Falls and gait disturbances in Huntington's disease
Identifieur interne : 002704 ( Main/Corpus ); précédent : 002703; suivant : 002705Falls and gait disturbances in Huntington's disease
Auteurs : Yvette A. M. Grimbergen ; Mirjam J. Knol ; Bastiaan R. Bloem ; Berry P. H. Kremer ; Raymund A. C. Roos ; Marten MunnekeSource :
- Movement Disorders [ 0885-3185 ] ; 2008-05-15.
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Abstract
Falls are common in patients with Huntington's disease, but the incidence, falling circumstances and contributing factors have never been examined. We recorded falls in 45 early to midstage Huntington's disease patients, both retrospectively (12 months) and prospectively (3 months). Fall rates were related to relevant baseline measures, including the Unified Huntington's Disease Rating Scale (UHDRS) and quantitative measures of balance (using angular velocity sensors) and gait (using a pressure‐sensitive walkway). Balance and gait measures were compared between patients and 27 healthy age‐matched controls. Twenty‐seven patients (60%) reported two or more falls in the previous year and were classified as fallers. During prospective follow‐up 40% reported at least one fall. A high proportion of falls (72.5%) caused minor injuries. Compared to nonfallers, fallers showed significantly higher scores for chorea, bradykinesia and aggression, as well as lower cognitive scores. Compared to controls, Huntington patients had a decreased gait velocity (1.15 m/s versus 1.45 m/s, P < 0.001) and a decreased stride length (1.29 m versus 1.52 m, P < 0.001). These abnormalities were all significantly greater in fallers compared to nonfallers. In addition, fallers had an increased stride length variability and a significantly greater trunk sway in medio‐lateral direction compared to nonfallers. We conclude that falls are common in Huntington's disease. Contributing factors include a combination of “motor” deficits (mainly gait bradykinesia, stride variability and chorea, leading to excessive trunk sway), as well as cognitive decline and perhaps behavioral changes. These factors should be considered as future targets for therapies that aim to reduce falls in Huntington's disease. © 2008 Movement Disorder Society
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DOI: 10.1002/mds.22003
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Bloem</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Kremer, Berry P H" sort="Kremer, Berry P H" uniqKey="Kremer B" first="Berry P. H." last="Kremer">Berry P. H. Kremer</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Roos, Raymund A C" sort="Roos, Raymund A C" uniqKey="Roos R" first="Raymund A. C." last="Roos">Raymund A. C. 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M." last="Grimbergen">Yvette A. M. Grimbergen</name><affiliation><mods:affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Knol, Mirjam J" sort="Knol, Mirjam J" uniqKey="Knol M" first="Mirjam J." last="Knol">Mirjam J. Knol</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R." last="Bloem">Bastiaan R. Bloem</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Kremer, Berry P H" sort="Kremer, Berry P H" uniqKey="Kremer B" first="Berry P. H." last="Kremer">Berry P. H. Kremer</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Roos, Raymund A C" sort="Roos, Raymund A C" uniqKey="Roos R" first="Raymund A. C." last="Roos">Raymund A. C. Roos</name><affiliation><mods:affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Munneke, Marten" sort="Munneke, Marten" uniqKey="Munneke M" first="Marten" last="Munneke">Marten Munneke</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. 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="2008-05-15">2008-05-15</date><biblScope unit="volume">23</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="970">970</biblScope><biblScope unit="page" to="976">976</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">CE1208958625921B38B05AB9CC4B76C789E524A5</idno><idno type="DOI">10.1002/mds.22003</idno><idno type="ArticleID">MDS22003</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Huntington's disease</term><term>balance</term><term>epidemiology</term><term>falls</term><term>gait</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Falls are common in patients with Huntington's disease, but the incidence, falling circumstances and contributing factors have never been examined. We recorded falls in 45 early to midstage Huntington's disease patients, both retrospectively (12 months) and prospectively (3 months). Fall rates were related to relevant baseline measures, including the Unified Huntington's Disease Rating Scale (UHDRS) and quantitative measures of balance (using angular velocity sensors) and gait (using a pressure‐sensitive walkway). Balance and gait measures were compared between patients and 27 healthy age‐matched controls. Twenty‐seven patients (60%) reported two or more falls in the previous year and were classified as fallers. During prospective follow‐up 40% reported at least one fall. A high proportion of falls (72.5%) caused minor injuries. Compared to nonfallers, fallers showed significantly higher scores for