A Manipulation of Visual Feedback during Gait Training in Parkinson's Disease
Identifieur interne : 000389 ( Pmc/Curation ); précédent : 000388; suivant : 000390A Manipulation of Visual Feedback during Gait Training in Parkinson's Disease
Auteurs : Quincy J. Almeida ; Haseel BhattSource :
- Parkinson's Disease [ 2090-8083 ] ; 2011.
Abstract
Visual cues are known to improve gait in Parkinson's disease (PD); however, the contribution of optic flow continues to be disputed. This study manipulated transverse line cues during two gait training interventions (6 weeks). PD subjects (
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DOI: 10.1155/2012/508720
PubMed: 21941685
PubMed Central: 3177092
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A Manipulation of Visual Feedback during Gait Training in Parkinson's Disease</title><author><name sortKey="Almeida, Quincy J" sort="Almeida, Quincy J" uniqKey="Almeida Q" first="Quincy J." last="Almeida">Quincy J. Almeida</name></author><author><name sortKey="Bhatt, Haseel" sort="Bhatt, Haseel" uniqKey="Bhatt H" first="Haseel" last="Bhatt">Haseel Bhatt</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21941685</idno><idno type="pmc">3177092</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177092</idno><idno type="RBID">PMC:3177092</idno><idno type="doi">10.1155/2012/508720</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">000389</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000389</idno><idno type="wicri:Area/Pmc/Curation">000389</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000389</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A Manipulation of Visual Feedback during Gait Training in Parkinson's Disease</title><author><name sortKey="Almeida, Quincy J" sort="Almeida, Quincy J" uniqKey="Almeida Q" first="Quincy J." last="Almeida">Quincy J. Almeida</name></author><author><name sortKey="Bhatt, Haseel" sort="Bhatt, Haseel" uniqKey="Bhatt H" first="Haseel" last="Bhatt">Haseel Bhatt</name></author></analytic><series><title level="j">Parkinson's Disease</title><idno type="ISSN">2090-8083</idno><idno type="eISSN">2042-0080</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Visual cues are known to improve gait in Parkinson's disease (PD); however, the contribution of optic flow continues to be disputed. This study manipulated transverse line cues during two gait training interventions (6 weeks). PD subjects (<italic>N</italic> = 42) were assigned to one of three groups: treadmill (TG), overground (OG), or control group (CG). Participants walked across lines placed on either treadmills or 16-meter carpets, respectively. The treadmill (TG) offered a reduced dynamic flow from the environment, while lines presented on the ground (OG) emphasized optic flow related to the participant's own displacement. Both interventions significantly improved (and maintained through retention period) step length, thus improving walking velocity. Only the OG improved in the TUG test, while only the TG showed hints of improving (and maintaining) motor symptoms. Since gait improvements were found in both training groups, we conclude that by reducing optic flow, gait benefits associated with visual cueing training can still be achieved.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Morris, Me" uniqKey="Morris M">ME Morris</name></author><author><name sortKey="Iansek, R" uniqKey="Iansek R">R Iansek</name></author><author><name sortKey="Matyas, Ta" uniqKey="Matyas T">TA Matyas</name></author><author><name sortKey="Summers, Jj" uniqKey="Summers J">JJ Summers</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Glickstein, M" uniqKey="Glickstein M">M Glickstein</name></author><author><name sortKey="Stein, J" uniqKey="Stein J">J Stein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Assaiante, C" uniqKey="Assaiante C">C Assaiante</name></author><author><name sortKey="Marchand, Ar" uniqKey="Marchand A">AR 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Parkinsons Dis</journal-id><journal-id journal-id-type="publisher-id">PD</journal-id><journal-title-group><journal-title>Parkinson's Disease</journal-title></journal-title-group><issn pub-type="ppub">2090-8083</issn><issn pub-type="epub">2042-0080</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21941685</article-id><article-id pub-id-type="pmc">3177092</article-id><article-id pub-id-type="doi">10.1155/2012/508720</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Study</subject></subj-group></article-categories><title-group><article-title>A Manipulation of Visual Feedback during Gait Training in Parkinson's Disease</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Almeida</surname><given-names>Quincy J.