共查询到20条相似文献，搜索用时 31 毫秒
1.
Alexander T. Peebles Adam P. Bruetsch Sharon G. Lynch Jessie M. Huisinga 《Archives of physical medicine and rehabilitation》2018,99(10):2030-2037
Objectives
To compare physiological impairments between persons with multiple sclerosis (MS) with a history of falls and persons with MS without a history of falls, and to investigate the association between physiological impairments and dynamic balance.Design
Cross-sectional study.Setting
University motion analysis laboratory.Participants
Persons with MS (N=55; 27 recurrent fallers and 28 nonfallers). Participants were classified as fallers if they self-reported ≥2 falls in the previous 6 months.Interventions
None.Main Outcome Measures
Physiological impairment was assessed with sensorimotor delays, spasticity, plantar cutaneous sensation, and the sensory, cerebellar, and pyramidal subscales of the Expanded Disability Status Scale (EDSS). Dynamic balance was assessed using the average and variability of margin of stability and variability of trunk accelerations.Results
Compared with nonfallers, fallers had lower plantar sensation, longer sensorimotor delays, more spasticity, and more impairment in the pyramidal and cerebellar subscales of the EDSS. Additionally, these impairments were all moderately to strongly correlated with worse dynamic balance.Conclusions
This study highlights the multifactorial nature of instability in persons with MS. A better understanding of the physiological mechanisms of dynamic instability in persons with MS can be used to improve methods of monitoring disease progression, identifying which impairments to target through interventions, and appropriately evaluating intervention efficacy. 相似文献2.
Stefano Negrini Luciano Bissolotti Alessandro Ferraris Fulvia Noro Mark D. Bishop Jorge Hugo Villafañe 《Journal of bodywork and movement therapies》2017,21(1):117-123
Background
Impaired postural stability places individuals with Parkinson's disease (PD) at an increased risk for falls.Objective
We evaluated the effectiveness of 10 vs. 15 sessions of Nintendo Wii Fit for balance recovery for outpatients PD.Methods
Twenty-seven patients, 48.1% female (66 ± 8 years), with PD. Patients with PD were consecutively assigned to one of two groups receiving either 10 or 15 sessions (low dose or high dose group, respectively) with Nintendo Wii Fit in recovering balancing ability. All outcome measures were collected at baseline, immediately following the intervention period, and 1-month following the end of the intervention. Main outcome measure: Falls risk test (FRT), Stability index (PST), Berg balance scale (BBS) and Tinetti scale.Results
The patients undergoing the 10 sessions demonstrated significantly improvement on the balance performances (Tinetti balance and gait scales, BBS and BSF) (all, P < 0.05) as those undergoing 15 treatment with Nintendo Wii Fit, but no significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way.Conclusions
The results suggest that functional improvement can be made in fewer visits during outpatient rehabilitation sessions with Nintendo Wii Fit improving the efficiency of intervention. 相似文献3.
Aqeel M. Alenazi Mohammed M. Alshehri Shaima Alothman Jason Rucker Kari Dunning Linda J. D’Silva Patricia M. Kluding 《PM & R》2018,10(8):806-816
Background
Falls are a common adverse event among people with stroke. Previous studies investigating risk of falls after stroke have relied primarily on retrospective fall history ranging from 6-12 months recall, with inconsistent findings.Objectives
To identify factors and balance assessment tools that are associated with number of falls in individuals with chronic stroke.Design
Secondary analysis of a randomized clinical trial.Setting
Multisite academic and clinical institutions.Participants
Data from 181 participants with stroke (age 60.67 ± 11.77 years, post stroke 4.51 ± 4.78 years) were included.Methods
Study participants completed baseline testing and were prospectively asked about falls. A multivariate negative binomial regression was used to identify baseline predictive factors predicting falls: age, endurance (6 minute walk test), number of medications, motor control (Fugl-Meyer lower extremity score), depression (Patient Health Questionnaire-9), physical activity (number of steps per week), and cognition (Mini Mental Status Exam score). A second negative binomial regression analysis was used to identify baseline balance assessment scores predicting falls: gait velocity (comfortable 10 Meter Walk), Berg Balance Scale (BBS), Timed Up and Go (TUG), and Functional Reach Test (FRT). Receiver operating characteristic (ROC) and area under the curve (AUC) were used to determine the cutoff scores for significant predictors of recurrent falls.Main Outcome Measurement
The number of falls during the 42-week follow-up period.Results
Baseline measures that significantly predicted the number of falls included increased number of medications, higher depression scores, and decreased FRT. Cutoff scores for the number of medications were 8.5 with an AUC of 0.68. Depression scores differentiated recurrent fallers at a threshold of 2.5 scores with an AUC of 0.62. FRT differentiated recurrent fallers at a threshold of 18.15 cm with an AUC of 0.66.Conclusions
Number of medications, depression scores, and decreased FRT distance at baseline were associated with increased number of falls. Increased medications might indicate multiple comorbidities or polypharmacy effect; increased depression scores may indicate psychological status; and decreased functional reach distance could indicate dynamic balance impairments.Level of Evidence
II 相似文献4.
