Maximum Step Length Test Performance in People With Parkinson Disease: A Cross-sectional Study

Abstract

Background and Purpose The Maximum Step Length Test (MSLT), a measure of one’s capacity to produce a large step, has been studied in older adults, but not in people with Parkinson disease (PD). We characterized performance and construct validity of the MSLT in PD. Methods Forty participants (mean age: 65.12±8.20; 45% female) with idiopathic PD completed the MSLT while OFF and ON anti-PD medication. Construct validity was investigated by examining relationships between MSLT and measures of motor performance. The following measures were collected: Mini-BESTest, ABC scale, gait velocity, 6MWT, MDS-UPDRS III, and TUG. A repeated measures ANOVA tested for main effects of medication and stepping direction and the interaction between the two. Pearson or Spearman correlations were used to assess the relationships between MSLT and motor performance measures (α=0.05). Results Regardless of medication status, participants stepped further in the forward direction compared to the backward and lateral directions (p<0.001). Participants increased MSLT performance when ON-medication compared to OFF-medication (p=0.004). Regardless of medication status, MSLT was moderately to strongly related to Mini-BESTest, TUG, and 6MWT. Discussion and Conclusions People with PD stepped furthest in the forward direction when performing the MSLT. Increased MSLT performance was observed ON-medication compared to OFF-medication; however, the small increase may not be clinically meaningful. Given the relationships between the MSLT and the Mini-BESTest, 6MWT, and TUG, MSLT performance appears to associated with balance and gait hypokinesia in people with PD. Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1).

Prediction of the Levodopa Challenge Test in Parkinson’s Disease Using Data from a Wrist-Worn Sensor

“…There is also variation in what constitutes a significant response: a %∆ of 30% is widely accepted [40,41] although changes including 20% [42], 25% [43], 33% [2], >40% [44] and 25–50% [45] are cited. Some centers measure the “ON” state at a specific time [2,38,39], typically 45 min [46,47], whereas others establish a peak score. There is also no uniformity in the size of the dose: most use an absolute dose [40,41,48] ranging from 150–400 mg of levodopa but others use some multiple of the usual morning dose [49,50,51].…”

Channel Characterization and Modeling for Optical Wireless Body-Area Networks

“…Referring to the general model in Subsection II-B, here, for the sake of simplicity, we consider a constant speed of v user = 0.45 m/s for all user movements, which is a reasonable value. Also, considering a reasonable d cycle of 2 m [55], [56], and setting N f = 27, which has been verified to capture the movement pattern, we have ∆t ≈ 0.17 sec. Note that with the classical RWP model, the user moves in a straight line from one point to another, producing a sharp rotation when reaching a waypoint.…”

Evaluation of the psychometric properties and clinical applications of the Timed Up and Go test in Parkinson disease: a systematic review

“…The titles and abstracts were screened using the inclusion criteria and 46 studies were selected. After reading the full text of these articles, 24 studies met the inclusion criteria and were included in the review (Bergström et al, 2012;Claesson et al, 2017;Da Silva et al, 2017;Dal Bello-Haas et al, 2011;Duncan et al, 2017;Falvo and Earhart, 2009;Foreman et al, 2011;Franchignoni et al, 2005;Huang et al, 2011;Johnston et al, 2013;Kleiner et al, 2018;Kobayashi et al, 2017;Lim et al, 2005;Mariani et al, 2013;Morris et al, 2001;Nilsson and Hagell, 2009;Schlenstedt et al,. 2015;Shine et al, 2012;Spagnuolo et al, 2018;Van Lummel et al, 2016;Verheyden et al, 2014;Vogler et al, 2015;Zhan et al, 2018).…”

“…We, therefore, structured the TUG validity analysis as a function of the quality or the physical capacity evaluated as contrast in these studies. With regard to the contrast test for balance, the scores shown are “good” for the Mini-BESTest ( Bergström et al, 2012 ), Berg Balance Scale and Fullerton Advance Balance ( Schlenstedt et al, 2015 ); “moderate” for the Mini-BESTest ( Da Silva et al, 2017 ; Schlenstedt et al, 2015 ) and Maximum Step Length Test ( Duncan et al, 2017 ); “weak” for the Berg Balance Scale ( Kobayashi et al, 2017 ) and Fear of Fall Measurement ( Franchignoni et al, 2005 ); and “poor” for the Bäckstrand Dahlberg Liljenäs balance scale ( Claesson et al, 2017 ). The TUG test gave different results when contrasted with the same test that assessed balance.…”