</given-names></name><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Bhatt</surname><given-names>Haseel</given-names></name></contrib></contrib-group><aff id="I1">Sunlife Financial Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, Waterloo, ON, Canada N2L 3C5</aff><author-notes><corresp id="cor1">*Quincy J. Almeida: <email>qalmeida@wlu.ca</email></corresp><fn fn-type="other"><p>Academic Editor: Gammon M. Earhart</p></fn></author-notes><pub-date pub-type="ppub"><year>2012</year></pub-date><pub-date pub-type="epub"><day>20</day><month>9</month><year>2011</year></pub-date><volume>2012</volume><elocation-id>508720</elocation-id><history><date date-type="received"><day>23</day><month>6</month><year>2011</year></date><date date-type="accepted"><day>5</day><month>7</month><year>2011</year></date></history><permissions><copyright-statement>Copyright © 2012 Q. J. Almeida and H. Bhatt.</copyright-statement><copyright-year>2012</copyright-year><license license-type="open-access"><license-p>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.</license-p></license></permissions><abstract><p>Visual cues are known to improve gait in Parkinson's disease (PD); however, the contribution of optic flow continues to be disputed. This study manipulated transverse line cues during two gait training interventions (6 weeks). PD subjects (<italic>N</italic> = 42) were assigned to one of three groups: treadmill (TG), overground (OG), or control group (CG). Participants walked across lines placed on either treadmills or 16-meter carpets, respectively. The treadmill (TG) offered a reduced dynamic flow from the environment, while lines presented on the ground (OG) emphasized optic flow related to the participant's own displacement. Both interventions significantly improved (and maintained through retention period) step length, thus improving walking velocity. Only the OG improved in the TUG test, while only the TG showed hints of improving (and maintaining) motor symptoms. Since gait improvements were found in both training groups, we conclude that by reducing optic flow, gait benefits associated with visual cueing training can still be achieved.</p></abstract></article-meta></front><floats-group><fig id="fig1" position="float"><label>Figure 1</label><caption><p>Step length significantly improves in TG and OG after six weeks (posttest) and is maintained after 12 weeks (retention test).</p></caption><graphic xlink:href="PD2012-508720.001"></graphic></fig><fig id="fig2" position="float"><label>Figure 2</label><caption><p>Velocity increases ~10 cm/s after 12-weeks (retention test) in only TG and OG.</p></caption><graphic xlink:href="PD2012-508720.002"></graphic></fig><fig id="fig3" position="float"><label>Figure 3</label><caption><p>Examination of TUG times reveals a short-term main effect in PD OG.</p></caption><graphic xlink:href="PD2012-508720.003"></graphic></fig><fig id="fig4" position="float"><label>Figure 4</label><caption><p>Motor scores showed at trend in improving symptoms in the TG, while the OG and CG seem to worsen symptoms.</p></caption><graphic xlink:href="PD2012-508720.004"></graphic></fig><table-wrap id="tab1" position="float"><label>Table 1</label><caption><p>Characteristics of the three groups.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Group</th><th align="center" rowspan="1" colspan="1">Age-M (yrs)</th><th align="center" rowspan="1" colspan="1">Height-M (cm)</th><th align="center" rowspan="1" colspan="1">UPDRS-M (score)</th><th align="center" rowspan="1" colspan="1">Gender</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">PD TG</td><td align="center" rowspan="1" colspan="1">63.86 (8.41)</td><td align="center" rowspan="1" colspan="1">170.97 (10.29)</td><td align="center" rowspan="1" colspan="1">23.68 (10.1)</td><td align="center" rowspan="1" colspan="1">8 male, 6 female</td></tr><tr><td align="left" rowspan="1" colspan="1">PD OG</td><td align="center" rowspan="1" colspan="1">73.93 (6.53)</td><td align="center" rowspan="1" colspan="1">170.72 (10.22)</td><td align="center" rowspan="1" colspan="1">22.07 (8.0)</td><td align="center" rowspan="1" colspan="1">12 male, 2 female</td></tr><tr><td align="left" rowspan="1" colspan="1">PD CG</td><td align="center" rowspan="1" colspan="1">67.43 (9.26)</td><td align="center" rowspan="1" colspan="1">170.15 (6.83)</td><td align="center" rowspan="1" colspan="1">24.21 (9.5)</td><td align="center" rowspan="1" colspan="1">11 male, 3 female</td></tr></tbody></table><table-wrap-foot><fn><p><italic>Note: </italic>M denotes mean, standard deviations found in brackets.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab2" position="float"><label>Table 2</label><caption><p>Mean (6 standard deviation) of outcome measures from pre-, post-, and retention test.