Sumaiyah Mat Chin Teck Ng Pey June Tan Norlisah Ramli Farhana Fadzli Faizatul Izza Rozalli Mazlina Mazlan Keith D. Hill Maw Pin Tan 《PM & R》2018,10(3):254-262
Background
Osteoarthritis (OA) is considered an established risk factor for falls. Published studies evaluating secondary falls prevention strategies among individuals with OA are limited.Objective
To evaluate the effect of a personalized home-based exercise program to improve postural balance, fear of falling, and falls risk in older fallers with knee OA and gait and balance problems.Design
Randomized controlled trial.Setting
University of Malaya Medical Centre.Participants
Fallers who had both radiological OA and a Timed Up and Go (TUG) score of over 13.5 seconds.Main Outcome Measure
Postural sway (composite sway) was quantified with the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) under 4 different sensory conditions: eyes open on firm surface, eyes closed on firm surface, eyes open on unstable foam surface, and eyes closed on unstable foam surface. Participants were asked to stand upright and to attempt to hold their position for 10 seconds for each test condition. The average reading for all conditions were calculated.Methods
Participants randomized to the intervention arm received a home-based modified Otago Exercise Program (OEP) as part of a multifactorial intervention, whereas control participants received general health advice and conventional treatment. This was a secondary subgroup analysis from an original randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT) (trial registration number: ISRCTN11674947). Posturography using a long force plate balance platform (Balancemaster, NeuroCom, USA), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the short-form Falls Efficacy Scale?International (short FES-I) were assessed at baseline and 6 months.Results
Results of 41 fallers with radiological evidence of OA and impaired TUG (intervention, 17; control, 24) were available for the final analysis. Between-group analysis revealed significant improvements in the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Limits of Stability (LOS), and short FES-I scores by the intervention group compared to the control group at 6 months. No significant difference in time to first fall or in fall-free survival between the intervention and control groups was found.Conclusion
Home-based balance and strength exercises benefited older fallers with OA and gait and balance disorders by improving postural control, with no observable trend in reduction of fall recurrence. Our findings will now inform a future, adequately powered, randomized controlled study using fall events as definitive outcomes.Level of Evidence
I 相似文献5.
