Gait and Balance in Essential Tremor : Variable Effects of Bilateral Thalamic Stimulation
Identifieur interne : 000F71 ( PascalFrancis/Corpus ); précédent : 000F70; suivant : 000F72Gait and Balance in Essential Tremor : Variable Effects of Bilateral Thalamic Stimulation
Auteurs : Gammon M. Earhart ; B. Ruth Clark ; Samer D. Tabbal ; Joel S. PerlmutterSource :
- Movement disorders [ 0885-3185 ] ; 2009.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
Essential tremor (ET) is a multi-faceted condition best known for postural and action tremor but also may include disordered gait and postural instability. Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus provides substantial tremor reduction yet some patients with bilateral VIM DBS have gait and balance impairment. This study examines gait and balance performance in 13 participants with ET who have bilateral VIM DBS compared with a matched control group. Participants with ET were tested with their stimulators off (DBS OFF) and on (DBS ON). For both standard and tandem walking, participants with ET walked significantly more slowly than controls, with significantly lower cadence, spending a lower percentage of the gait cycle in single limb support and a higher percentage in double support compared with controls. Participants with ET also had significantly lower tandem and one leg stance times, Berg balance scores, balance confidence, and required significantly greater time to perform the Timed Up-and-Go relative to controls. There were no significant differences in any gait or balance measures in the DBS OFF versus DBS ON conditions, but the effects of DBS on gait and balance were highly variable among individuals. Future studies are needed to determine why some individuals experience gait and balance difficulties after bilateral thalamic DBS and others do not. A better understanding of the mechanisms underlying gait and balance impairments in those with bilateral DBS is critical to reduce falls and fractures in this group.
Notice en format standard (ISO 2709)
Pour connaître la documentation sur le format Inist Standard.
pA |
|
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Format Inist (serveur)
NO : | PASCAL 09-0136785 INIST |
---|---|
ET : | Gait and Balance in Essential Tremor : Variable Effects of Bilateral Thalamic Stimulation |
AU : | EARHART (Gammon M.); CLARK (B. Ruth); TABBAL (Samer D.); PERLMUTTER (Joel S.) |
AF : | Program in Physical Therapy, Washington University/St. Louis, Missouri/Etats-Unis (1 aut., 2 aut., 4 aut.); Department of Anatomy and Neurobiology, Washington University/St. Louis, Missouri/Etats-Unis (1 aut., 4 aut.); Department of Neurology, Washington University/St. Louis, Missouri/Etats-Unis (1 aut., 2 aut., 3 aut., 4 aut.); Department of Radiology, Washington University/St. Louis, Missouri/Etats-Unis (4 aut.) |
DT : | Publication en série; Niveau analytique |
SO : | Movement disorders; ISSN 0885-3185; Etats-Unis; Da. 2009; Vol. 24; No. 3; Pp. 386-391; Bibl. 19 ref. |
LA : | Anglais |
EA : | Essential tremor (ET) is a multi-faceted condition best known for postural and action tremor but also may include disordered gait and postural instability. Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus provides substantial tremor reduction yet some patients with bilateral VIM DBS have gait and balance impairment. This study examines gait and balance performance in 13 participants with ET who have bilateral VIM DBS compared with a matched control group. Participants with ET were tested with their stimulators off (DBS OFF) and on (DBS ON). For both standard and tandem walking, participants with ET walked significantly more slowly than controls, with significantly lower cadence, spending a lower percentage of the gait cycle in single limb support and a higher percentage in double support compared with controls. Participants with ET also had significantly lower tandem and one leg stance times, Berg balance scores, balance confidence, and required significantly greater time to perform the Timed Up-and-Go relative to controls. There were no significant differences in any gait or balance measures in the DBS OFF versus DBS ON conditions, but the effects of DBS on gait and balance were highly variable among individuals. Future studies are needed to determine why some individuals experience gait and balance difficulties after bilateral thalamic DBS and others do not. A better understanding of the mechanisms underlying gait and balance impairments in those with bilateral DBS is critical to reduce falls and fractures in this group. |
CC : | 002B17; 002B17A01 |
FD : | Tremblement; Pathologie du système nerveux; Locomotion; Stimulation cérébrale profonde |
FG : | Mouvement involontaire; Trouble neurologique |
ED : | Tremor; Nervous system diseases; Locomotion; Deep brain stimulation |
EG : | Involuntary movement; Neurological disorder |
SD : | Temblor; Sistema nervioso patología; Locomoción |
LO : | INIST-20953.354000186999840100 |
ID : | 09-0136785 |
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<front><div type="abstract" xml:lang="en">Essential tremor (ET) is a multi-faceted condition best known for postural and action tremor but also may include disordered gait and postural instability. Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus provides substantial tremor reduction yet some patients with bilateral VIM DBS have gait and balance impairment. This study examines gait and balance performance in 13 participants with ET who have bilateral VIM DBS compared with a matched control group. Participants with ET were tested with their stimulators off (DBS OFF) and on (DBS ON). For both standard and tandem walking, participants with ET walked significantly more slowly than controls, with significantly lower cadence, spending a lower percentage of the gait cycle in single limb support and a higher percentage in double support compared with controls. Participants with ET also had significantly lower tandem and one leg stance times, Berg balance scores, balance confidence, and required significantly greater time to perform the Timed Up-and-Go relative to controls. There were no significant differences in any gait or balance measures in the DBS OFF versus DBS ON conditions, but the effects of DBS on gait and balance were highly variable among individuals. Future studies are needed to determine why some individuals experience gait and balance difficulties after bilateral thalamic DBS and others do not. A better understanding of the mechanisms underlying gait and balance impairments in those with bilateral DBS is critical to reduce falls and fractures in this group.</div>
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<ET>Gait and Balance in Essential Tremor : Variable Effects of Bilateral Thalamic Stimulation</ET>
<AU>EARHART (Gammon M.); CLARK (B. Ruth); TABBAL (Samer D.); PERLMUTTER (Joel S.)</AU>
<AF>Program in Physical Therapy, Washington University/St. Louis, Missouri/Etats-Unis (1 aut., 2 aut., 4 aut.); Department of Anatomy and Neurobiology, Washington University/St. Louis, Missouri/Etats-Unis (1 aut., 4 aut.); Department of Neurology, Washington University/St. Louis, Missouri/Etats-Unis (1 aut., 2 aut., 3 aut., 4 aut.); Department of Radiology, Washington University/St. Louis, Missouri/Etats-Unis (4 aut.)</AF>
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<EA>Essential tremor (ET) is a multi-faceted condition best known for postural and action tremor but also may include disordered gait and postural instability. Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus provides substantial tremor reduction yet some patients with bilateral VIM DBS have gait and balance impairment. This study examines gait and balance performance in 13 participants with ET who have bilateral VIM DBS compared with a matched control group. Participants with ET were tested with their stimulators off (DBS OFF) and on (DBS ON). For both standard and tandem walking, participants with ET walked significantly more slowly than controls, with significantly lower cadence, spending a lower percentage of the gait cycle in single limb support and a higher percentage in double support compared with controls. Participants with ET also had significantly lower tandem and one leg stance times, Berg balance scores, balance confidence, and required significantly greater time to perform the Timed Up-and-Go relative to controls. There were no significant differences in any gait or balance measures in the DBS OFF versus DBS ON conditions, but the effects of DBS on gait and balance were highly variable among individuals. Future studies are needed to determine why some individuals experience gait and balance difficulties after bilateral thalamic DBS and others do not. A better understanding of the mechanisms underlying gait and balance impairments in those with bilateral DBS is critical to reduce falls and fractures in this group.</EA>
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