131 research outputs found
Table_e1._Virtual_Environments.Description_Proof – Supplemental material for Advanced virtual reality-based rehabilitation of balance and gait in clinical practice
No full textSupplemental material, Table_e1._Virtual_Environments.Description_Proof for Advanced virtual reality-based rehabilitation of balance and gait in clinical practice by Desiderio Cano Porras, Hadar Sharon, Rivka Inzelberg, Yitzhak Ziv-Ner, Gabriel Zeilig and Meir Plotnik in Therapeutic Advances in Chronic Disease</p
Table_e2._Clinical_Thresholds_EN_Proof – Supplemental material for Advanced virtual reality-based rehabilitation of balance and gait in clinical practice
No full textSupplemental material, Table_e2._Clinical_Thresholds_EN_Proof for Advanced virtual reality-based rehabilitation of balance and gait in clinical practice by Desiderio Cano Porras, Hadar Sharon, Rivka Inzelberg, Yitzhak Ziv-Ner, Gabriel Zeilig and Meir Plotnik in Therapeutic Advances in Chronic Disease</p
Table_e3._Suitability_Evaluation_Questionnaire_-_Proof – Supplemental material for Advanced virtual reality-based rehabilitation of balance and gait in clinical practice
No full textSupplemental material, Table_e3._Suitability_Evaluation_Questionnaire_-_Proof for Advanced virtual reality-based rehabilitation of balance and gait in clinical practice by Desiderio Cano Porras, Hadar Sharon, Rivka Inzelberg, Yitzhak Ziv-Ner, Gabriel Zeilig and Meir Plotnik in Therapeutic Advances in Chronic Disease</p
Neurologic aspects and falls
No full textFalls are widely recognized as a social problem due to the related economic burden on public health budgets. Following the growing body of evidences on the physiopathology of postural control in humans, many factors leading to falls are already
well established in the literature. Given the high prevalence of falls among elderly people, the present review focuses on parkinsonism and those “mild parkinsonian signs” frequently presented by elderly subjects. Parkinsonism is a good paradigm for the understanding of the pathophysiology
of falling. Specifically, parkinsonian patients display specific features related to falls, such as axial motor symptoms, the impairment of executive functions and of the interplay between motion and cognition, as revealed by the disruption of automaticit
Working on asymmetry in Parkinson's disease: randomized, controlled pilot study
No full textPosture, gait and balance problems are very disabling symptoms in Parkinson's disease (PD). An increased stride-to-stri de variability, reduction of automaticity and asymmetry of lower limbs function characterize parkinsonian gait. These features predispose to freezing of gait (FOG), which often leads to falls. The aim of this study was to evaluate how the modulation of asymmetry through physiotherapy might improve gait and reduce FOG, thus preventing falls. Twenty-eight PD patients entered a double-blind pilot feasibility controlled study and were evaluated at baseline and after 3 months of a rehabilitative program (performed twice a week) by means of the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS-III), Gait and Falls Questionnaire, Tinetti balance and gait scale, Short Physical Performance Battery (SPPB), European Quality of Life questionnaire. Patients were randomly assigned to three treatment arms: (1) worst side improvement; (2) best side improvement; (3) standard therapy. All study arms showed a significant improvement of the Tinetti and SPPB scores. BSI led to a greater improvement than ST in terms of UPDRS-III (p = 0.01); Tinetti total score (p = 0.05) and Tinetti gait subscore (p = 0.01). Our study confirms the efficacy of physical therapy in the treatment of PD and, more importantly, suggests that specific intervention tailored on individual feature (e.g., asymmetry of motor condition) might be even more effective than standard rehabilitative programs
Author Correction: Higher cognitive load interferes with head-hand coordination: virtual reality-based study
No full textThe role of gait rhythmicity and bilateral coordination of stepping in the pathophysiology of freezing of gait in Parkinson's disease
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Coupling between leg muscle activation and EEG during normal walking, intentional stops, and freezing of gait in Parkinson's disease
No full textIn this paper, we apply novel techniques for characterizing leg muscle activation patterns via electromyograms (EMGs) and for relating them to changes in electroencephalogram (EEG) activity during gait experiments. Specifically, we investigate changes of leg-muscle EMG amplitudes and EMG frequencies during walking, intentional stops, and unintended freezing-of-gait (FOG) episodes. FOG is a frequent paroxysmal gait disturbance occurring in many patients suffering from Parkinson's disease (PD). We find that EMG amplitudes and frequencies do not change significantly during FOG episodes with respect to walking, while drastic changes occur during intentional stops. Phase synchronization between EMG signals is most pronounced during walking in controls and reduced in PD patients. By analyzing cross-correlations between changes in EMG patterns and brain-wave amplitudes (from EEGs), we find an increase in EEG-EMG coupling at the beginning of stop and FOG episodes. Our results may help to better understand the enigmatic pathophysiology of FOG, to differentiate between FOG events and other gait disturbances, and ultimately to improve diagnostic procedures for patients suffering from PD. Copyright © 2019 Günther, Bartsch, Miron-Shahar, Hassin-Baer, Inzelberg, Kurths, Plotnik and Kantelhardt
Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for Treatment
No full textSeveral gait impairments have been associated with freezing of gait (FOG) in patients with Parkinson's disease (PD). These include deteriorations in rhythm control, gait symmetry, bilateral coordination of gait, dynamic postural control and step scaling. We suggest that these seemingly independent gait features may have mutual interactions which, during certain circumstances, jointly drive the predisposed locomotion system into a FOG episode. This new theoretical framework is illustrated by the evaluation of the potential relationships between the so-called “sequence effect”, that is, impairments in step scaling, and gait asymmetry just prior to FOG. We further discuss what factors influence gait control to maintain functional gait. “Triggers”, for example, such as attention shifts or trajectory transitions, may precede FOG. We propose distinct categories of interventions and describe examples of existing work that support this idea: (a) interventions which aim to maintain a good level of locomotion control especially with respect to aspects related to FOG; (b) those that aim at avoiding FOG “triggers”; and (c) those that merely aim to escape from FOG once it occurs. The proposed theoretical framework sets the stage for testable hypotheses regarding the mechanisms that lead to FOG and may also lead to new treatment ideas
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