Freezing of gait (FoG) is associated with less automatic gait and more impaired cognition, balance and postural transitions compared to people with PD who do not have FoG. However, it is unknown whether dual-task cost during postural sway, postural transitions (such as gait initiation and turning), and gait are more in subjects with Parkinson’s disease (PD) who have freezing of gait (FoG+) compared to those who do not have FoG (FoG−). Here, we hypothesized that the effects of a cognitive dual task on postural sway, postural transitions and gait would be larger in FoG+ than FoG−. Thirty FoG− and 24 FoG+ performed an Instrumented Stand and Walk test in OFF medication state, with and without a secondary cognitive task (serial subtraction by 3s). Measures of postural sway, gait initiation, turning, and walking were extracted using body-worn inertial sensors. FoG+ showed significantly larger dual task cost than FoG− for several gait metrics, but not during postural sway or postural transitions. During walking, FoG+ exhibited a larger dual task cost than FoG− resulting in shorter stride length and slower stride velocity. During standing, FoG+ showed a larger postural sway compared to FoG− and during gait initiation, FoG+, but not FoG−, showed a longer first step duration during the dual-task condition compared to single-task condition (interaction effect, p = 0.04). During turning, both groups showed a slower turn peak speed in the dual-task condition compared to single task condition. These findings partly support our hypothesis that dual task cost on walking is greater in FoG+ than FoG−.
This study aimed to perform a clinical evaluation of low cost and easily applied to detect the presence of peripheral diabetic neuropathy (DPN) in individuals with DM and to correlate the score of the esthesiometry’s test and MNSI. We evaluated 44 participants with a diagnosis of DM.The NDP was diagnosed by the Michigan Neuropathy Screening Instrument (MNSI) and by esthesiometry with Semmes-Weinstein monofilaments. Eighteen (40.9%) subjects were diagnosed with neuropathy by MNSI and 30 (68.2%) by esthesiometry, the two tests showed a significant correlation, then, is possible to conclude that these two tests are effective when used together for such a diagnosis
Introdução: Tanto na estabilidade como na orientação, o controle postural ocorre através de um balanço entre sinergias neuromusculares, mecanismos antecipatórios e adaptativos, representações internas e componentes periféricos, bem como é integrado às informações dos múltiplos sistemas sensoriais, incluindo o somatossensorial, visual e vestibular. Objetivo: Avaliar a oscilação corporal de mulheres durante a postura ereta, em diferentes condições: com os olhos abertos, olhos fechados e com diminuição da base de sustentação. Método: Participaram do estudo 14 mulheres, 63,5±5,86 anos, com entradas sensoriais preservadas (visual, vestibular e somatossensitiva). Para avaliação do desempenho do sistema de controle postural, durante a manutenção da postura em pé, foi analisada a oscilação ântero-posterior e médio-lateral do corpo por sistema de cinemetria em três condições: com olhos abertos, olhos fechados e diminuição da base de sustentação (semi tandem). A análise estatística foi realizada por meio do teste de ANOVA para medidas repetidas e post hoc de Tukey. Resultados: Evidenciou-se diferença significante entre as três condições da avaliação do controle postural para as variáveis amplitude de oscilação médio-lateral (p<0,001), velocidade de oscilação antero-posterior (p= 0,013) e velocidade de oscilação médio-lateral (p<0,001). Conclusão: os sistemas sensoriais somatossensorial, visual e vestibular mostraram-se fundamentais para a manutenção do controle motor. Ainda, com o presente estudo foi confirmada a necessidade de uma boa base de sustentação podálica para manutenção da postura e do controle postural.
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