Clinical and dual‐tasking aspects in frequent and infrequent fallers with progressive supranuclear palsy
Identifieur interne : 001173 ( Istex/Corpus ); précédent : 001172; suivant : 001174Clinical and dual‐tasking aspects in frequent and infrequent fallers with progressive supranuclear palsy
Auteurs : Ulrich Lindemann ; Simone Nicolai ; Denis Beische ; Clemens Becker ; Karin Srulijes ; Elisabeth Dietzel ; Sarah Bauer ; Daniela Berg ; Walter MaetzlerSource :
- Movement Disorders [ 0885-3185 ] ; 2010-06-15.
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Abstract
Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease with no sufficient therapeutic options to date. Falls are the most devastating feature. The causes of these falls are not well understood. To test the impact of PSP‐associated motor and cognitive features on falls, 26 PSP patients were prospectively recruited and divided into frequent fallers (> one fall/month, 18 patients) and infrequent fallers (≤ one fall/month, 8 patients). Further parameters were assessed by clinical investigation and biomechanical gait and balance analysis with and without dual‐task paradigms. Physical activity was measured through an ambulatory device. Frequent fallers scored higher on the total PSP rating scale and the subscales “history,” “mental,” “bulbar,” “supranuclear ocular motor,” and “gait/midline exam” but not on disease duration, the subscale “limb exam,” the UPDRS motor score and the sway analysis. Frequent fallers also showed an increased probability of an altered walking pattern with shortened step lengths and increased cadence under a dual‐task situation. It is concluded that the occurrence of falls in PSP seems strongly associated with the deterioration of bulbar function, but not relevantly with typical parkinsonian features like rigidity and bradykinesia. The decreased ability to deal with distraction of attention under a dual‐task situation points to a relevant impact of cortical and subcortical dysfunction on the frequency of falls. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23023
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Falls are the most devastating feature. The causes of these falls are not well understood. To test the impact of PSP‐associated motor and cognitive features on falls, 26 PSP patients were prospectively recruited and divided into frequent fallers (> one fall/month, 18 patients) and infrequent fallers (≤ one fall/month, 8 patients). Further parameters were assessed by clinical investigation and biomechanical gait and balance analysis with and without dual‐task paradigms. Physical activity was measured through an ambulatory device. Frequent fallers scored higher on the total PSP rating scale and the subscales “history,” “mental,” “bulbar,” “supranuclear ocular motor,” and “gait/midline exam” but not on disease duration, the subscale “limb exam,” the UPDRS motor score and the sway analysis. Frequent fallers also showed an increased probability of an altered walking pattern with shortened step lengths and increased cadence under a dual‐task situation. It is concluded that the occurrence of falls in PSP seems strongly associated with the deterioration of bulbar function, but not relevantly with typical parkinsonian features like rigidity and bradykinesia. The decreased ability to deal with distraction of attention under a dual‐task situation points to a relevant impact of cortical and subcortical dysfunction on the frequency of falls. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Ulrich Lindemann PhD</name><affiliations><json:string>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</json:string></affiliations></json:item><json:item><name>Simone Nicolai MSc</name><affiliations><json:string>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</json:string></affiliations></json:item><json:item><name>Denis Beische MSc</name><affiliations><json:string>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</json:string></affiliations></json:item><json:item><name>Clemens Becker PhD</name><affiliations><json:string>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</json:string></affiliations></json:item><json:item><name>Karin Srulijes</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Elisabeth Dietzel</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Sarah Bauer</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Daniela Berg MD</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Walter Maetzler MD</name><affiliations><json:string>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</json:string><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>balance</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dual‐task</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>falls</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>gait analysis</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease with no sufficient therapeutic options to date. Falls are the most devastating feature. The causes of these falls are not well understood. To test the impact of PSP‐associated motor and cognitive features on falls, 26 PSP patients were prospectively recruited and divided into frequent fallers (> one fall/month, 18 patients) and infrequent fallers (≤ one fall/month, 8 patients). Further parameters were assessed by clinical investigation and biomechanical gait and balance analysis with and without dual‐task paradigms. Physical activity was measured through an ambulatory device. Frequent fallers scored higher on the total PSP rating scale and the subscales “history,” “mental,” “bulbar,” “supranuclear ocular motor,” and “gait/midline exam” but not on disease duration, the subscale “limb exam,” the UPDRS motor score and the sway analysis. Frequent fallers also showed an increased probability of an altered walking pattern with shortened step lengths and increased cadence under a dual‐task situation. It is concluded that the occurrence of falls in PSP seems strongly associated with the deterioration of bulbar function, but not relevantly with typical parkinsonian features like rigidity and bradykinesia. 