Tianma Xu Lindy Clemson Kate O&#x;Loughlin Natasha A. Lannin Catherine Dean Gerald Koh 《Archives of physical medicine and rehabilitation》2018,99(3):563-573.e5
Objective
To identify the risk factors for falls in community stroke survivors.Data Sources
A comprehensive search for articles indexed in MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, and Web of Science databases was conducted.Study Selection
Prospective studies investigating fall risk factors in community stroke survivors were included. Reviewers in pair independently screened the articles and determined inclusion through consensus. Studies meeting acceptable quality rating using the Q-Coh tool were included in the meta-analysis.Data Extraction
Data extraction was done in duplicate by 4 reviewers using a standardized data extraction sheet and confirmed by another independent reviewer for completeness and accuracy.Data Synthesis
Twenty-one articles met the minimum criteria for inclusion; risk factors investigated by ≥3 studies (n=16) were included in the meta-analysis. The following risk factors had a strong association with all fallers: impaired mobility (odds ratio [OR], 4.36; 95% confidence interval [CI], 2.68–7.10); reduced balance (OR, 3.87; 95% CI, 2.39–6.26); use of sedative or psychotropic medications (OR, 3.19; 95% CI, 1.36–7.48); disability in self-care (OR, 2.30; 95% CI, 1.51–3.49); depression (OR, 2.11; 95% CI, 1.18–3.75); cognitive impairment (OR, 1.75; 95% CI, 1.02–2.99); and history of fall (OR, 1.67; 95% CI, 1.03–2.72). A history of fall (OR, 4.19; 95% CI, 2.05–7.01) had a stronger association with recurrent fallers.Conclusions
This study confirms that balance and mobility problems, assisted self-care, taking sedative or psychotropic medications, cognitive impairment, depression, and history of falling are associated with falls in community stroke survivors. We recommend that any future research into fall prevention programs should consider addressing these modifiable risk factors. Because the risk factors for falls in community stroke survivors are multifactorial, interventions should be multidimensional. 相似文献6.
Hilary Gunn Michelle Cameron Phu Hoang Stephen Lord Steve Shaw Jennifer Freeman 《Archives of physical medicine and rehabilitation》2018,99(10):2022-2029
Objective
This study evaluated the relationship between physiological and perceived fall risk in people with multiple sclerosis (MS).Design
Secondary analysis of data from prospective cohort studies undertaken in Australia, the United Kingdom, and the United States.Setting
Community.Participants
Ambulatory people with MS (N=416) (age 51.5±12.0 years; 73% female; 62% relapsing-remitting MS; 13.7±9.9 years disease duration).Interventions
Not applicable.Main Outcome Measures
All participants completed measures of physiological (Physiological Profile Assessment [PPA]) and perceived (Falls Efficacy Scale-international [FESi]) fall risk and prospectively recorded falls for 3 months.Results
155 (37%) of the participants were recurrent fallers (≥2 falls). Mean PPA and FESi scores were high (PPA 2.14±1.87, FESi 34.27±11.18). The PPA and the FESi independently predicted faller classification in logistic regression, which indicated that the odds of being classified as a recurrent faller significantly increased with increasing scores (PPA odds ratio [OR] 1.30 [95% CI 1.17-1.46], FESi OR 1.05 [95% CI 1.03-1.07]). Classification and regression tree analysis divided the sample into four groups based on cutoff values for the PPA: (1) low physiological/low perceived risk (PPA <2.83, FESi <27.5), (2) low physiological/high perceived risk (PPA <2.83, FESi >27.5), (3) high physiological/low perceived risk (PPA >2.83, FESi <35.5), and (4) high physiological/high perceived risk (PPA <2.83, FESi >35.5). Over 50% of participants had a disparity between perceived and physiological fall risk; most were in group 2. It is possible that physiological risk factors not detected by the PPA may also be influential.Conclusions
This study highlights the importance of considering both physiological and perceived fall risk in MS and the need for further research to explore the complex interrelationships of perceptual and physiological risk factors in this population. This study also supports the importance of developing behavioral and physical interventions that can be tailored to the individual’s needs. 相似文献7.
