- A Randomized Controlled Trial of Movement Strategies A Randomized Controlled Trial of Movement Strategies Compared with Exercise for People with Parkinson's Disease This randomized controlled clinical trial was conducted to compare the effects of movement rehabilitation strategies and exercise therapy in hospitalized patients with idiopathic Parkinson's disease.
- Application of gait analysis in Parkinson's disease This study evaluated with Gait Analysis (GA) kinematic and kinetic alterations in PD subjects, it characterized groups of different severity levels of pathology identified by UPDRS scale and it searched a correlation between GA indices and UPDRS scale.
- Assessment of postural asymmetry in mild to moderate Parkinson's disease Asymmetry of symptoms of Parkinson's disease is clinically most evident for appendicular impairments. For axial impairments such as freezing of gait, asymmetry is less obvious. To date, asymmetries in balance control in PD patients have seldom been studied. Therefore, in this study we investigated whether postural control can be asymmetrically affected in mild to moderate PD patients.
- Deep brain stimulation of the pedunculopontine tegmentum and subthalamic nucleus Deep brain stimulation of the pedunculopontine tegmentum and subthalamic nucleus: Effects on gait in Parkinson's disease This study examines the effects of subthalamic nucleus (STN) deep brain stimulation (DBS) and pedunculopontine tegmentum (PPTg) DBS in advanced Parkinson's disease using gait analysis. Methods: Five people underwent bilateral DBS in both the STN and PPTg. Gait analysis was performed one year after neurosurgery using an optoelectronic system.
- Does gait analysis quantify motor rehabilitation efficacy? Does gait analysis quantify motor rehabilitation efficacy in Parkinson’s disease patients? Sixteen rigid-akinetic idiopathic Parkinson’s disease patients (PD) and 13 healthy control subjects (controls) were included in this study.
- Dynamic sEMG analysis of gait in Parkinson's patients with freezing in ON Freezing of gait (FOG) represents one of the most disabling and least understood symptoms in PD, strongly associated with falls. Episodes of FOG are characterized by a sudden but transient motor block occurring at the beginning or during walking performance. The kinematics analysis of gait pointed out that the steps of PD patients with FOG present, during their 'normal' walk, alterations that are common for all PD subjects: reduced velocity and step width, altered anticipatory corrections both laterally and antero-posteriorly, but is unclear the connection with FOG. The aim of this study was to quantify the electromyographic activity of the distal and proximal muscles during three steps just before freezing, in order to accurately analyse the alterations in the muscular activation strategies and to evaluate hypotheses about the ON freezing generation in PD.
- Effect of bilateral subthalamic nucleus stimulation on gait in Parkinson's disease The fundamental disturbance of the parkinsonian gait is the reduction in walking velocity. This is mainly due to reduction in stride length, while cadence (steps/min) is slightly enhanced. Treatment with L-dopa increases stride length while cadence is unchanged. Chronic stimulation of the thalamus has no effect on Parkinsonian gait. The efficacy of electrical stimulation of the subthalamic nucleus (STN) on gait in advanced Parkinson's disease has been clearly demonstrated clinically. The aim of the present study was to quantify the changes in gait measures induced by STN stimulation and L-dopa and to assess possible differential or additive effects.
- Effect of gait speed on gait rhythmicity in Parkinson's disease Effect of gait speed on gait rhythmicity in Parkinson's disease: variability of stride time and swing time respond differently The ability to maintain a steady gait rhythm is impaired in patients with Parkinson's disease (PD). This aspect of locomotor dyscontrol, which likely reflects impaired automaticity in PD, can be quantified by measuring the stride-to-stride variability of gait timing. Previous work has shown an increase in both the variability of the stride time and swing time in PD, but the origins of these changes are not fully understood. Patients with PD also generally walk with a reduced gait speed, a potential confounder of the observed changes in variability. The purpose of the present study was to examine the relationship between walking speed and gait variability.
- Effects of bilateral subthalamic stimulation on gait kinematics and kinetics in Parkinson's disease Subthalamic nucleus (STN) stimulation, a recent surgical approach to Parkinson's disease (PD), has been shown to be effective in relieving motor symptoms. The present study carried out a full body gait analysis, during overground walking, on ten PD patients with bilaterally implanted STN stimulation devices. Walking performance was analyzed on the same day, in four conditions (Stim Off-Med Off, Stim On-Med Off, Stim Off-Med On, Stim On-Med On).
- Early biomechanical markers of postural instability in Parkinson's disease The study results demonstrate that PD changes the response to a balance disturbance which can be quantiﬁed using biomechanical variables even before the presence of clinically detectable postural instability. Further studies are required to determine if these variables are sensitive and speciﬁc to postural instability.
