impairing function, health-related quality of life, mobility, and independence (Gray & Hildebrand, 2000;Giladi et al, 2001). Because of its episodic nature, patients with FOG have an increased risk for falls, nursing home admission, and mortality (Gray & Hildebrand, 2000).…”

Section: Freezing Of Gaitmentioning

confidence: 99%

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Hausdorff

2007

Human Movement Science

712

594

View full text Add to dashboard Cite

Until recently, quantitative studies of walking have typically focused on properties of a typical or average stride, ignoring the stride-to-stride fluctuations and considering these fluctuations to be noise. Work over the past two decades has demonstrated, however, that the alleged noise actually conveys important information. The magnitude of the stride-to-stride fluctuations and their changes over time during a walk -gait dynamics -may be useful in understanding the physiology of gait, in quantifying age-related and pathologic alterations in the locomotor control system, and in augmenting objective measurement of mobility and functional status Indeed, alterations in gait dynamics may help to determine disease severity, medication utility, and fall risk, and to objectively document improvements in response to therapeutic interventions, above and beyond what can be gleaned from measures based on the average, typical stride. This review discusses support for the idea that gait dynamics has meaning and may be useful in providing insight into the neural control of locomtion and for enhancing functional assessment of aging, chronic disease, and their impact on mobility.

show abstract

“…The episodic gait disturbances include festination, start hesitation, and freezing of gait. 7,13,14 The latter is a debilitating phenomenon that is most commonly experienced by patients with ad- …”

Section: A Gait Disturbances In Pd: Classification and Clinical Ramimentioning

confidence: 99%

Gait dynamics in Parkinson’s disease: Common and distinct behavior among stride length, gait variability, and fractal-like scaling

Hausdorff

2009

Chaos: An Interdisciplinary Journal of Nonlinear Science

501

409

View full text Add to dashboard Cite

Parkinson’s disease (PD) is a common, debilitating neurodegenerative disease. Gait disturbances are a frequent cause of disability and impairment for patients with PD. This article provides a brief introduction to PD and describes the gait changes typically seen in patients with this disease. A major focus of this report is an update on the study of the fractal properties of gait in PD, the relationship between this feature of gait and stride length and gait variability, and the effects of different experimental conditions on these three gait properties. Implications of these findings are also briefly described. This update highlights the idea that while stride length, gait variability, and fractal scaling of gait are all impaired in PD, distinct mechanisms likely contribute to and are responsible for the regulation of these disparate gait properties.

show abstract

Fall Risk Factors in Parkinsonʼs Disease

Cited by 308 publications

References 0 publications

At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease

At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Gait dynamics in Parkinson’s disease: Common and distinct behavior among stride length, gait variability, and fractal-like scaling

Contact Info

Product

Resources

About