Alex W.K. Wong Stephen C.L. Lau Mandy W.M. Fong David Cella Jin-Shei Lai Allen W. Heinemann 《Archives of physical medicine and rehabilitation》2018,99(9):1763-1775
Objective
To determine the extent to which the content of the Quality of Life in Neurological Disorders (Neuro-QoL) covers the International Classification of Functioning, Disability and Health (ICF) Core Sets for multiple sclerosis (MS), stroke, spinal cord injury (SCI), and traumatic brain injury (TBI) using summary linkage indicators.Design
Content analysis by linking content of the Neuro-QoL to corresponding ICF codes of each Core Set for MS, stroke, SCI, and TBI.Setting
Three academic centers.Participants
None.Interventions
None.Main Outcome Measures
Four summary linkage indicators proposed by MacDermid et al were estimated to compare the content coverage between Neuro-QoL and the ICF codes of Core Sets for MS, stroke, MS, and TBI.Results
Neuro-QoL represented 20% to 30% Core Set codes for different conditions in which more codes in Core Sets for MS (29%), stroke (28%), and TBI (28%) were covered than those for SCI in the long-term (20%) and early postacute (19%) contexts. Neuro-QoL represented nearly half of the unique Activity and Participation codes (43%–49%) and less than one third of the unique Body Function codes (12%?32%). It represented fewer Environmental Factors codes (2%?6%) and no Body Structures codes. Absolute linkage indicators found that at least 60% of Neuro-QoL items were linked to Core Set codes (63%?95%), but many items covered the same codes as revealed by unique linkage indicators (7%?13%), suggesting high concept redundancy among items.Conclusions
The Neuro-QoL links more closely to ICF Core Sets for stroke, MS, and TBI than to those for SCI, and primarily covers activity and participation ICF domains. Other instruments are needed to address concepts not measured by the Neuro-QoL when a comprehensive health assessment is needed. 相似文献8.
Cheng-Ya Huang Yu-An Chen Ing-Shiou Hwang Ruey-Meei Wu 《Archives of physical medicine and rehabilitation》2018,99(8):1540-1546.e2
Objective
To examine the task prioritization effects on postural-suprapostural dual-task performance in patients with early-stage Parkinson disease (PD) without clinically observed postural symptoms.Design
Cross-sectional study. Participants performed a force-matching task while standing on a mobile platform, and were instructed to focus their attention on either the postural task (posture-first strategy) or the force-matching task (posture-second strategy).Setting
University research laboratory.Participants
Individuals (N=16) with early-stage PD who had no clinically observed postural symptoms.Interventions
Not applicable.Main Outcome Measures
Dual-task change (DTC; percent change between single-task and dual-task performance) of posture error, posture approximate entropy (ApEn), force error, and reaction time (RT). Positive DTC values indicate higher postural error, posture ApEn, force error, and force RT during dual-task conditions compared with single-task conditions.Results
Compared with the posture-first strategy, the posture-second strategy was associated with smaller DTC of posture error and force error, and greater DTC of posture ApEn. In contrast, greater DTC of force RT was observed under the posture-second strategy.Conclusions
Contrary to typical recommendations, our results suggest that the posture-second strategy may be an effective dual-task strategy in patients with early-stage PD who have no clinically observed postural symptoms in order to reduce the negative effect of dual tasking on performance and facilitate postural automaticity. 相似文献9.
József Tollár Ferenc Nagy Norbert Kovács Tibor Hortobágyi 《Archives of physical medicine and rehabilitation》2018,99(12):2478-2484.e1
Objective
To determine the effects of a high-intensity exercise therapy using sensorimotor and visual stimuli on nondemented Parkinson disease (PD) patients’ clinical symptoms, mobility, and standing balance.Design
Randomized clinical intervention, using a before-after trial design.Setting
University hospital setting.Participants
A total of 72 PD patients with Hoehn and Yahr stage of 2-3, of whom 64 were randomized, and 55 completed the study.Intervention
PD patients were randomly assigned to a no physical intervention control (n=20 of 29 completed, 9 withdrew before baseline testing) or to a high-intensity agility program (15 sessions, 3 weeks, n=35 completed).Main Outcome Measures
Primary outcome was the Movement Disorders Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS) motor experiences of daily living (M-EDL). Secondary outcomes were Beck Depression score, Parkinson Disease Questionnaire-39 (PDQ-39), EuroQoL Five-Dimension (EQ5D) Questionnaire visual analog scale, Schwab and England Activities of Daily Living (SE ADL) Scale, timed Up and Go (TUG) test, and 12 measures of static posturography.Results
The agility program improved MDS-UPDRS M-EDL by 38% compared with the 2% change in control (group by time interaction, P=.001). Only the intervention group improved in PDQ-39 (6.6 points), depression (18%), EQ5D visual analog scale score (15%), the SE ADL Scale score (15%), the TUG test (39%), and in 8 of 12 posturography measures by 42%-55% (all P<.001). The levodopa equivalent dosage did not change.Conclusion
A high-intensity agility program improved nondemented, stage 2-3 PD patients’ clinical symptoms, mobility, and standing balance by functionally meaningful margins at short-term follow-up. 相似文献10.