- Immediate effects of speed-dependent treadmill training on gait parameters in early PD To compare the immediate effects of different training interventions on gait parameters in patients with early Parkinson's disease (PD). Seventeen patients with early PD (Hoehn and Yahr stages I through III) and gait disturbances. Basic gait parameters (overground walking speed and stride length at self-adapted speeds) and parameters of gait analysis based on vertical ground reaction forces.
- Information theory for detecting upper limb motor dysfunction On the use of information theory for detecting upper limb motor dysfunction:
- Kinematic angular parameters in PD Kinematic angular parameters in PD: Reliability of joint angle curves and comparison with healthy subjects We have developed the use of validated statistic tools for unambiguously comparing PD patients and controls in terms of joint angle curve differences.
- Long-term monitoring of gait in Parkinson's disease A new system for long-term monitoring of gait in Parkinson's disease (PD) has been developed and validated.
- Parkinsonian patients walking on treadmill: A comparative surface EMG study We have performed the following study by aiming to observe and compare over-time modifications of lower limb muscle activation during a treadmill 30-min walk with respect to over-ground gait in PD subjects.
- Quantification of effects of levodopa treatment in parkinsonian syndromes The purpose of this chapter is to present the experience of the Posture and Motion Laboratory at the "San Raffaele Cassino" in the field of use of Gait Analysis (GA) in patients with Parkinson’s disease (PD) and with Progressive Supranuclear Palsy (PSP). In particular, the effects of levodopa medication on PD vs. PSP patients were quantified, comparing the OFF and ON state in the two different pathological conditions, using functional evaluation and GA.
- Quantitative analysis of gait in Parkinson's disease Quantitative analysis of gait in Parkinson’s disease: a pilot study on the effects of bilateral sub-thalamic stimulation Four patients with Parkinson’s disease who had a Subthalamic Nucleus (STN) stimulator implanted and four age-matched controls underwent gait analysis using a three-dimensional system. STN stimulation substantially improved most of the key variables in the patients, without producing inefficient compensatory movements of the trunk. A reduction of ankle power production during push off was the most persistent abnormality seen when the patients were stimulated. We also found a reduction of trunk lateral bending and torsion when the patients were not stimulated when compared with controls.
- Reduction of freezing of gait in Parkinson's disease Reduction of freezing of gait in Parkinson's disease by repetitive robot-assisted treadmill training: a pilot study Parkinson's disease is a chronic, neurodegenerative disease characterized by gait abnormalities. Freezing of gait (FOG), an episodic inability to generate effective stepping, is reported as one of the most disabling and distressing parkinsonian symptoms. While there are no specific therapies to treat FOG, some external physical cues may alleviate these types of motor disruptions. The purpose of this study was to examine the potential effect of continuous physical cueing using robot-assisted sensorimotor gait training on reducing FOG episodes and improving gait.
- Reliability of the new freezing of gait questionnaire Reliability of the new freezing of gait questionnaire: Agreement between patients with Parkinson's disease and their carers Freezing of gait (FOG) is difﬁcult tomeasure due to its unpredictable occurrence. This study investigated: (1) whether the new freezing of gait questionnaire (NFOG-Q) is a reliable measure of freezing by comparing patients' ratings with those of carers' and (2) whether adding a video improved its reliability. Non-demented people with Parkinson's disease (PD) (N = 102) and their carers of similar age and cognitive status were recruited from movement disorders clinics in three countries.
- Robot-assisted gait training versus equal intensity treadmill training Robot-assisted gait training versus equal intensity treadmill training in patients with mild to moderate Parkinson’s disease: A randomized controlled trial There is a lack of evidence about the most effective strategy for training gait in mild to moderate Parkinson's disease. The aim of this study was to compare the effects of robotic gait training versus equal intensity treadmill training and conventional physiotherapy on walking ability in patients with mild to moderate Parkinson’s disease.
- Robot-assisted gait training versus treadmill Robot-assisted gait training versus treadmill training in patients with Parkinson’s disease: a kinematic evaluation with gait profile score The purpose of this study was to quantitatively compare the effects, on walking performance, of end-effector robotic rehabilitation locomotor training versus intensive training with a treadmill in Parkinson's disease (PD). Fifty patients with PD were randomly divided into two groups: 25 were assigned to the robot-assisted therapy group (RG) and 25 to the intensive treadmill therapy group (IG). They were evaluated with clinical examination and 3D quantitative gait analysis [gait profile score (GPS) and its constituent gait variable scores (GVSs) were calculated from gait analysis data] at the beginning (T0) and at the end (T1) of the treatment. In the RG no differences were found in the GPS, but there were significant improvements in some GVSs (Pelvic Obl and Hip Ab-Add). The IG showed no statistically significant changes in either GPS or GVSs. The end-effector robotic rehabilitation locomotor training improved gait kinematics and seems to be effective for rehabilitation in patients with mild PD.
