1,720,996 research outputs found
When gait isn't straight forward: how do you assess the ability to turn?
No full textFor people with Parkinson’s Disease (PD), difficulty
turning is a notorious cause of freezing and falls (Bloem
et al, 2001; Stack and Ashburn, 1999; Nieuwboer et al,
1998; Yekutiel, 1993; Giladi et al, 1992) and may lead
to a physiotherapy referral. What do therapists record
when turning is assessed informally, perhaps during a
standard mobility test? How do their findings guide
them? Turning is poorly understood in comparison
with straight forward gait:
• Studies have been small, with young, healthy
participants
• ‘Step Count’ and ‘Turn Time’ have dominated the
literature
• Unsubstantiated claims have been made about
‘normal’ turning
• Few existing measures have been validated
• Laboratory-based protocols are unsuitable for use
clinically or in PD research.
A new measure, the video-based Standing Start 180º
Turn Test (SS-180), has recently been developed at the
University of Southampton (Stack, 2003) and a paper
submitted to Physiotherapy detailing its design, validation
against a laboratory-based ‘gold standard’ and
initial reliability. The test is currently being used in a
number of studies. The purpose of this article is to raise
awareness of the SS-180 and to encourage consideration
of the issues associated with difficulty turning from
the clinical and research perspectives
Fall-events described by people with Parkinson's disease: implications for clinical interviewing and the research agenda
No full textBackground and purpose: the aim of this study was to describe the terminology used by people with Parkinson's disease (PD) when recounting falls and near-misses (fall events) and to identify the surrounding circumstances.Method: this cross-sectional study (part of an investigation identifying risk factors for falling in PD) utilized structured interviews about falling, conducted in participants' homes. Content analysis of participants' descriptions of events was performed. Fifty-five independently mobile, community-dwelling people with PD, identified via general practices in Southampton took part in the study.Results: mean participant age was 71.5 years (SD = 7.6 years); mean time since diagnosis was 3.6 years (SD = 2.3 years). Thirty-four participants (62%) reported having fallen and 41 (75%) reported having nearly fallen in the previous 12 months. Recounting events, participants mentioned the location, frequency, process and landing, their activity and fall-avoidance. Falls at home, tripping, events arising when turning, falling forward, frequent near-misses and unsuccessful restoration of balance were commonly described.Conclusions: frequent recounting of processes, locations and landings suggest these details are memorable and easily recalled. Eliciting the activities during which events occurred, their frequency and avoidance-strategies, may necessitate probing by interviewers. An interview schedule is proposed. Aspects common to falls and near-misses, particularly turning, suggest a natural progression of activity-related fall
Early development of the standing-start 180° turn test
No full textObjectives: To design and validate a new video-based tool for quantifying turning during gait in people with Parkinson's Disease. Dysfunctional turning is common in Parkinson's Disease but most existing measurement tools are inadequate for this group, lack validity and are laboratory-based.Design: Descriptors of turning were identified and the new tool, the Standing-start 180° Turn Test (SS-180), was derived from a short-list. Criterion validity was tested using Cartesian Optoelectronic Dynamic Anthropometry (CODA) as the criterion measure, and intra-rater and inter-rater reliability were tested.Participants: Thirty-two healthy adults (aged 21–83 years) and eight people with Parkinson's Disease (aged 69–85 years).Results: Seventy descriptors were identified and 20 were short-listed and combined to form four items: Turning Steps, Turn Time, Turn Type and Turn Quality. Time measurements from video and CODA agreed within 0.5 s on 95% of occasions in healthy adults and within 20% of each other in people with Parkinson's Disease; there was 92% agreement on Turning Steps and 84% agreement on Turn Type. Intra-rater reliability was 100% for Turning Steps, Turn Type and Turn Quality; mean Turn Time difference 0.1 s (95% limits of agreement ?0.3 to 0.1 s). Inter-rater reliability was 80% for Turning Steps, 100% for Turn Type and 90% for Turn Quality; mean Turn Time difference 0.0 s (95% limits of agreement ?0.4 to 0.5 s).Conclusions: The video-based SS -180 was developed for measurement in Parkinson's Disease. Preliminary studies suggest that the simple turn test compares well with a laboratory-based criterion measure, and that reliability exceeds similar existing observational analysis tool
Impaired mobility and Parkinson’s disease
No full textImpaired mobility associated with frequent falls is common in Parkinson's disease (PD) and is the focus of three related papers in this issue. Walking quietly forward, in a straight line across a smooth surface presents people with PD with a basic challenge but when the mobility task is in any way more complex, the level of challenge rises steeply for people with PD.Ashburn et al.'s diary-based survey of over 600 falls suggests that only a handful of activities account for the majority of falls among people with PD, with ‘tripping while walking’ taking first place and ‘falling while turning’ being associated with serious injury. Jones et al.'s qualitative study explores how the distressing uncertainty that one can walk safely from A to B without falling is detrimental to self-esteem and participation in society. In this paper, like that of Ashburn et al., the authors discuss how any kind of ‘multi-tasking’ exacerbates the risk of falling. Stack et al.'s paper describes an analysis of turning to walk from a standing start, an activity that most healthy adults accomplish readily, and discusses why people with PD find turning so notoriously challenging. All three papers address methodological issues around the assessment of mobility, falls and fallers and the authors make innovative suggestions about rehabilitation practice. Together, this survey, interview set and movement analysis add to the existing knowledge base on falls and illuminate difficulties specific to PD. The combination of research methods is successfully drawing researchers to what patients consider the key issues, optimizing the immediate relevance of the research output<br/
Movements used during turning and factors influencing the way in which people with Parkinson's Disease turn
No full textEThOS - Electronic Theses Online ServiceGBUnited Kingdo
Leisure activity among people with Parkinson's disease: preferences, perceived benefits and reasons for abandonment
No full text- …
