Motor and Cognitive Impairments in Parkinson Disease

Paul, Serene S.; Sherrington, Catherine; Fung, Victor S.C.; Canning, Colleen G.

doi:10.1177/1545968312446754

Cited by 28 publications

(11 citation statements)

References 55 publications

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“…Our findings supporting the role of age in gait and mobility performance corroborate prior studies (Rochester et al, 2008; Falvo & Earhart, 2009; Paul et al, 2013; Strouwen et al, 2016; Nemanich et al, 2013). However, our results showed a relatively small impact of age (0-2.9% of variance in outcomes explained) which is on par with some previous studies (Rochester et al, 2008; Strouwen et al, 2016), but substantially lower compared to others, including one in which age explained 19% of variance in preferred pace and 18% of variance in fast walking velocity (Nemanich et al, 2013).…”

Section: Discussionsupporting

confidence: 92%

“…Different combinations of factors including demographic characteristics, disease severity, fall history, fear of falling, other gait and mobility measures, freezing of gait, balance, balance confidence, muscle power, cognition, and depression, have been identified as significant predictors (explaining up to 30-73% of variance) of gait and mobility performance in single and dual task conditions (Varalta et al, 2015; Rochester et al, 2008; Falvo & Earhart, 2009; Lord et al, 2010; Paul et al, 2013; Stegemöller et al, 2014; Lord et al, 2014; Strouwen et al, 2016; Nemanich et al, 2013). All except one of these previous studies measured participants while on anti-parkinson medication, and the single study testing ‘off’ medication included a relatively small sample (Lord et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Investigation of factors impacting mobility and gait in Parkinson disease

Christofoletti

McNeely

Campbell

et al. 2016

Human Movement Science

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Mobility and gait limitations are major issues for people with Parkinson disease (PD). Identification of factors that contribute to these impairments may inform treatment and intervention strategies. In this study we investigated factors that predict mobility and gait impairment in PD. Participants with mild to moderate PD and without dementia (n=114) were tested in one session ‘off’ medication. Mobility measures included the 6-Minute Walk test and Timed-Up-and-Go. Gait velocity was collected in four conditions: forward preferred speed, forward dual task, forward fast as possible and backward walking. The predictors analyzed were age, gender, disease severity, balance, balance confidence, fall history, self-reported physical activity, and executive function. Multiple regression models were used to assess the relationships between predictors and outcomes. The predictors, in different combinations for each outcome measure, explained 55.7% to 66.9% of variability for mobility and 39.5% to 52.8% for gait velocity. Balance was the most relevant factor (explaining up to 54.1% of variance in mobility and up to 45.6% in gait velocity). Balance confidence contributed to a lesser extent (2.0% to 8.2% of variance) in all models. Age explained a small percentage of variance in mobility and gait velocity (up to 2.9%). Executive function explained 3.0% of variance during forward walking only. The strong predictive relationships between balance deficits and mobility and gait impairment suggest targeting balance deficits may be particularly important for improving mobility and gait in people with PD, regardless of an individual’s age, disease severity, fall history, or other demographic features.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Investigation of factors impacting mobility and gait in Parkinson disease

Christofoletti

McNeely

Campbell

et al. 2016

Human Movement Science

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“…Interestingly, the complex processes of adaptive behavior in a balancing task are able to produce true learning, the uniqueness of which would be to prepare the body to counteract more general features of platform motion (Van Ooteghem et al, 2008; Kanekar and Aruin, 2015). The analytical approach described here could be easily applied to patients with balance problems of different nature, as for instance patients with Parkinson’s disease, who may well show adaptation problems contributing to their balance dysfunction (Schieppati and Nardone, 1991; De Nunzio and Schieppati, 2007; Weissblueth et al, 2008; Nanhoe-Mahabier et al, 2012; Paul et al, 2013; Schoneburg et al, 2013), and patients with stroke (Kitago and Krakauer, 2013) or spinal cord injury, in which co-activation of TA and Sol contribute to impaired balance and walking ability (Beauparlant et al, 2013; Manella et al, 2013). …”

Section: Discussionmentioning

confidence: 99%

Calibration of the Leg Muscle Responses Elicited by Predictable Perturbations of Stance and the Effect of Vision

Sozzi

Nardone

Schieppati

2016

Front. Hum. Neurosci.

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Motor adaptation due to task practice implies a gradual shift from deliberate control of behavior to automatic processing, which is less resource- and effort-demanding. This is true both for deliberate aiming movements and for more stereotyped movements such as locomotion and equilibrium maintenance. Balance control under persisting critical conditions would require large conscious and motor effort in the absence of gradual modification of the behavior. We defined time-course of kinematic and muscle features of the process of adaptation to repeated, predictable perturbations of balance eliciting both reflex and anticipatory responses. Fifty-nine sinusoidal (10 cm, 0.6 Hz) platform displacement cycles were administered to 10 subjects eyes-closed (EC) and eyes-open (EO). Head and Center of Mass (CoM) position, ankle angle and Tibialis Anterior (TA) and Soleus (Sol) EMG were assessed. EMG bursts were classified as reflex or anticipatory based on the relationship between burst amplitude and ankle angular velocity. Muscle activity decreased over time, to a much larger extent for TA than Sol. The attenuation was larger for the reflex than the anticipatory responses. Regardless of muscle activity attenuation, latency of muscle bursts and peak-to-peak CoM displacement did not change across perturbation cycles. Vision more than doubled speed and the amount of EMG adaptation particularly for TA activity, rapidly enhanced body segment coordination, and crucially reduced head displacement. The findings give new insight on the mode of amplitude- and time-modulation of motor output during adaptation in a balancing task, advocate a protocol for assessing flexibility of balance strategies, and provide a reference for addressing balance problems in patients with movement disorders.

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“…Postural instability and balance impairments are common symptoms of PD [41], contributing to an increased frequency of falls and injuries [42] which in turn increases morbidity and mortality [43]. The large impact of postural instability on patients is a significant concern, especially considering that dopamine replacement medications are often insufficient to control these deficits [44].…”

Section: Exercise In Parkinson’s Diseasementioning

confidence: 99%

An Evidence-Based Exercise Regimen for Patients with Mild to Moderate Parkinson’s Disease

Salgado

Williams

Kotian³

et al. 2013

Brain Sciences

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Parkinson’s disease (PD) is a neurological disorder that is manifested in the form of both motor and non-motor symptoms such as resting tremor, bradykinesia, muscular rigidity, depression, and cognitive impairment. PD is progressive in nature, ultimately leading to debilitating disruption of activities of daily living. Recently, a myriad of research has been focused on non-pharmacological interventions to alleviate the motor and non-motor symptoms of the disease. However, while there is a growing body of evidence supporting exercise as a viable therapy option for the treatment of Parkinson’s disease, there is a lack of literature enumerating a specific exercise sequence for patients with PD. In this literature review, we analyze the success of specific modalities of exercise in order to suggest an optimal exercise regimen for Parkinson’s disease patients.

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Motor and Cognitive Impairments in Parkinson Disease

Abstract: Information gained from this study about the relationships between impairments and specific balance and mobility tasks may be able to guide the development of interventional strategies for people with PD.

Cited by 28 publications

References 55 publications

Investigation of factors impacting mobility and gait in Parkinson disease

Investigation of factors impacting mobility and gait in Parkinson disease

Calibration of the Leg Muscle Responses Elicited by Predictable Perturbations of Stance and the Effect of Vision

An Evidence-Based Exercise Regimen for Patients with Mild to Moderate Parkinson’s Disease

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