Marcos Eduardo Scheicher Ligia Cristiane Santos Fonseca Tiago Buso Bortolloto Isabela Feitosa de Carvalho 《Journal of bodywork and movement therapies》2018,22(2):482-486
Background
The deterioration in the somatosensory and motor systems observed with increasing age can cause balance problems. Studies have shown that the use of infrapatellar bandages can enhance proprioception and improve postural balance.Aims
To evaluate the effect of an infrapatellar bandage on static balance and mobility in elderly female fallers and non-fallers.Methods
Forty older women (20 fallers and 20 non-fallers) were evaluated. Mobility (Timed Up and Go test) and balance (force platform) were measured in the presence and absence of additional sensory information (elastic infrapatellar bandage).Results
Mobility differed in fallers (p = 0.0001), but not in non-fallers (p = 0.27), when the patellar bandage was applied. Additional sensory information did not improve static balance in either group (p > 0.05), but a trend towards improvement was observed in fallers.Conclusion
Additional sensory input from an infrapatellar bandage improves mobility but not bipedal stance in elderly fallers. 相似文献11.
Nam G. Lee Joshua H. You Chung H. Yi Hye S. Jeon Bong S. Choi Dong R. Lee Jae M. Park Tae H. Lee In T. Ryu Hyun S. Yoon 《Archives of physical medicine and rehabilitation》2018,99(11):2168-2174
Objectives
To compare the effects of conventional core stabilization and dynamic neuromuscular stabilization (DNS) on anticipatory postural adjustment (APA) time, balance performance, and fear of falls in chronic hemiparetic stroke.Design
Two-group randomized controlled trial with pretest-posttest design.Setting
Hospital rehabilitation center.Participants
Adults with chronic hemiparetic stroke (N=28).Interventions
Participants were randomly divided into either conventional core stabilization (n=14) or DNS (n=14) groups. Both groups received a total of 20 sessions of conventional core stabilization or DNS training for 30 minutes per session 5 times a week during the 4-week period.Main Outcome Measures
Electromyography was used to measure the APA time for bilateral external oblique (EO), transverse abdominis (TrA)/internal oblique (IO), and erector spinae (ES) activation during rapid shoulder flexion. Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), and Falls Efficacy Scale (FES) were used to measure trunk movement control, balance performance, and fear of falling.Results
Baseline APA times were delayed and fear of falling was moderately high in both the conventional core stabilization and DNS groups. After the interventions, the APA times for EO, TrA/IO, and ES were shorter in the DNS group than in the conventional core stabilization group (P<.008). The BBS and TIS scores (P<.008) and the FES score (P<.003) were improved compared with baseline in both groups, but FES remained stable through the 2-year follow-up period only in the DNS group (P<.003).Conclusions
This is the first clinical evidence highlighting the importance of core stabilization exercises for improving APA control, balance, and fear of falls in individuals with hemiparetic stroke. 相似文献12.