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No. IST‐045622;</note><note>Forschungskolleg Geriatrie</note><note>Robert Bosch Foundation, Stuttgart, Germany - No. Nr. 32.5.1141.0019.0;</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Clinical and dual‐tasking aspects in frequent and infrequent fallers with progressive supranuclear palsy</title><author><persName><forename type="first">Ulrich</forename><surname>Lindemann</surname><roleName type="degree">PhD</roleName></persName><affiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</affiliation></author><author><persName><forename type="first">Simone</forename><surname>Nicolai</surname><roleName type="degree">MSc</roleName></persName><affiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</affiliation></author><author><persName><forename type="first">Denis</forename><surname>Beische</surname><roleName type="degree">MSc</roleName></persName><affiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</affiliation></author><author><persName><forename type="first">Clemens</forename><surname>Becker</surname><roleName type="degree">PhD</roleName></persName><affiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</affiliation></author><author><persName><forename type="first">Karin</forename><surname>Srulijes</surname></persName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Elisabeth</forename><surname>Dietzel</surname></persName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Sarah</forename><surname>Bauer</surname></persName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Daniela</forename><surname>Berg</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Walter</forename><surname>Maetzler</surname><roleName type="degree">MD</roleName></persName><note type="correspondence"><p>Correspondence: Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Otfried Mueller‐Strasse 27, Tuebingen D‐72076, Germany</p></note><affiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</affiliation><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. 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The causes of these falls are not well understood. To test the impact of PSP‐associated motor and cognitive features on falls, 26 PSP patients were prospectively recruited and divided into frequent fallers (> one fall/month, 18 patients) and infrequent fallers (≤ one fall/month, 8 patients). Further parameters were assessed by clinical investigation and biomechanical gait and balance analysis with and without dual‐task paradigms. Physical activity was measured through an ambulatory device. Frequent fallers scored higher on the total PSP rating scale and the subscales “history,” “mental,” “bulbar,” “supranuclear ocular motor,” and “gait/midline exam” but not on disease duration, the subscale “limb exam,” the UPDRS motor score and the sway analysis. Frequent fallers also showed an increased probability of an altered walking pattern with shortened step lengths and increased cadence under a dual‐task situation. 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href="file:MDS.MDS23023.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="2"></count><count type="referenceTotal" number="34"></count><count type="wordTotal" number="4836"></count></countGroup><titleGroup><title type="main" xml:lang="en">Clinical and dual‐tasking aspects in frequent and infrequent fallers with progressive supranuclear palsy<link href="#fn1"></link></title><title type="short" xml:lang="en">Falls in PSP</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Ulrich</givenNames><familyName>Lindemann</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Simone</givenNames><familyName>Nicolai</familyName><degrees>MSc</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Denis</givenNames><familyName>Beische</familyName><degrees>MSc</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Clemens</givenNames><familyName>Becker</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Karin</givenNames><familyName>Srulijes</familyName></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Elisabeth</givenNames><familyName>Dietzel</familyName></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Sarah</givenNames><familyName>Bauer</familyName></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Daniela</givenNames><familyName>Berg</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af1 #af2" corresponding="yes"><personName><givenNames>Walter</givenNames><familyName>Maetzler</familyName><degrees>MD</degrees></personName><contactDetails><email normalForm="walter.maetzler@uni-tuebingen.de">walter.maetzler@uni‐tuebingen.de</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="DE" type="organization"><unparsedAffiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">balance</keyword><keyword xml:id="kwd2">dual‐task</keyword><keyword xml:id="kwd3">falls</keyword><keyword xml:id="kwd4">gait analysis</keyword></keywordGroup><fundingInfo><fundingAgency>European Commission</fundingAgency><fundingNumber>FP6 project SENSACTION‐AAL</fundingNumber><fundingNumber>IST‐045622</fundingNumber></fundingInfo><fundingInfo><fundingAgency>Forschungskolleg Geriatrie</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Robert Bosch Foundation, Stuttgart, Germany</fundingAgency><fundingNumber>Nr. 32.5.1141.0019.0</fundingNumber></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease with no sufficient therapeutic options to date. Falls are the most devastating feature. The causes of these falls are not well understood. To test the impact of PSP‐associated motor and cognitive features on falls, 26 PSP patients were prospectively recruited and divided into frequent fallers (> one fall/month, 18 