Emerging therapies for gait disability and balance impairment: Promises and pitfalls
Identifieur interne : 000387 ( Istex/Corpus ); précédent : 000386; suivant : 000388Emerging therapies for gait disability and balance impairment: Promises and pitfalls
Auteurs : Walter Maetzler ; Freek Nieuwhof ; Sandra E. Hasmann ; Bastiaan R. BloemSource :
- Movement Disorders [ 0885-3185 ] ; 2013-09-15.
Abstract
Therapeutic management of gait and balance impairment during aging and neurodegeneration has long been a neglected topic. This has changed considerably during recent years, for several reasons: (1) an increasing recognition that gait and balance deficits are among the most relevant determinants of an impaired quality of life and increased mortality for affected individuals; (2) the arrival of new technology, which has allowed for new insights into the anatomy and functional (dis)integrity of gait and balance circuits; and (3) based in part on these improved insights, the development of new, more specific treatment strategies in the field of pharmacotherapy, deep brain surgery, and physiotherapy. The initial experience with these emerging treatments is encouraging, although much work remains to be done. The objective of this narrative review is to discuss several promising developments in the field of gait and balance treatment. We also address several pitfalls that can potentially hinder a fast and efficient continuation of this vital progress. Important issues that should be considered in future research include a clear differentiation between gait and balance as two distinctive targets for treatment and recognition of compensatory mechanisms as a separate target for therapeutic intervention. © 2013 International Parkinson and Movement Disorder Society
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DOI: 10.1002/mds.25682
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ISTEX:2BFB7C9C1B2F8AE3914B5A7DCD84F0D15FAC8C03Le document en format XML
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This has changed considerably during recent years, for several reasons: (1) an increasing recognition that gait and balance deficits are among the most relevant determinants of an impaired quality of life and increased mortality for affected individuals; (2) the arrival of new technology, which has allowed for new insights into the anatomy and functional (dis)integrity of gait and balance circuits; and (3) based in part on these improved insights, the development of new, more specific treatment strategies in the field of pharmacotherapy, deep brain surgery, and physiotherapy. The initial experience with these emerging treatments is encouraging, although much work remains to be done. The objective of this narrative review is to discuss several promising developments in the field of gait and balance treatment. We also address several pitfalls that can potentially hinder a fast and efficient continuation of this vital progress. 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Bloem, Professor of Neurology, Medical Director, Parkinson Centre Nijmegen (ParC), Department of Neurology, 935, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands; <email>b.bloem@neuro.umcn.nl</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS25682.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="main">Emerging therapies for gait disability and balance impairment: Promises and pitfalls</title><title type="short">Therapies for gait and balance</title><title type="shortAuthors">Maetzler et al.</title></titleGroup><creators><creator affiliationRef="#mds25682-aff-0001 #mds25682-aff-0002" creatorRole="author" xml:id="mds25682-cr-0001"><personName><givenNames>Walter</givenNames> <familyName>Maetzler</familyName><degrees>MD</degrees></personName></creator><creator affiliationRef="#mds25682-aff-0003" creatorRole="author" xml:id="mds25682-cr-0003"><personName><givenNames>Freek</givenNames> <familyName>Nieuwhof</familyName></personName></creator><creator affiliationRef="#mds25682-aff-0001 #mds25682-aff-0002" creatorRole="author" xml:id="mds25682-cr-0004"><personName><givenNames>Sandra E.</givenNames> <familyName>Hasmann</familyName></personName></creator><creator affiliationRef="#mds25682-aff-0004" corresponding="yes" creatorRole="author" xml:id="mds25682-cr-0005"><personName><givenNames>Bastiaan R.</givenNames> <familyName>Bloem</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation countryCode="DE" type="organization" xml:id="mds25682-aff-0001"><orgDiv>Hertie Institute for Clinical Brain Research, Department of Neurodegeneration</orgDiv><orgName>Center of Neurology, University of Tübingen</orgName><address><city>Tübingen</city><country>Germany</country></address></affiliation><affiliation countryCode="DE" type="organization" xml:id="mds25682-aff-0002"><orgName>German Center for Neurodegenerative Diseases (DNZE)</orgName><address><city>Tübingen</city><country>Germany</country></address></affiliation><affiliation type="organization" xml:id="mds25682-aff-0003"><orgDiv>Department of Geriatric Medicine</orgDiv><orgName>Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen Medical Center</orgName><address><city>Nijmegen</city><country>the Netherlands</country></address></affiliation><affiliation type="organization" xml:id="mds25682-aff-0004"><orgDiv>Department of Neurology and Parkinson Center</orgDiv><orgName>Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen Medical Center, Nijmegen</orgName><address><city>Nijmegen</city><country>the Netherlands</country></address></affiliation></affiliationGroup><keywordGroup type="author"><keyword xml:id="mds25682-kwd-0001">ageing</keyword><keyword xml:id="mds25682-kwd-0002">falls</keyword><keyword xml:id="mds25682-kwd-0003">Parkinson's disease</keyword><keyword xml:id="mds25682-kwd-0004">pharmacotherapy</keyword><keyword xml:id="mds25682-kwd-0005">treatment</keyword></keywordGroup><abstractGroup><abstract type="main"><title type="main">ABSTRACT</title><p>Therapeutic management of gait and balance impairment during aging and neurodegeneration has long been a neglected topic. This has changed considerably during recent