- Six weeks intensive treadmill training improves gait and quality of life in patients with PD Gait disturbances are common among patients with Parkinson's disease (PD), leading to falls and functional dependence and impinging on quality of life (QOL). Treadmill walking may act as an external cue to improve gait pacing, thereby producing a more rhythmic and less variable gait and enhanced mobility and QOL.
- Subthalamic nucleus stimulation and gait in Parkinson's Disease: a notalways fruitful relationship Deep brain stimulation (DBS) of the subthalamic nucleus (STN) provides ef!cient treatment for the alleviation of motor signs in patients with advanced Parkinson’s disease (PD), but its speci!c effects on gait is sometimes less successful as it may even lead to an aggravation of freezing of gait. To better understand when axial symptoms can be expected to improve and when they may worsen or be resistant to STN-DBS, we propose here a narrative review that considers the recent literature evidences based on instrumental gait analysis data. Our aim is to report about the ef!cacy of STN-DBS on PD gait, analyzing the clinical and procedural factors involved, and discussing the strategies for optimizing such effectiveness in patients with advanced PD.
- Treadmill training for the treatment of gait disturbances Treadmill training for the treatment of gait disturbances in people with Parkinson's disease: a mini-review This report reviews recent investigations of the effects of treadmill training (TT) on the gait of patients with Parkinson's disease. A literature search identified 14 relevant studies. Three studies reported on the immediate effects of TT; over-ground walking improved (e.g., increased speed and stride length) after one treadmill session. Effects persisted even 15 min later. Eleven longer-term trials demonstrated feasibility, safety and efficacy, reporting positive benefits in gait speed, stride length and other measures such as disease severity (e.g., Unified Parkinson's Disease Rating Scale) and health-related quality of life, even several weeks after cessation of the TT. Long-term carryover effects also raise the possibility that TT may elicit positive neural plastic changes. While encouraging, the work to date is preliminary; none of the identified studies received a quality rating of Gold or level Ia. Additional high quality randomized controlled studies are needed before TT can be recommended with evidence-based support.
A, B, C
Our results confirm that gait analysis is a valid tool for evaluating changes in PD patients’ ability to walk and for quantifying the improvements gained through a motor rehabilitation program.
E, F, G, H
An application to Parkinson’s disease Parkinson's disease (PD) is a chronic neurodegenerative disorder characterized by a selective loss of dopaminergic neurons in the substantia nigra, decreased striatal dopamine levels, and consequent extrapyramidal motor dysfunctions. Several potential early diagnostic markers of PD have been proposed. We found that the MI is a sensitive metric in detecting upper limb motor dysfunction, thus suggesting that this method might be applicable to quantitatively evaluating the effects of the antiparkinsonian medication and to monitor the disease progression.
- Use of the Gait Deviation Index and spatiotemporal variables Use of the Gait Deviation Index and spatiotemporal variables for the assessment of dual task interference paradigm Three-dimensional gait analysis (3DGA) is an important element in the quantitative evaluation of gait in subjects with Parkinson’s disease (PD). Indexes, such as the Gait Deviation Index (GDI), have recently been proposed as a summary measure of gait. The aim of the present study was to investigate the effectiveness of the GDI and spatiotemporal variables in the quantification of changes in gait during a dual-task (DT) exercise. Fourteen patients with idiopathic PD and nine healthy subjects (CG) participated in the study. All subjects walked under two conditions: free walking and DT walking. The GDI was computed from the 3DGA data. The results show gait impairment during DT, a significant difference between groups regarding GDI and an interaction effect involving the group, side and task factors. The CG and PDG were different independent of interference and side, but interference was only different for the PDG group. The results also demonstrate that the GDI should be an appropriate outcome measure for the evaluation of the effects of DT on patients with Parkinson’s disease.
- Validation of GDI, GPS and GVS for use in Parkinson's disease Validation of GDI, GPS and GVS for use in Parkinson’s disease through evaluation of effects of subthalamic deep brain stimulation and levodopa The Gait Deviation Index (GDI), Gait Profile Score (GPS) and Gait Variable Scores (GVSs) have been proposed as measures of gait quality and validated for use with children with cerebral palsy. The aim of this study was to extend this validation to people with Parkinson’s disease by evaluating the effects of subthalamic deep brain stimulation and levodopa on gait. 16 participants had their gait evaluated with stimulation, medication or a combination of both.