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Background: Postural instability is a debilitating cardinal symptom of Parkinson's disease (PD). Its onset marks a pivotal milestone in PD when balance impairment results in disability in many activities of daily living. Early detection of postural instability by non-expensive tools that can be widely used in clinical practice is a key factor in the prevention of falls in widespread population and their negative consequences. Objective: This study aimed to investigate the effectiveness of a two-dimensional balance assessment to identify the decline in postural control associated with PD progression. Methods: This study recruited 55 people with PD, of which 37 were men. Eleven participants were in stage I, twenty-three in stage II, and twenty-one in stage III. According to the Hoehn and Yahr (H&Y) rating scale, three clinical balance tests (Timed Up and Go test, Balance Evaluation Systems Test, and Push and Release test) were carried out in addition to a static stance test recorded by a two-dimensional movement analysis software. Based on kinematic variables generated by the software, a Postural Instability Index (PII) was created, allowing a comparison between its results and those obtained by clinical tests. Results: There were differences between sociodemographic variables directly related to PD evolution. Although all tests were correlated with H&Y stages, only the PII was able to differentiate the first three stages of disease evolution (H&Y I and II: p = 0.03; H&Y I and III: p = 0.00001; H&Y II and III: p = 0.02). Other clinical tests were able to differentiate only people in the moderate PD stage (H&Y III). Conclusion: Based on the PII index, it was possible to differentiate the postural control decline among the first three stages of PD evolution. This study offers a promising possibility of a low-cost, early identification of subtle changes in postural control in people with PD in clinical practice.
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Background: Gait is one of the activities most affected by the symptoms of Parkinson's disease and may show a linear decline as the disease progresses. Early assessment of its performance through clinically relevant tests is a key factor in designing efficient therapeutic plans and procedures, which can be enhanced using simple and low-cost technological instruments. Objective: To investigate the effectiveness of a two-dimensional gait assessment to identify the decline in gait performance associated with Parkinson's disease progression. Methods: One hundred and seventeen people with Parkinson's disease, classified between early and intermediate stages, performed three clinical gait tests (Timed Up and Go, Dynamic Gait Index, and item 29 of the Unified Parkinson's Disease Rating Scale), in addition to a six-meter gait test recorded by a two-dimensional movement analysis software. Based on variables generated by the software, a gait performance index was created, allowing a comparison between its results with the results obtained by clinical tests. Results: There were differences between sociodemographic variables directly related to the evolution of Parkinson's disease. Compared to clinical tests, the index proposed to analyze gait showed greater sensitivity and was able to differentiate the first three stages of disease evolution (Hoehn and Yahr I and II: p = 0.03; Hoehn and Yahr I and III: p = 0.00001; Hoehn and Yahr II and III: p = 0.02). Conclusion: Based on the index provided by a two-dimensional movement analysis software that uses kinematic gait variables, it was possible to differentiate the gait performance decline among the three first stages of Parkinson's disease evolution. This study offers a promising possibility of early identification of subtle changes in an essential function of people with Parkinson's disease.
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Background: People with Parkinson's disease (PD) display poorer gait performance when walking under complex conditions than under simple conditions. Screening tests that evaluate gait performance changes under complex walking conditions may be valuable tools for early intervention, especially if allowing for massive data collection. Objectives: To investigate the use of the Goalkeeper Game (GG) to predict impairment in gait performance under complex conditions in people with Parkinson's disease (PPD) and compare its predictive power with the one of the Montreal Cognitive Assessment (MoCA) test. Methods: 74 PPD (HY stages: 23 in stage 1; 31 in stage 2; 20 in stage 3), without dementia (MoCA cut-off 21), tested in ON period with dopaminergic medication were submitted to single individual cognitive/motor evaluation sessions. MoCA and GG were used to assess cognition, and the dynamic gait index (DGI) test was used to assess gait performance under complex condition. GG test resulted in 9 measures extracted via a statistical model. The predictive power of the GG measures and the MoCA score with respect to gait performance, as assessed by DGI, were compared. Results: The predictive models based on GG obtained a better score of prediction (65%) then MoCA (56%) for DGI scores (at a 50% specificity). Conclusion: GG is a novel tool for noninvasive screening that showed a superior predictive power in assessing gait performance under complex condition in people with PD than the well-established MoCa test.
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O objetivo deste estudo foi conhecer o estilo de vida (EV) de pessoas idosas portadoras de sequelas remanescentes por AVE, cadastradas e assistidas pelo Núcleo Interdisciplinar de Estudos e Extensão em Cuidados à Saúde da Família em Convibilidade com Doenças Crônicas. Foi utilizado como instrumento o Perfil do Estilo de Vida Individual (PEVI) para análise quantitativa. Os resultados não demonstraram índice positivo de bem-estar para esta população, haja vista a necessidade se continuar investigando sobre o EV e suas representações no modo de viver humano.
The objective of this study was to know the life style (LS) of aged people suffering from stroke for the remaining sequels, attended and registered of the Center Interdisciplinary Studies and Extended Care at the Family Health in Coexistence with Chronic Diseases. Was used as the instrument profile Life styles (PEVI) for quantitative analysis. The results showed no positive index of well being for this population, given the need to continue investigating on the LS and their representations in the way of human living.
Asunto(s)
Humanos , Anciano , Anciano , Estilo de Vida , Accidente CerebrovascularRESUMEN
O objetivo deste estudo foi conhecer o estilo de vida (EV) de pessoas idosas portadoras de sequelas remanescentes por AVE, cadastradas e assistidas pelo Núcleo Interdisciplinar de Estudos e Extensão em Cuidados à Saúde da Família em Convibilidade com Doenças Crônicas. Foi utilizado como instrumento o Perfil do Estilo de Vida Individual (PEVI) para análise quantitativa. Os resultados não demonstraram índice positivo de bem-estar para esta população, haja vista a necessidade se continuar investigando sobre o EV e suas representações no modo de viver humano.(AU)
The objective of this study was to know the life style (LS) of aged people suffering from stroke for the remaining sequels, attended and registered of the Center Interdisciplinary Studies and Extended Care at the Family Health in Coexistence with Chronic Diseases. Was used as the instrument profile Life styles (PEVI) for quantitative analysis. The results showed no positive index of well being for this population, given the need to continue investigating on the LS and their representations in the way of human living.(AU)