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Measure</th><th align="center" rowspan="1" colspan="1">Test</th><th align="center" rowspan="1" colspan="1">PD control</th><th align="center" rowspan="1" colspan="1">PD treadmill group</th><th align="center" rowspan="1" colspan="1">PD overground group</th><th align="center" rowspan="1" colspan="1">ANOVA <italic>Pre-, Post-, </italic>and<italic> Retention </italic></th></tr></thead><tbody><tr><td align="left" rowspan="3" colspan="1">Step length (cm)</td><td align="center" rowspan="1" colspan="1"><italic>Pretest</italic></td><td align="center" rowspan="1" colspan="1">57.7 (12.3)</td><td align="center" rowspan="1" colspan="1">63.9 (10.6)</td><td align="center" rowspan="1" colspan="1">57.6 (62.3)</td><td align="center" rowspan="3" colspan="1"><italic>P</italic> = 0.003</td></tr><tr><td align="center" rowspan="1" colspan="1"><italic>Posttest</italic></td><td align="center" rowspan="1" colspan="1">59.3 (12.7)</td><td align="center" rowspan="1" colspan="1">69.4 (9.9)**</td><td align="center" rowspan="1" colspan="1">62.3 (8.3)**</td></tr><tr><td align="center" rowspan="1" colspan="1"><italic>Retention test</italic></td><td align="center" rowspan="1" colspan="1">58.8 (14.0)</td><td align="center" rowspan="1" colspan="1">69.9 (12.4)**</td><td align="center" rowspan="1" colspan="1">64.2 (10.3)**</td></tr><tr><td align="center" colspan="6" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="3" colspan="1">Velocity (cm/sec)</td><td align="center" rowspan="1" colspan="1"><italic>Pretest</italic></td><td align="center" rowspan="1" colspan="1">109.0 (27.7)</td><td align="center" rowspan="1" colspan="1">119.2 (15.6)</td><td align="center" rowspan="1" colspan="1">108.5 (23.8)</td><td align="center" rowspan="3" colspan="1"><italic>P</italic> = 0.008</td></tr><tr><td align="center" rowspan="1" colspan="1"><italic>Posttest </italic></td><td align="center" rowspan="1" colspan="1">109.6 (27.1)</td><td align="center" rowspan="1" colspan="1">128.3 (16.5)</td><td align="center" rowspan="1" colspan="1">112.2 (18.1)</td></tr><tr><td align="center" rowspan="1" colspan="1"><italic>Retention</italic> <italic>test </italic></td><td align="center" rowspan="1" colspan="1">104.3 (32.8)</td><td align="center" rowspan="1" colspan="1">129.1 (18.0)</td><td align="center" rowspan="1" colspan="1">118.9 (19.0) </td></tr><tr><td align="center" colspan="6" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="3" colspan="1">TUG time (seconds)</td><td align="center" rowspan="1" colspan="1"><italic>Pretest</italic></td><td align="center" rowspan="1" colspan="1">9.0 (3.0)</td><td align="center" rowspan="1" colspan="1">7.7 (2.0)</td><td align="center" rowspan="1" colspan="1">9.9 (4.2)</td><td align="center" rowspan="3" colspan="1"><italic>P</italic> = 0.046</td></tr><tr><td align="center" rowspan="1" colspan="1"><italic>Posttest </italic></td><td align="center" rowspan="1" colspan="1">9.1 (3.3)</td><td align="center" rowspan="1" colspan="1">6.3 (2.0)</td><td align="center" rowspan="1" colspan="1">8.4 (3.7)</td></tr><tr><td align="center" rowspan="1" colspan="1"><italic>Retention</italic> <italic>test </italic></td><td align="center" rowspan="1" colspan="1">9.1 (3.7)</td><td align="center" rowspan="1" colspan="1">6.5 (2.5)</td><td align="center" rowspan="1" colspan="1">10.2 (5.8) </td></tr><tr><td align="center" colspan="6" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="3" colspan="1">UPDRS score</td><td align="center" rowspan="1" colspan="1"><italic>Pretest</italic></td><td align="center" rowspan="1" colspan="1">24.6 (9.7)</td><td align="center" rowspan="1" colspan="1">23.6 (10.5)</td><td align="center" rowspan="1" colspan="1">22.1 (8.0)</td><td align="center" rowspan="3" colspan="1">NS</td></tr><tr><td align="center" rowspan="1" colspan="1"><italic>Posttest </italic></td><td align="center" rowspan="1" colspan="1">26.7 (8.8)</td><td align="center" rowspan="1" colspan="1">23.0 (8.0)</td><td align="center" rowspan="1" colspan="1">25.5 (7.0)</td></tr><tr><td align="center" rowspan="1" colspan="1"><italic>Retention</italic> <italic>test </italic></td><td align="center" rowspan="1" colspan="1">26.8 (8.8)</td><td align="center" rowspan="1" colspan="1">22.6 (8.0)</td><td align="center" rowspan="1" colspan="1">27.8 (9.1)</td></tr></tbody></table><table-wrap-foot><fn><p>NS: denotes a nonsignificant interaction.</p></fn><fn><p>**: denotes significantly different from pretest (<italic>P</italic> < .05). </p></fn><fn><p>3 patients removed from the current analysis.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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