Targeting dopa‐sensitive and dopa‐resistant gait dysfunction in Parkinson's disease: Selective responses to internal and external cues
Identifieur interne : 001356 ( Main/Exploration ); précédent : 001355; suivant : 001357Targeting dopa‐sensitive and dopa‐resistant gait dysfunction in Parkinson's disease: Selective responses to internal and external cues
Auteurs : Lynn Rochester [Royaume-Uni] ; Katherine Baker [Royaume-Uni] ; Alice Nieuwboer [Belgique] ; David Burn [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 2011-02-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (therapeutic use), Chemotherapy, Cues, Dopa, Dysfunction, Female, Gait Disorders, Neurologic (drug therapy), Gait Disorders, Neurologic (etiology), Humans, Levodopa (pharmacology), Levodopa (therapeutic use), Male, Middle Aged, Nervous system diseases, Parkinson Disease (complications), Parkinson Disease (drug therapy), Parkinson disease, Parkinson's disease, Strategy, Targeting, Time Factors, Walking, attentional strategies, dopaminergic medications, dopa‐resistant, external cues, gait.
- MESH :
- chemical , pharmacology : Levodopa.
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- complications : Parkinson Disease.
- drug therapy : Gait Disorders, Neurologic, Parkinson Disease.
- etiology : Gait Disorders, Neurologic.
- Aged, Cues, Female, Humans, Male, Middle Aged, Time Factors, Walking.
Abstract
Background:: Independence of certain gait characteristics from dopamine replacement therapies highlights its complex pathophysiology in Parkinson's disease (PD). We explored the effect of two different cue strategies on gait characteristics in relation to their response to dopaminergic medications. Patients and Methods:: Fifty people with PD (age 69.22 ± 6.6 years) were studied. Participants walked with and without cues presented in a randomized order. Cue strategies were: (1) internal cue (attention to increase step length) and (2) external cue (auditory cue with instruction to take large step to the beat). Testing was carried out two times at home (on and off medication). Gait was measured using a Stride Analyzer (B&L Engineering). Gait outcomes were walking speed, stride length, step frequency, and coefficient of variation (CV) of stride time and double limb support duration (DLS). Results:: Walking speed, stride length, and stride time CV improved on dopaminergic medications, whereas step frequency and DLS CV did not. Internal and external cues increased stride time and walking speed (on and off dopaminergic medications). Only the external cue significantly improved stride time CV and DLS CV, whereas the internal cue had no effect (on and off dopaminergic medications). Conclusions:: Internal and external cues selectively modify gait characteristics in relation to the type of gait disturbance and its dopa‐responsiveness. Although internal (attention) and external cues target dopaminergic gait dysfunction (stride length), only external cues target stride to stride fluctuations in gait. Despite an overlap with dopaminergic pathways, external cues may effectively address nondopaminergic gait dysfunction and potentially increase mobility and reduce gait instability and falls. © 2010 Movement Disorder Society
Url:
DOI: 10.1002/mds.23450
Affiliations:
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Le document en format XML
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-02-15">2011-02-15</date><biblScope unit="vol">26</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="430">430</biblScope><biblScope unit="page" to="435">435</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">CD906250882BD7CBEE75696ACB8E657735DED4CE</idno><idno type="DOI">10.1002/mds.23450</idno><idno type="ArticleID">MDS23450</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antiparkinson Agents (therapeutic use)</term><term>Chemotherapy</term><term>Cues</term><term>Dopa</term><term>Dysfunction</term><term>Female</term><term>Gait Disorders, Neurologic (drug therapy)</term><term>Gait Disorders, Neurologic (etiology)</term><term>Humans</term><term>Levodopa (pharmacology)</term><term>Levodopa (therapeutic use)</term><term>Male</term><term>Middle Aged</term><term>Nervous system diseases</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Strategy</term><term>Targeting</term><term>Time Factors</term><term>Walking</term><term>attentional strategies</term><term>dopaminergic medications</term><term>dopa‐resistant</term><term>external cues</term><term>gait</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Gait Disorders, Neurologic</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Gait Disorders, Neurologic</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Cues</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Time Factors</term><term>Walking</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Chimiothérapie</term><term>Ciblage</term><term>Dopa</term><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Stratégie</term><term>Trouble fonctionnel</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background:: Independence of certain gait characteristics from dopamine replacement therapies highlights its complex pathophysiology in Parkinson's disease (PD). We explored the effect of two different cue strategies on gait characteristics in relation to their response to dopaminergic medications. Patients and Methods:: Fifty people with PD (age 69.22 ± 6.6 years) were studied. Participants walked with and without cues presented in a randomized order. Cue strategies were: (1) internal cue (attention to increase step length) and (2) external cue (auditory cue with instruction to take large step to the beat). Testing was carried out two times at home (on and off medication). Gait was measured using a Stride Analyzer (B&L Engineering). Gait outcomes were walking speed, stride length, step frequency, and coefficient of variation (CV) of stride time and double limb support duration (DLS). Results:: Walking speed, stride length, and stride time CV improved on dopaminergic medications, whereas step frequency and DLS CV did not. Internal and external cues increased stride time and walking speed (on and off dopaminergic medications). Only the external cue significantly improved stride time CV and DLS CV, whereas the internal cue had no effect (on and off dopaminergic medications). Conclusions:: Internal and external cues selectively modify gait characteristics in relation to the type of gait disturbance and its dopa‐responsiveness. Although internal (attention) and external cues target dopaminergic gait dysfunction (stride length), only external cues target stride to stride fluctuations in gait. Despite an overlap with dopaminergic pathways, external cues may effectively address nondopaminergic gait dysfunction and potentially increase mobility and reduce gait instability and falls. © 2010 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Belgique</li><li>Royaume-Uni</li></country></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Rochester, Lynn" sort="Rochester, Lynn" uniqKey="Rochester L" first="Lynn" last="Rochester">Lynn Rochester</name></noRegion><name sortKey="Baker, Katherine" sort="Baker, Katherine" uniqKey="Baker K" first="Katherine" last="Baker">Katherine Baker</name><name sortKey="Burn, David" sort="Burn, David" uniqKey="Burn D" first="David" last="Burn">David Burn</name><name sortKey="Rochester, Lynn" sort="Rochester, Lynn" uniqKey="Rochester L" first="Lynn" last="Rochester">Lynn Rochester</name></country><country name="Belgique"><noRegion><name sortKey="Nieuwboer, Alice" sort="Nieuwboer, Alice" uniqKey="Nieuwboer A" first="Alice" last="Nieuwboer">Alice Nieuwboer</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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