Mehdi Kargarfard Ardalan Shariat Lee Ingle Joshua A. Cleland Mina Kargarfard 《Archives of physical medicine and rehabilitation》2018,99(2):234-241
Objective
To assess the effects of an 8-week aquatic exercise training program on functional capacity, balance, and perceptions of fatigue in women with multiple sclerosis (MS).Design
Randomized controlled design.Setting
Referral center of an MS society.Participants
Women (N=32; mean age ± SD, 36.4±8.2y) with diagnosed relapsing-remitting MS. After undergoing baseline testing by a neurologist, participants were allocated to either an intervention (aquatic training program, n=17) or a control group (n=15).Interventions
The intervention consisted of an 8-week aquatic training program (3 supervised training sessions per week; session duration, 45–60min; 50%–75% estimated maximum heart rate).Main Outcome Measures
Six-minute walk test (6-MWT), balance (Berg Balance Scale [BBS]), and perceptions of fatigue (Modified Fatigue Impact Scale; [MFIS]) at baseline and after the 8-week intervention. Differences over time between the experimental and control groups were assessed by a 2×2 (group by time) repeated-measures analysis of variance.Results
Thirty-two women completed the 8-week aquatic training intervention (experimental group, n=17; control group, n=15). All outcome measures improved in the experimental group: 6-MWT performance (pretest mean ± SD, 451±58m; posttest mean ± SD, 503±57m; P<.001); BBS (pretest mean ± SD, 53.59±1.70; posttest mean ± SD, 55.18±1.18; P<.001), and MFIS (pretest mean ± SD, 43.1±14.6; posttest mean ± SD, 32.8±5.9; P<.01). A significant group-by-time interaction was evident between the experimental and control groups for 6-MWT (P<.001, partial eta2 [ηp2]=.551), BBS (P<.001, ηp2=.423), and MFIS (P<.001, ηp2=.679).Conclusions
Aquatic exercise training improved functional capacity, balance, and perceptions of fatigue in women with MS. 相似文献13.
Mia Forslin Katharina Fink Ulf Hammar Lena von Koch Sverker Johansson 《Archives of physical medicine and rehabilitation》2018,99(8):1483-1490
Objective
To identify predictors for employment status after 10 years in a cohort of people with multiple sclerosis (MS), with the aim to increase knowledge concerning factors present at an early stage that are important for working life and work-life balance.Design
A 10-year longitudinal observational cohort study.Setting
University hospital.Participants
A consecutive sample of people with MS (N=154) of working age were included at baseline, of which a total of 116 people participated in the 10-year follow-up; 27 people declined participation and 11 were deceased.Interventions
Not applicable.Main Outcome Measures
Baseline data on personal factors and functioning were used as independent variables. Employment status 10 years after baseline, categorized as full-time work, part-time work, and no work, was used as the dependent variable. A generalized ordinal logistic regression was used to analyze the predictive value of the independent variables.Results
Predictors for full- or part-time work after 10 years were young age (P=.002), low perceived physical impact of MS (P=.02), fatigue (P=.03), full-time work (P=.001), and high frequency of social/lifestyle activities (P=.001) at baseline. Low perceived physical impact of MS (P=.02) at baseline also predicted full-time work after 10 years.Conclusions
This study underlines the complexity of working life for people with MS, and indicates that it may be valuable to give more attention to the balance between working and private life, both in clinical practice and future research, to achieve a sustainable working life over time. 相似文献14.
Azam Karimi-AhmadAbadi Soofia Naghdi Noureddin Nakhostin Ansari Zahra Fakhari Maede Khalifeloo 《Journal of bodywork and movement therapies》2018,22(2):242-246
Summary
Balance disorder is a very common cause of disability in patients after a stroke. Vibration therapy is one of the physiotherapeutic modalities used to improve balance.Objective
To investigate the immediate effects of plantar vibration on balance in patients with stroke.Methods
In this single blind comparative study, 22 patients with stroke (8 females, 14 males; age 55.82 ± 11.87 years old) participated. Patients underwent treatment, first with the placebo vibration and 1 week later with active vibration (frequency 100 HZ, 5 min). Mini-BESTest score, Modified Modified Ashworth Scale for plantar flexor spasticity, and ankle dorsiflexion passive range of motion (PROM) were evaluated before and immediately after the placebo or active vibration.Results
A significant clinical improvement in balance, ankle plantar flexor spasticity, and the ankle dorsiflexion PROM was observed following either placebo or active vibration. The improvements after active vibration were significantly greater for all outcome measures compared with placebo vibration. There was a large effect size (Cohen's d = 0.85) for balance after active vibration.Conclusion
The vibration applied to the sole of the affected foot of patients after stroke was effective for improving balance, reducing ankle plantar flexor spasticity, and increasing ankle dorsiflexion PROM. 相似文献15.
