Gait in Parkinson’s disease: A visuo-cognitive challenge

Stuart, Samuel; Lord, Sue; Hill, Elizabeth; Rochester, Lynn

doi:10.1016/j.neubiorev.2016.01.002

Cited by 40 publications

(43 citation statements)

References 258 publications

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“…This pilot study adds to the body of evidence [5, 7, 28–30] that lower global cognitive function is correlated with worse performance in different domains of gait and balance. Importantly, this is the first study to demonstrate the correlation between reduced processing speed and impaired turning.…”

Section: Discussionmentioning

confidence: 82%

Global cognitive function and processing speed are associated with gait and balance dysfunction in Parkinson’s disease

Pal

O’Keefe

Robertson-Dick

et al. 2016

J NeuroEngineering Rehabil

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BackgroundOur primary objective was to determine the relationship between global cognitive function and specific domains of gait and balance in a cohort of Parkinson’s disease (PD) subjects. In a secondary analysis, we determined whether specific cognitive domains correlated with gait and balance performance.MethodsFourteen PD subjects (mean age 61.1 ± 7.8 years) were recruited from the Rush University Medical Center Movement Disorders clinic. Subjects underwent clinical assessment using the motor subsection of the Unified Parkinson’s Disease Rating Scale (UPDRS) followed by quantitative gait and balance assessments using the APDM Mobility Lab™ system (Mobility Lab, APDM Inc., Portland, OR). Subjects completed global cognitive testing using the Mattis Dementia Rating Scale (MDRS) as well as domain specific cognitive measures. Spearman’s rho was used to assess correlations between cognitive measures and gait and balance function, with False Discovery Rate (FDR) correction for multiple comparisons.ResultsGlobal cognitive function had the strongest correlation with stride velocity (r = 0.816, p = 0.001), turn duration (r = −0.806, p = 0.001), number of steps to turn (r = −0.830, p = 0.001), and mean velocity of postural sway in the medio-lateral direction (r = −0.726, p = 0.005). A significant correlation was found between processing speed and two turning measures (turn duration, r = −0.884, p = 0.001; number of steps to turn, r = −0.954, p < 0.001), but no other associations were found between specific cognitive domains and gait domains.ConclusionsThis pilot study provides preliminary data regarding the association between global cognitive function and pace-related measures of gait, turning, and postural sway. Furthermore, reduced processing speed was found to be associated with difficulty in performing turns.

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Section: Discussionmentioning

confidence: 82%

Global cognitive function and processing speed are associated with gait and balance dysfunction in Parkinson’s disease

Pal

O’Keefe

Robertson-Dick

et al. 2016

J NeuroEngineering Rehabil

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“…It is therefore likely that cue response relates to both attentional and visual processes; however, previous studies have limited investigation to their independent contribution. Simultaneous measurement of visual and attentional processing is possible through the real‐time monitoring of saccadic (fast) eye movements (Stuart et al ., ). Saccades, particularly saccade frequency, form the basis of visual exploration and are influenced by both visual and attentional neural processes (Kimmig et al ., ), which provides a means to examine the mechanisms underlying response to visual cues.…”

Section: Introductionmentioning

confidence: 97%

“…We hypothesised that a visual cue would increase saccade frequency in both PD and older adults; that saccade frequency would be reduced in both groups under dual‐task regardless of a visual cue; and changes in saccade frequency would be associated with cued gait and underpinned by attention rather than visual function. An a priori model from our previous literature review guided data analysis (Stuart et al ., ).…”

Section: Introductionmentioning

confidence: 97%

Saccade frequency response to visual cues during gait in Parkinson's disease: the selective role of attention

