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      The Parkinsonian Gait Spatiotemporal Parameters Quantified by a Single Inertial Sensor before and after Automated Mechanical Peripheral Stimulation Treatment

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          Abstract

          This study aims to evaluate the change in gait spatiotemporal parameters in subjects with Parkinson's disease (PD) before and after Automated Mechanical Peripheral Stimulation (AMPS) treatment. Thirty-five subjects with PD and 35 healthy age-matched subjects took part in this study. A dedicated medical device (Gondola) was used to administer the AMPS. All patients with PD were treated in off levodopa phase and their gait performances were evaluated by an inertial measurement system before and after the intervention. The one-way ANOVA for repeated measures was performed to assess the differences between pre- and post-AMPS and the one-way ANOVA to assess the differences between PD patients and the control group. Spearman's correlations assessed the associations between patients with PD clinical status (H&Y) and the percentage of improvement of the gait variables after AMPS ( α < 0.05 for all tests). The PD group had an improvement of 14.85% in the stride length; 14.77% in the gait velocity; and 29.91% in the gait propulsion. The correlation results showed that the higher the H&Y classification, the higher the stride length percentage of improvement. The treatment based on AMPS intervention seems to induce a better performance in the gait pattern of PD patients, mainly in intermediate and advanced stages of the condition.

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          Most cited references17

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          Diagnostic criteria for Parkinson disease.

          The clinical diagnosis of Parkinson disease (PD) is based on the identification of some combination of the cardinal motor signs of bradykinesia, rigidity, tremor, and postural instability, but few attempts have been made to develop explicit diagnostic criteria. We propose a clinical diagnostic classification based on a comprehensive review of the literature regarding the sensitivity and specificity of the characteristic clinical features of PD. Three levels of diagnostic confidence are differentiated: Definite, Probable, and Possible. The diagnoses of Possible and Probable PD are based on clinical criteria alone. Neuropathologic confirmation is required for the diagnosis of Definite PD in patients with the clinical diagnosis of Possible or Probable PD. Criteria for histopathologic confirmation of PD are also presented.
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            Gait assessment in Parkinson's disease: toward an ambulatory system for long-term monitoring.

            An ambulatory gait analysis method using body-attached gyroscopes to estimate spatio-temporal parameters of gait has been proposed and validated against a reference system for normal and pathologic gait. Later, ten Parkinson's disease (PD) patients with subthalamic nucleus deep brain stimulation (STN-DBS) implantation participated in gait measurements using our device. They walked one to three times on a 20-m walkway. Patients did the test twice: once STN-DBS was ON and once 180 min after turning it OFF. A group of ten age-matched normal subjects were also measured as controls. For each gait cycle, spatio-temporal parameters such as stride length (SL), stride velocity (SV), stance (ST), double support (DS), and gait cycle time (GC) were calculated. We found that PD patients had significantly different gait parameters comparing to controls. They had 52% less SV, 60% less SL, and 40% longer GC. Also they had significantly longer ST and DS (11% and 59% more, respectively) than controls. STN-DBS significantly improved gait parameters. During the stim ON period, PD patients had 31% faster SV, 26% longer SL, 6% shorter ST, and 26% shorter DS. GC, however, was not significantly different. Some of the gait parameters had high correlation with Unified Parkinson's Disease Rating Scale (UPDRS) subscores including SL with a significant correlation (r = -0.90) with UPDRS gait subscore. We concluded that our method provides a simple yet effective way of ambulatory gait analysis in PD patients with results confirming those obtained from much more complex and expensive methods used in gait labs.
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              Levodopa Is a Double-Edged Sword for Balance and Gait in People With Parkinson's Disease.

              The effects of levodopa on balance and gait function in people with Parkinson's disease (PD) is controversial. This study compared the relative responsiveness to l-dopa on six domains of balance and gait: postural sway in stance; gait pace; dynamic stability; gait initiation; arm swing; and turning in people with mild and severe PD, with and without dyskinesia.
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                Author and article information

                Journal
                Parkinsons Dis
                Parkinsons Dis
                PD
                Parkinson's Disease
                Hindawi Publishing Corporation
                2090-8083
                2042-0080
                2015
                1 October 2015
                : 2015
                : 390512
                Affiliations
                1Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milano, Lombardia, Italy
                2Movement Analysis and Neuroscience-Neurological Rehabilitation Laboratories, University of Health Sciences of Porto Alegre, 90050-170 Porto Alegre, RS, Brazil
                3IRCCS San Raffaele Pisana Tosinvest Sanitá, 00163 Roma, Lazio, Italy
                4San Raffaele Cassino Hospital Tosinvest Sanitá, 03043 Roma, Lazio, Italy
                5UNIMED Hospital, 13500-391 Rio Claro, SP, Brazil
                Author notes

                Academic Editor: Talia Herman

                Article
                10.1155/2015/390512
                4606184
                26495152
                697d1a8c-d0af-46d4-abd1-667c160f8451
                Copyright © 2015 Ana Kleiner et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 May 2015
                : 5 August 2015
                : 2 September 2015
                Categories
                Clinical Study

                Neurology
                Neurology

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