Motor, cognitive and mobility deficits in 1000 geriatric patients: protocol of a quantitative observational study before and after routine clinical geriatric treatment – the ComOn-study

Geritz, Johanna; Maetzold, Sara; Steffen, Maren; Padovani, Alessandro; Moscovich, Mariana; Rizzetti, Maria Cristina; Borroni, Barbara; Padovani, Alessandro; Alpes, Annekathrin; Bang, Corinna; Barcellos, Igor; Baron, Ralf; Bartsch, Thorsten; Becktepe, Jos S.; Berg, Daniela; Bergeest, Lu M.; Bergmann, Philipp; Bouça‐Machado, Raquel; Drey, Michael; Elshehabi, Morad; Farahmandi, Susan; Ferreira, Joaquim J.; Franke, André; Friederich, Anja; Geisler, Corinna; Hüllemann, Philipp; Gierthmühlen, Janne; Granert, Oliver; Heinzel, Sebastian; Heller, Maren K.; Hobert, Markus A.; Hofmann, M.; Jemlich, Björn; Kerkmann, Laura; Knüpfer, Stephanie C.; Krause, Katharina; Kress, M.M.; Krupp, Sonja; Kudelka, Jennifer; Kuhlenbäumer, Gregor; Kurth, Roland; Leypoldt, Frank; Maetzler, Corina; Maia, Luı́s F.; Moewius, Andreas; Neumann, Patricia; Niemann, K. Olaf; Ortlieb, Christian; Paschen, Steffen; Pham, Minh; Puehler, Thomas; Radloff, Franziska; Riedel, Christian; Rogalski, Marten; Sablowsky, Simone; Schanz, Elena M.; Schebesta, Linda; Schicketmüller, Andreas; Studt, Simone; Thieves, Martina; Tönges, Lars; Ullrich, Sebastian; Urbán, Péter; Vila‐Chã, Nuno; Wiegard, Anna; Warmerdam, Elke; Warnecke, Tobias; Weiss, Michael; Welzel, Julius; Hansen, Clint; Maetzler, Walter

doi:10.1186/s12877-020-1445-z

Cited by 20 publications

(31 citation statements)

References 119 publications

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“…The present study investigated gait parameters over the entire range of mobile PwP (i.e., H&Y 1–4) by combining the data from two prospective observational studies in PwP [ 7 , 20 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Data of 68 PwP from the MODEP (MODelling Epidemiological data to study Parkinson’s disease progression, 45 PwP) and ComOn (Cognitive and Motor Interaction in the Older Population, 23 PwP) study were analysed (see [ 19 , 20 ] for details including inclusion and exclusion criteria). In brief, the MODEP study was a prospective observational study modelling epidemiological data to study Parkinson’s disease progression, and was finished in 2014.…”

Section: Methodsmentioning

confidence: 99%

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Step Length Is a Promising Progression Marker in Parkinson’s Disease

Welzel

Wendtland

Warmerdam

et al. 2021

Sensors

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Current research on Parkinson’s disease (PD) is increasingly concerned with the identification of objective and specific markers to make reliable statements about the effect of therapy and disease progression. Parameters from inertial measurement units (IMUs) are objective and accurate, and thus an interesting option to be included in the regular assessment of these patients. In this study, 68 patients with PD (PwP) in Hoehn and Yahr (H&Y) stages 1–4 were assessed with two gait tasks—20 m straight walk and circular walk—using IMUs. In an ANCOVA model, we found a significant and large effect of the H&Y scores on step length in both tasks, and only a minor effect on step time. This study provides evidence that from the two potentially most important gait parameters currently accessible with wearable technology under supervised assessment strategies, step length changes substantially over the course of PD, while step time shows surprisingly little change in the progression of PD. These results show the importance of carefully evaluating quantitative gait parameters to make assumptions about disease progression, and the potential of the granular evaluation of symptoms such as gait deficits when monitoring chronic progressive diseases such as PD.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Step Length Is a Promising Progression Marker in Parkinson’s Disease

Welzel

Wendtland

Warmerdam

et al. 2021

Sensors

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“…For that purpose, it is necessary to assess and differentiate characteristics of motor fluctuations by consistent and patient independent methods in addition to the MDS-UPDRS IV. Here, the use of wearable sensors as an objective and continuous monitoring of dyskinesia should be taken into consideration [ 67 , 68 , 69 ].…”

Section: Discussionmentioning

confidence: 99%

Parkinson’s Disease Multimodal Complex Treatment (PD-MCT): Analysis of Therapeutic Effects and Predictors for Improvement

