Introduction: Lateral reactive stepping is correlated with impairment in people with Parkinson’s Disease (PwPD). Despite this, there is little known of lateral stepping strategies and performance of these strategies in reactive stepping. Objective: To characterize step strategy in people with PD, characterize changes in these stepping strategies through training, and identify performance improvements in the lateral step strategies. Methods: A total of 31 PwPd who are currently at risk for falls took part in an 18-week various background reactive stepping intervention. The stepping strategies were assessed on two baseline assessments (B1 and B2) immediately followed by a 6- session step training intervention occurring over two weeks. Step strategies were again assessed immediately after training (P1) and two months later (P2). Initial outcomes were characterized step strategies, changes in step strategies, and improvement in performance of step strategies. Results: Three step strategies were established and split into two groups (no cross and cross). Changes in step strategies did not occur significantly both before and after training. Improvement in performance of the step strategies occurred at a significant amount (p=0.05) via a decrease in use of support after training occurred for any step strategies utilized. Conclusion: Step strategies were characterized, and performance of strategies was improved upon following the 2-week training. Lateral step strategies are defined and repeated throughout reactive step training with potential for improvement.
While REM Sleep Behavior disorder (RBD) has been linked with synucleinopathies, difficulties persist in clinically convenient diagnostic tools which can differentiate between underlying diseases. Identifying markers in the gait of RBD patients may ease the diagnostic process and indicate potential or status for developing more severe disorders. Individuals were referred to Movement Disorders Center of Arizona (MDCA) by a sleep specialist with a confirmed diagnosis of RBD, or those who were clinically indicated after questioning. All participants underwent a skin-biopsy test for α-synuclein, I-ioflupane dopamine transporter(DAT) scan, and had their gait velocity, cadence and stride dynamics assessed by an automated gait analysis system.
Parkinson’s Disease (PD) is characterized by involuntary tremors, muscle rigidity, slowed movement, and cognitive impairments. Some people with PD experience “Freezing of Gait” (FOG), which is an acute inability to release effective stepping. The severity of Freezing of Gait can be influenced by disease duration, disease severity, and medication. Freezing of Gait can lead to an increased risk of falls, mood disorders, reduced quality of life, poorer cognition, and executive function impairments (Morris et. al.). It is important to understand how Freezing of Gait can affect cognition, as this can alter the plan of cognitive rehabilitation that the patient receives in order to improve their cognition. Within each of these domains, are a variety of tests that all claim to measure the same cognition the same way and achieve similar results. A recent meta analysis assessed this hypothesized effect. However, to best understand this relationship, it is important to assess whether the effects of FOG status on cognition are similar across cognitive tests of the same domain. This research was performed by using a previously completed meta analysis on PD tests and the domains that tests fall into. Each of the domains were analyzed individually, and the most common tests used within each domain were compared to determine their effect sizes. The effect sizes were then compared to determine which tests have a greater influence on cognition, and if the effect sizes of each test within the same domain are similar, showing that FOG affects cognition to a similar degree.
The purpose of the present analysis was to (1) determine the DTI for absolute and percentage-based measures of gait and cognitive performance and (2) quantitatively characterize the prioritization between tasks for people with PD and healthy older controls. W evaluated a gait task and a cognitive task (backwards counting) during single-task and dual-task conditions in healthy older adults and patients with PD and noted their respective dual-task interference and prioritization scores. We found that this analysis does not totally support the literature that patients with PD will exhibit a Posture-Second strategy when presented with dual-tasking conditions. Instead, this analysis found that with both healthy older adults as well as adults with PD, there is an inconclusive Prioritization strategy utilized by both groups. The exception to this was the Male Controls, who exhibited a more Posture-First strategy. With the current knowledge, future research into Prioritization strategies for both healthy older adults and adults with Parkinson's should investigate the effect of Gender.
Down syndrome (DS) is caused by either an extra copy of chromosome 21 or by extra material on chromosome 21. This causes various levels of intellectual disability and issues with gross motor skill development which can prevent these individuals from participating in activities of daily living (ADL) such as getting dressed, self-care, or grocery shopping. People with DS have a decreased ability to balance, an abnormal and slower gait pattern, difficulty adapting to new environments, and a lack of improvement in these areas with growth and development when compared to their neurotypical peers. The objective of this study was to determine the immediate effects of resistance training (RT) and assisted cycle therapy (ACT) on adults with DS’s balance ability and gait speed. Each participant completed one session of RT, ACT (stationary cycling with the assistance of a motor to maintain a cadence of at least 35% greater than their voluntary cycling speed), and no training in a randomly selected order. Balance and gait speed were measured by a Clinical Test of Sensory Interaction on Balance (CTSIB) (i.e., eyes open firm surface, eyes closed firm surface, eyes open foam surface, eyes closed foam surface) on a Balance Tracking System Board (Btracks board) and by a Timed Up and Go (TUG) test. A total of ten participants’ data was used for analysis. The measures of total path length (cm), anterior-posterior (AP) excursion, and medial-lateral (ML) excursion were used to analyze the CTSIB. The average time was used to analyze the TUG test. The results showed that the eyes closed foam surface balance task was the most challenging balance task for every participant in every intervention. Furthermore, the most improvement was evident in the eyes closed foam surface balance task from pre to post intervention in all of the interventions. Post hoc tests also indicated statistically significant improvements of path length from pre to post in the RT intervention with the eyes closed foam surface balance task as well as with AP excursion in the ACT intervention with the eyes closed foam surface balance task. Possible explanations for improvements from pre to post in the eyes closed foam balance task across all interventions will be discussed with respect to the length of the intervention, and the effect of strength, social and learned factors on balance in adults with DS.