Stuart

Lord

Galna

et al. 2018

Eur J of Neuroscience

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Gait impairment is a core feature of Parkinson's disease (PD) with implications for falls risk. Visual cues improve gait in PD, but the underlying mechanisms are unclear. Evidence suggests that attention and vision play an important role; however, the relative contribution from each is unclear. Measurement of visual exploration (specifically saccade frequency) during gait allows for real-time measurement of attention and vision. Understanding how visual cues influence visual exploration may allow inferences of the underlying mechanisms to response which could help to develop effective therapeutics. This study aimed to examine saccade frequency during gait in response to a visual cue in PD and older adults and investigate the roles of attention and vision in visual cue response in PD. A mobile eye-tracker measured saccade frequency during gait in 55 people with PD and 32 age-matched controls. Participants walked in a straight line with and without a visual cue (50 cm transverse lines) presented under single task and dual-task (concurrent digit span recall). Saccade frequency was reduced when walking in PD compared to controls; however, visual cues ameliorated saccadic deficit. Visual cues significantly increased saccade frequency in both PD and controls under both single task and dual-task. Attention rather than visual function was central to saccade frequency and gait response to visual cues in PD. In conclusion, this study highlights the impact of visual cues on visual exploration when walking and the important role of attention in PD. Understanding these complex features will help inform intervention development.

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“…All patients were evaluated during "on" periods (when drugs were effective). 3), değerlendirmeden önceki 6 ayda düştükleri belirlenmiştir. H&Y Evrelemesi'ne göre olguların 25'i (%28,7) 1,5, 22'si (%25,3) 2 evresinde oldukları tespit edilmiştir.…”

Section: Patientsunclassified

“…Patients swing slowly like a block and swinging could be performed with multiple steps. These conditions constitute risk factors for falls (3,4).…”

Section: Introductionmentioning

confidence: 99%

Frequency of Falls and Relationship Between Falls, Socio-demographic and Clinical

Soyuer¹,

Cankurtaran²,

Gültekın³

et al. 2017

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Objective: Falls are major problems for people with Parkinson's disease. This study aimed to determine fall frequency, and the relation of socio-demographic and clinical factors in idiopathic Parkinson's disease (IPH). Materials and Methods:Eighty-seven patients with IPH who were under follow-up in Erciyes University Faculty of Medicine, Neurology Department [37 females (42.5%), and 50 males (57.5%)] were included in the study. The participants were evaluated with neurologic examination, mini-mental state examination, the Unified Parkinson's Disease Rating Scale (UPDRS), 6-meter walking test, turning time, freezing phenomenon, Hoehn and Yahr (H&Y) Scale, and ranking of fear of falls. Fall was recorded as history of fall in the 6 months before testing.Results: A total of 22 (25.3%) patients reported a fall in the 6-month period before testing. Twenty-five patients (28.7%) were stage 1.5, and 22 (25.3%) were stage 2 according to the H&Y Scale. Freezing phenomenon was observed in 34 39.1%) patients. There was no significant difference between patients with and without a history of falls according to age, sex, education, occupation, and marital status (p>0.05). According to disease period, H&Y Scale and the UPDRS, motor, turning time 360 degrees from right, turning time 360 degrees from left, balance defect at 360 degrees right turning, balance defect at 360 degrees left turning, and freezing phenomenon there were no significant difference between those with and without a history of fall (p>0.05). There was a significant difference between those who had fallen and had not fallen according to UPDRS-mental, UPDRS-ADL, degree of fear of falling, 6-m walking time, 6-m walking test, and number of steps (p<0.05). Conclusion:Our study showed that frequency of falls and walking speed, fear of falling, activities of daily living, and mental function are important factors for falls in IPH. Fall assessment in IPH is needed for a multifactorial approach and determining these factors will be helpful for taking measures against falls.

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Gait in Parkinson’s disease: A visuo-cognitive challenge

Cited by 40 publications

References 258 publications

Global cognitive function and processing speed are associated with gait and balance dysfunction in Parkinson’s disease

Global cognitive function and processing speed are associated with gait and balance dysfunction in Parkinson’s disease

Saccade frequency response to visual cues during gait in Parkinson's disease: the selective role of attention

Frequency of Falls and Relationship Between Falls, Socio-demographic and Clinical

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