Hartelt

Scherbaum

Kinkel³

et al. 2020

JCM

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Parkinson’s disease Multimodal Complex Treatment (PD-MCT) is a multidisciplinary inpatient treatment approach that has been demonstrated to improve motor function and quality of life in patients with Parkinson’s disease (PD). In this study, we assessed the efficacy of PD-MCT and calculated predictors for improvement. We performed a prospective analysis in a non-randomized, open-label observational patient cohort. Study examinations were done at baseline (BL), at discharge after two-weeks of inpatient treatment (DC) and at a six-week follow-up examination (FU). Besides Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III as a primary outcome, motor performance was measured by the Timed Up-and-Go (TUG), the Berg Balance Scale (BBS) and the Perdue Pegboard Test (PPT). Until DC, motor performance improved significantly in several parameters and was largely maintained until FU (MDS-UPDRS III BL-to-DC: −4.7 ± 1.2 (SE) p = 0.0012, BL-to-FU: −6.1 ± 1.3 p = 0.0001; TUG BL-to-DC: −2.5 ± 0.9 p = 0.015, BL-to-FU: 2.4 ± 0.9 p = 0.027; BBS BL-to-DC: 2.4 ± 0.7 p = 0.003, BL-to-FU: 1.3 ± 0.7 p = 0.176, PPT BL-to-DC: 3.0 ± 0.5 p = 0.000004, BL-to-FU: 1.7 ± 0.7 p = 0.059). Overall, nontremor items were more therapy responsive than tremor items. Motor complications evaluated with MDS-UPDRS IV occurred significantly less frequent at DC (−1.8 ± 0.5 p = 0.002). Predictor analyses revealed an influence of initial motor impairment and disease severity on the treatment response in different motor aspects. In summary, we demonstrate a significant positive treatment effect of PD-MCT on motor function of PD patients which can be maintained in several parameters for an extended time period of six weeks and identify predictors for an improvement of motor function.

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“…IMUs commonly consist of accelerometers, gyroscopes, and magnetometers, and provide the opportunity to assess gait and balance directly on the clinical ward, without the need for a dedicated laboratory [ 16 ]. Such supervised assessments can be used to monitor improvements over time e.g., during hospitalization, or serve as digital clinical endpoints to quantify the success or failure of an intervention [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Reliability of IMU-Derived Static Balance Parameters in Neurological Diseases

Hansen

Beckbauer

Romijnders

et al. 2021

IJERPH

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Static balance is a commonly used health measure in clinical practice. Usually, static balance parameters are assessed via force plates or, more recently, with inertial measurement units (IMUs). Multiple parameters have been developed over the years to compare patient groups and understand changes over time. However, the day-to-day variability of these parameters using IMUs has not yet been tested in a neurogeriatric cohort. The aim of the study was to examine day-to-day variability of static balance parameters of five experimental conditions in a cohort of neurogeriatric patients using data extracted from a lower back-worn IMU. A group of 41 neurogeriatric participants (age: 78 ± 5 years) underwent static balance assessment on two occasions 12–24 h apart. Participants performed a side-by-side stance, a semi-tandem stance, a tandem stance on hard ground with eyes open, and a semi-tandem assessment on a soft surface with eyes open and closed for 30 s each. The intra-class correlation coefficient (two-way random, average of the k raters’ measurements, ICC2, k) and minimal detectable change at a 95% confidence level (MDC95%) were calculated for the sway area, velocity, acceleration, jerk, and frequency. Velocity, acceleration, and jerk were calculated in both anterior-posterior (AP) and medio-lateral (ML) directions. Nine to 41 participants could successfully perform the respective balance tasks. Considering all conditions, acceleration-related parameters in the AP and ML directions gave the highest ICC results. The MDC95% values for all parameters ranged from 39% to 220%, with frequency being the most consistent with values of 39–57%, followed by acceleration in the ML (43–55%) and AP direction (54–77%). The present results show moderate to poor ICC and MDC values for IMU-based static balance assessment in neurogeriatric patients. This suggests a limited reliability of these tasks and parameters, which should induce a careful selection of potential clinically relevant parameters.

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Motor, cognitive and mobility deficits in 1000 geriatric patients: protocol of a quantitative observational study before and after routine clinical geriatric treatment – the ComOn-study

Cited by 20 publications

References 119 publications

Step Length Is a Promising Progression Marker in Parkinson’s Disease

Step Length Is a Promising Progression Marker in Parkinson’s Disease

Parkinson’s Disease Multimodal Complex Treatment (PD-MCT): Analysis of Therapeutic Effects and Predictors for Improvement

Reliability of IMU-Derived Static Balance Parameters in Neurological Diseases

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