Ana Francisca Rozin Kleiner Aline Souza Pagnussat Camila Pinto Ritchele Redivo Marchese Ana Paula Salazar Manuela Galli 《Archives of physical medicine and rehabilitation》2018,99(12):2420-2429
Objective
To assess the effects of automated peripheral stimulation (AMPS) in reducing gait variability of subjects with Parkinson disease (PD) and freezing of gait (FOG) treated with AMPS and to explore the effects of this treatment on gait during a single task (walking) and a dual task (walking while attending the word-color Stroop test).Design
Interventional, double-blinded, placebo-controlled, randomized trial.Setting
Clinical rehabilitation.Participants
Thirty subjects were randomized into 2 groups: AMPS (n=15) and AMPS sham (n=15).Interventions
Both groups received 2 treatment sessions a week for 4 consecutive weeks (totaling 8 treatment sessions). AMPS was applied by using a medical device (Gondola?) and consisted in mechanical pressure stimulations delivered by metallic actuators on 4 areas of the feet. Treatment parameters and device configuration were modified for AMPS sham group.Main Outcome Measures
Gait analyses were measured at baseline and after the first, fourth, and eighth treatment sessions.Results
Interactions among groups and sessions were found for both conditions while off anti-Parkinsonian medications. AMPS decreased gait variability in subjects with PD and FOG for both single and dual task conditions.Conclusions
AMPS is an effective add-on therapy for treating gait variability in patients with PD and FOG. 相似文献16.
Hossein Negahban Saeideh Monjezi Mohammad Mehravar Neda Mostafaee Ali Shoeibi 《Journal of bodywork and movement therapies》2018,22(2):502-510
Introduction
Evaluating responsiveness has an important role in design and interpretation of the interventional studies. The aim was to estimate the responsiveness and minimally important difference (MID) of postural performance measures following balance rehabilitation in patients with Multiple Sclerosis (MS, n = 38).Methods
Postural measures were evaluated at baseline and after 4 weeks intervention. Laboratory-based measures were center of pressure parameters. Clinically-based measures were Activities-specific Balance Confidence (ABC), Berg Balance Scale (BBS), Functional Gait Assessment (FGA); and walking measures 2 Minute Walk (2 MW), 10 Meter Timed Walk (10 MTW) and Timed Up and Go (TUG) performed under single and dual-task conditions. To evaluate responsiveness, we calculated the Receiver Operating Characteristics (ROC) and the Area Under the ROC Curve (AUC). The optimal values for the MID were the cutoffs corresponding to the upper left corner of the ROC curve.Results
The AUCs for mean and standard deviation of sway velocity were above the cutoff of 0.50 in most conditions. For the clinically-based measures, the highest AUCs were found for the ABC, and cognitive-2MW, followed by the BBS and 10 MTW.Conclusions
In this preliminary study, the most appropriate postural performance measures and the MID values for detecting meaningful changes in MS undergoing balance rehabilitation have been provided. 相似文献17.
Kuan-yi Li Yu-pei Hsiao Rou-shayn Chen Ching-yi Wu 《Archives of physical medicine and rehabilitation》2018,99(7):1303-1310
Objective
To investigate the kinematic and myographic effects of weighted wrist cuffs on individuals with Parkinson disease (PD) during a reaching task.Design
Cross-sectional study.Setting
Biomechanics research laboratory.Participants
Individuals (N=39) with PD (n=19) and healthy age-matched control subjects (n=20).Interventions
Participants were instructed to reach and grasp a can at a distance of 80% of their arm length without a wrist cuff, while wearing separate 0.5- and 1.0-kg wrist cuffs, and subsequently without a wrist cuff.Main Outcome Measures
Movement time, kinematic, and electromyographic data were recorded during all reach and grasp movements. Four end point coordinate strategy variables, 3 joint recruitment variables, and 2 co-contraction indices were derived from the raw data for analysis.Results
Significant interaction effects were found in the trunk and index finger movement time as the weight of the cuff increased from 0.5 to 1.0kg. The group of individuals with PD showed decreased movement times in both instances, whereas the control group showed increased movement times as the weight of the wrist cuff increased from baseline to 0.5 and 1.0kg. No group difference was observed in the co-contraction index of the upper arm and forearm.Conclusions
Adoption of weighted wrist cuffs in the clinic should be cautiously undertaken because compensatory movements may be induced in the trunk of individuals with PD. 相似文献18.
