Low to moderate relationships between gait and postural responses in  Parkinson disease

Sutter, Ellen N.; Seidler, Katie J.; Duncan, Ryan P.; Earhart, Gammon M.; McNeely, Marie E.

doi:10.2340/16501977-2238

Cited by 8 publications

(29 citation statements)

References 42 publications

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“…In the future, it might be interesting also to validate our model with accelerometers that offer a series of advantages such as lower cost and applicability in free-living situations. However, right now we believe it is important to have a model usable with electronic walkways since they are still frequently used in scientific studies and clinical practice [7,[65][66][67][68].…”

Section: Limitationsmentioning

confidence: 99%

Proposal of a new conceptual gait model for patients with Parkinson’s disease based on factor analysis

et al. 2019

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Background Gait impairment is a risk factor for falls in patients with Parkinson’s disease (PD). Gait can be conveniently assessed by electronic walkways, but there is need to select which spatiotemporal gait variables are useful for assessing gait in PD. Existing models for gait variables developed in healthy subjects and patients with PD show some methodological shortcomings in their validation through exploratory factor analysis (EFA), and were never confirmed by confirmatory factor analysis (CFA). The aims of this study were (1) to create a new model of gait for PD through EFA, (2) to analyze the factorial structure of our new model and compare it with existing models through CFA. Results From the 37 variables initially considered in 250 patients with PD, 10 did not show good-to-excellent reliability and were eliminated, while further 19 were eliminated after correlation matrix and Kaiser–Meyer–Olkin measure. The remaining eight variables underwent EFA and three factors emerged: pace/rhythm, variability, and asymmetry. Structural validity of our new model was then examined with CFA, using the structural equation modeling. After some modifications, suggested by the Modification Indices, we obtained a final model that showed an excellent fit. In contrast, when the structure of previous models of gait was analyzed, no model achieved convergence with our sample of patients. Conclusions Our model for spatiotemporal gait variables of patients with PD is the first to be developed through an accurate EFA and confirmed by CFA. It contains eight gait variables divided into three factors and shows an excellent fit. Reasons for the non-convergence of other models could be their inclusion of highly inter-correlated or low-reliability variables or could be possibly due to the fact that they did not use more recent methods for determining the number of factors to extract.

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Section: Limitationsmentioning

confidence: 99%

Proposal of a new conceptual gait model for patients with Parkinson’s disease based on factor analysis

et al. 2019

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“…Individuals with PD who exhibit postural instability are at greater risk of rapid functional decline [17]. Thus, it is essential that professionals attain an accurate measurement of postural control in order to determine optimal rehabilitation goals.…”

Section: Discussionmentioning

confidence: 99%

Postural instability in subjects with Parkinson’s disease undergoing different sensory pitfalls

et al. 2018

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Purpose. Previous research has reported postural instability in subjects with Parkinson's disease (PD). However, there are still doubts about the effect of sensory stimuli on one's balance. In this study, we further investigated the stabilometric measures of individuals with PD, analysing the impact of different sensory stimuli on the outcomes. Methods. The total of 26 participants (13 with PD and 13 matched control peers) were submitted to 8 sensorimotor dynamics differing in relation to support base (30 cm vs. 10 cm, feet in parallel vs. feet in semi-tandem position), contact surface (foam vs. no foam), and visual conditions (eyes open vs. eyes closed). The measures used to assess one's balance were body position in space, area of support base, and velocity of postural control. The variables involved the anterior-posterior and the mediolateral axes. Participants with PD were evaluated during the off medication state. Mann-Whitney U test and Friedman's test were applied to carry out inter-and intra-group comparisons. Significance was set at 5%. Results. Cross-sectional analyses illustrated that tasks with sensory pitfalls impacted postural stability to a larger extent in PD subjects. The differences were found in anterior-posterior body position, area of support base, anterior-posterior velocity, and mediolateral velocity. Complementary analyses confirmed considerable instability on balance when support bases were small and visual information was absent (p < 0.05). Conclusions. The current results confirm worse postural stability response in subjects with PD and highlight that the interference of the sensory pitfalls is notable when individuals are off medication.

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“…Freezers were shown to have slower and smaller corrective stepping responses compared to non-freezers (Smulders et al, 2014;Sutter et al, 2017), whereas other studies reported that reactive postural control was similar between freezer and nonfreezers (Nonnekes et al, 2015;Peterson and Horak, 2016), or even better in freezers (Vervoort et al, 2013). The study with the largest population reported more impaired compensatory stepping in freezers, but the higher disease severity in this group and lack of standardized measurement compromised the freezing-specificity of the findings (Sutter et al, 2017). Inconsistent results were also specific to the direction of the platform translations.…”

Section: Fog and Reactive Postural Controlmentioning

confidence: 99%

Balancing between the two: Are freezing of gait and postural instability in Parkinson’s disease connected?

Bekkers

Dijkstra

Heremans

et al. 2018

Neuroscience & Biobehavioral Reviews

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Postural instability and freezing of gait (FoG) are key features of Parkinson's disease (PD) closely related to falls. Growing evidence suggests that co-existing postural deficits could influence the occurrence and severity of FoG. To date, the exact nature of this interrelationship remains largely unknown. We analyzed the complex interaction between postural instability and gait disturbance by comparing the findings available in the posturographic literature between patients with and without FoG. Results showed that FoG and postural instability are intertwined, can influence each other behaviorally and may coincide neurologically. The most common FoG-related postural deficits included weight-shifting impairments, and inadequate scaling and timing of postural responses most apparent at forthcoming postural changes under time constraints. Most likely, a negative cycle of combined and more severe postural deficits in people with FoG will enhance postural stability breakdown. As such, the wide brain network deficiencies involved in FoG may also concurrently influence postural stability. Future work needs to examine whether training interventions targeting both symptoms will have extra clinical benefits on fall frequency.

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Low to moderate relationships between gait and postural responses in Parkinson disease

Cited by 8 publications

References 42 publications

Proposal of a new conceptual gait model for patients with Parkinson’s disease based on factor analysis

Proposal of a new conceptual gait model for patients with Parkinson’s disease based on factor analysis

Postural instability in subjects with Parkinson’s disease undergoing different sensory pitfalls

Balancing between the two: Are freezing of gait and postural instability in Parkinson’s disease connected?

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