years, for several reasons: (1) an increasing recognition that gait and balance deficits are among the most relevant determinants of an impaired quality of life and increased mortality for affected individuals; (2) the arrival of new technology, which has allowed for new insights into the anatomy and functional (dis)integrity of gait and balance circuits; and (3) based in part on these improved insights, the development of new, more specific treatment strategies in the field of pharmacotherapy, deep brain surgery, and physiotherapy. The initial experience with these emerging treatments is encouraging, although much work remains to be done. The objective of this narrative review is to discuss several promising developments in the field of gait and balance treatment. We also address several pitfalls that can potentially hinder a fast and efficient continuation of this vital progress. Important issues that should be considered in future research include a clear differentiation between gait and balance as two distinctive targets for treatment and recognition of compensatory mechanisms as a separate target for therapeutic intervention. © 2013 International Parkinson and Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="mds25682-note-0001"><p><b>Funding agencies:</b> The present research is part of the European Union project SENSE‐PARK, funded under the Seventh Framework Programme, Cooperation‐ICT (grant agreement no. 288557). Sandra E. Hasmann was supported by an Interdisciplinary Center for Clinical Research (IZKF) grant from the University of Tubingen. Bastiaan R. Bloem was supported by a research grant from the Stichting Internationaal Parkinson Fonds.</p></note><note xml:id="mds25682-note-0002"><p><b>Relevant conflicts of interest/financial disclosures:</b> Nothing to report.</p></note><note xml:id="mds25682-note-0003"><p>Full financial disclosures and author roles may be found in the online version of this article.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Emerging therapies for gait disability and balance impairment: Promises and pitfalls</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Therapies for gait and balance</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Emerging therapies for gait disability and balance impairment: Promises and pitfalls</title></titleInfo><name type="personal"><namePart type="given">Walter</namePart><namePart type="family">Maetzler</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tübingen, Tübingen, Germany</affiliation><affiliation>German Center for Neurodegenerative Diseases (DNZE), Tübingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Freek</namePart><namePart type="family">Nieuwhof</namePart><affiliation>Department of Geriatric Medicine, Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sandra E.</namePart><namePart type="family">Hasmann</namePart><affiliation>Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tübingen, Tübingen, Germany</affiliation><affiliation>German Center for Neurodegenerative Diseases (DNZE), Tübingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bastiaan R.</namePart><namePart type="family">Bloem</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology and Parkinson Center, Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, Nijmegen, the Netherlands</affiliation><affiliation>E-mail: b.bloem@neuro.umcn.nl</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="reviewArticle"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2013-09-15</dateIssued><dateCreated encoding="w3cdtf">2013-09-09</dateCreated><dateCaptured encoding="w3cdtf">2013-06-18</dateCaptured><dateValid encoding="w3cdtf">2013-08-13</dateValid><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Therapeutic management of gait and balance impairment during aging and neurodegeneration has long been a neglected topic. This has changed considerably during recent years, for several reasons: (1) an increasing recognition that gait and balance deficits are among the most relevant determinants of an impaired quality of life and increased mortality for affected individuals; (2) the arrival of new technology, which has allowed for new insights into the anatomy and functional (dis)integrity of gait and balance circuits; and (3) based in part on these improved insights, the development of new, more specific treatment strategies in the field of pharmacotherapy, deep brain surgery, and physiotherapy. The initial experience with these emerging treatments is encouraging, although much work remains to be done. The objective of this narrative review is to discuss several promising developments in the field of gait and balance treatment. We also address several pitfalls that can potentially hinder a fast and efficient continuation of this vital progress. Important issues that should be considered in future research include a clear differentiation between gait and balance as two distinctive targets for treatment and recognition of compensatory mechanisms as a separate target for therapeutic intervention. © 2013 International Parkinson and Movement Disorder Society</abstract><subject><genre>keywords</genre><topic>ageing</topic><topic>falls</topic><topic>Parkinson's disease</topic><topic>pharmacotherapy</topic><topic>treatment</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov Disord.</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Review</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2013</date><detail type="title"><title>Gait and Balance in Movement Disorders</title></detail><detail type="volume"><caption>vol.</caption><number>28</number></detail><detail type="issue"><caption>no.</caption><number>11</number></detail><extent unit="pages"><start>1576</start><end>1586</end><total>11</total></extent></part></relatedItem><identifier type="istex">2BFB7C9C1B2F8AE3914B5A7DCD84F0D15FAC8C03</identifier><identifier type="DOI">10.1002/mds.25682</identifier><identifier type="ArticleID">MDS25682</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2013 Movement Disorder Society© 2013 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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