patients) and infrequent fallers (≤ one fall/month, 8 patients). Further parameters were assessed by clinical investigation and biomechanical gait and balance analysis with and without dual‐task paradigms. Physical activity was measured through an ambulatory device. Frequent fallers scored higher on the total PSP rating scale and the subscales “history,” “mental,” “bulbar,” “supranuclear ocular motor,” and “gait/midline exam” but not on disease duration, the subscale “limb exam,” the UPDRS motor score and the sway analysis. Frequent fallers also showed an increased probability of an altered walking pattern with shortened step lengths and increased cadence under a dual‐task situation. It is concluded that the occurrence of falls in PSP seems strongly associated with the deterioration of bulbar function, but not relevantly with typical parkinsonian features like rigidity and bradykinesia. The decreased ability to deal with distraction of attention under a dual‐task situation points to a relevant impact of cortical and subcortical dysfunction on the frequency of falls. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: Nothing to report.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Clinical and dual‐tasking aspects in frequent and infrequent fallers with progressive supranuclear palsy</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Falls in PSP</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Clinical and dual‐tasking aspects in frequent and infrequent fallers with progressive supranuclear palsy</title></titleInfo><name type="personal"><namePart type="given">Ulrich</namePart><namePart type="family">Lindemann</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Simone</namePart><namePart type="family">Nicolai</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Denis</namePart><namePart type="family">Beische</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Clemens</namePart><namePart type="family">Becker</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karin</namePart><namePart type="family">Srulijes</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elisabeth</namePart><namePart type="family">Dietzel</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sarah</namePart><namePart type="family">Bauer</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Daniela</namePart><namePart type="family">Berg</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Walter</namePart><namePart type="family">Maetzler</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Clinical Gerontology, Robert‐Bosch‐Hospital, Stuttgart, Germany</affiliation><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, Tuebingen, Germany</affiliation><description>Correspondence: Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Otfried Mueller‐Strasse 27, Tuebingen D‐72076, Germany</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-06-15</dateIssued><dateCaptured encoding="w3cdtf">2009-09-11</dateCaptured><dateValid encoding="w3cdtf">2009-12-21</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">2</extent><extent unit="references">34</extent><extent unit="words">4836</extent></physicalDescription><abstract lang="en">Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease with no sufficient therapeutic options to date. Falls are the most devastating feature. The causes of these falls are not well understood. To test the impact of PSP‐associated motor and cognitive features on falls, 26 PSP patients were prospectively recruited and divided into frequent fallers (> one fall/month, 18 patients) and infrequent fallers (≤ one fall/month, 8 patients). Further parameters were assessed by clinical investigation and biomechanical gait and balance analysis with and without dual‐task paradigms. Physical activity was measured through an ambulatory device. Frequent fallers scored higher on the total PSP rating scale and the subscales “history,” “mental,” “bulbar,” “supranuclear ocular motor,” and “gait/midline exam” but not on disease duration, the subscale “limb exam,” the UPDRS motor score and the sway analysis. Frequent fallers also showed an increased probability of an altered walking pattern with shortened step lengths and increased cadence under a dual‐task situation. It is concluded that the occurrence of falls in PSP seems strongly associated with the deterioration of bulbar function, but not relevantly with typical parkinsonian features like rigidity and bradykinesia. The decreased ability to deal with distraction of attention under a dual‐task situation points to a relevant impact of cortical and subcortical dysfunction on the frequency of falls. © 2010 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: Nothing to report.</note><note type="funding">European Commission - No. FP6 project SENSACTION‐AAL; No. IST‐045622; </note><note type="funding">Forschungskolleg Geriatrie</note><note type="funding">Robert Bosch Foundation, Stuttgart, Germany - No. Nr. 32.5.1141.0019.0; </note><subject lang="en"><genre>Keywords</genre><topic>balance</topic><topic>dual‐task</topic><topic>falls</topic><topic>gait analysis</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><subject><genre>article category</genre><topic>Research Article</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>2010</date><detail type="volume"><caption>vol.</caption><number>25</number></detail><detail type="issue"><caption>no.</caption><number>8</number></detail><extent unit="pages"><start>1040</start><end>1046</end><total>7</total></extent></part></relatedItem><identifier type="istex">2CCF20D1FBBCADFBD6A98FE7B7952E2BB75C34C1</identifier><identifier type="DOI">10.1002/mds.23023</identifier><identifier type="ArticleID">MDS23023</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2010 Movement Disorder Society</accessCondition><recordInfo><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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