Yi-Jing Huang Gong-Hong Lin Shih-Chieh Lee Yi-Miau Chen Sheau-Ling Huang Ching-Lin Hsieh 《Archives of physical medicine and rehabilitation》2018,99(3):529-533
Objectives
To examine both group- and individual-level responsiveness of the 3-point Berg Balance Scale (BBS-3P) and 3-point Postural Assessment Scale for Stroke Patients (PASS-3P) in patients with stroke, and to compare the responsiveness of both 3-point measures versus their original measures (Berg Balance Scale [BBS] and Postural Assessment Scale for Stroke Patients [PASS]) and their short forms (short-form Berg Balance Scale [SFBBS] and short-form Postural Assessment Scale for Stroke Patients [SFPASS]) and between the BBS-3P and PASS-3P.Design
Data were retrieved from a previous study wherein 212 patients were assessed at 14 and 30 days after stroke with the BBS and PASS.Setting
Medical center.Participants
Patients (N=212) with first onset of stroke within 14 days before hospitalization.Interventions
Not applicable.Main Outcome Measures
Group-level responsiveness was examined by the standardized response mean (SRM), and individual-level responsiveness was examined by the proportion of patients whose change scores exceeded the minimal detectable change of each measure. The responsiveness was compared using the bootstrap approach.Results
The BBS-3P and PASS-3P had good group-level (SRM, .60 and SRM, .56, respectively) and individual-level (48.1% and 44.8% of the patients with significant improvement, respectively) responsiveness. Bootstrap analyses showed that the BBS-3P generally had superior responsiveness to the BBS and SFBBS, and the PASS-3P had similar responsiveness to the PASS and SFPASS. The BBS-3P and PASS-3P were equally responsive to both group and individual change.Conclusions
The responsiveness of the BBS-3P and PASS-3P was comparable or superior to those of the original and short-form measures. We recommend the BBS-3P and PASS-3P as responsive outcome measures of balance for individuals with stroke. 相似文献19.
Hsin-Yu Chiang Wen-Shian Lu Wan-Hui Yu I-Ping Hsueh Ching-Lin Hsieh 《Archives of physical medicine and rehabilitation》2018,99(8):1499-1506
Objective
To examine the interrater and intrarater reliability of the Balance Computerized Adaptive Test (Balance CAT) in patients with chronic stroke having a wide range of balance functions.Design
Repeated assessments design (1wk apart).Setting
Seven teaching hospitals.Participants
A pooled sample (N=102) including 2 independent groups of outpatients (n=50 for the interrater reliability study; n=52 for the intrarater reliability study) with chronic stroke.Interventions
Not applicable.Main Outcome Measures
Balance CAT.Results
For the interrater reliability study, the values of intraclass correlation coefficient, minimal detectable change (MDC), and percentage of MDC (MDC%) for the Balance CAT were .84, 1.90, and 31.0%, respectively. For the intrarater reliability study, the values of intraclass correlation coefficient, MDC, and MDC% ranged from .89 to .91, from 1.14 to 1.26, and from 17.1% to 18.6%, respectively.Conclusions
The Balance CAT showed sufficient intrarater reliability in patients with chronic stroke having balance functions ranging from sitting with support to independent walking. Although the Balance CAT may have good interrater reliability, we found substantial random measurement error between different raters. Accordingly, if the Balance CAT is used as an outcome measure in clinical or research settings, same raters are suggested over different time points to ensure reliable assessments. 相似文献20.
Andrew Sawers Brian Hafner 《Archives of physical medicine and rehabilitation》2018,99(8):1491-1498.e1