chorea, bradykinesia and aggression, as well as lower cognitive scores. Compared to controls, Huntington patients had a decreased gait velocity (1.15 m/s versus 1.45 m/s, P < 0.001) and a decreased stride length (1.29 m versus 1.52 m, P < 0.001). These abnormalities were all significantly greater in fallers compared to nonfallers. In addition, fallers had an increased stride length variability and a significantly greater trunk sway in medio‐lateral direction compared to nonfallers. We conclude that falls are common in Huntington's disease. Contributing factors include a combination of “motor” deficits (mainly gait bradykinesia, stride variability and chorea, leading to excessive trunk sway), as well as cognitive decline and perhaps behavioral changes. These factors should be considered as future targets for therapies that aim to reduce falls in Huntington's disease. © 2008 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Yvette A.M. Grimbergen MD</name><affiliations><json:string>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</json:string></affiliations></json:item><json:item><name>Mirjam J. Knol</name><affiliations><json:string>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</json:string></affiliations></json:item><json:item><name>Bastiaan R. Bloem MD, PhD</name><affiliations><json:string>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</json:string></affiliations></json:item><json:item><name>Berry P.H. Kremer MD, PhD</name><affiliations><json:string>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</json:string></affiliations></json:item><json:item><name>Raymund A.C. 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We recorded falls in 45 early to midstage Huntington's disease patients, both retrospectively (12 months) and prospectively (3 months). Fall rates were related to relevant baseline measures, including the Unified Huntington's Disease Rating Scale (UHDRS) and quantitative measures of balance (using angular velocity sensors) and gait (using a pressure‐sensitive walkway). Balance and gait measures were compared between patients and 27 healthy age‐matched controls. Twenty‐seven patients (60%) reported two or more falls in the previous year and were classified as fallers. During prospective follow‐up 40% reported at least one fall. A high proportion of falls (72.5%) caused minor injuries. Compared to nonfallers, fallers showed significantly higher scores for chorea, bradykinesia and aggression, as well as lower cognitive scores. Compared to controls, Huntington patients had a decreased gait velocity (1.15 m/s versus 1.45 m/s, P > 0.001) and a decreased stride length (1.29 m versus 1.52 m, P > 0.001). These abnormalities were all significantly greater in fallers compared to nonfallers. In addition, fallers had an increased stride length variability and a significantly greater trunk sway in medio‐lateral direction compared to nonfallers. We conclude that falls are common in Huntington's disease. Contributing factors include a combination of “motor” deficits (mainly gait bradykinesia, stride variability and chorea, leading to excessive trunk sway), as well as cognitive decline and perhaps behavioral changes. 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We recorded falls in 45 early to midstage Huntington's disease patients, both retrospectively (12 months) and prospectively (3 months). Fall rates were related to relevant baseline measures, including the Unified Huntington's Disease Rating Scale (UHDRS) and quantitative measures of balance (using angular velocity sensors) and gait (using a pressure‐sensitive walkway). Balance and gait measures were compared between patients and 27 healthy age‐matched controls. Twenty‐seven patients (60%) reported two or more falls in the previous year and were classified as fallers. During prospective follow‐up 40% reported at least one fall. A high proportion of falls (72.5%) caused minor injuries. Compared to nonfallers, fallers showed significantly higher scores for chorea, bradykinesia and aggression, as well as lower cognitive scores. Compared to controls, Huntington patients had a decreased gait velocity (1.15 m/s versus 1.45 m/s, P < 0.001) and a decreased stride length (1.29 m versus 1.52 m, P < 0.001). These abnormalities were all significantly greater in fallers compared to nonfallers. In addition, fallers had an increased stride length variability and a significantly greater trunk sway in medio‐lateral direction compared to nonfallers. We conclude that falls are common in Huntington's disease. Contributing factors include a combination of “motor” deficits (mainly gait bradykinesia, stride variability and chorea, leading to excessive trunk sway), as well as cognitive decline and perhaps behavioral changes. 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We recorded falls in 45 early to midstage Huntington's disease patients, both retrospectively (12 months) and prospectively (3 months). Fall rates were related to relevant baseline measures, including the Unified Huntington's Disease Rating Scale (UHDRS) and quantitative measures of balance (using angular velocity sensors) and gait (using a pressure‐sensitive walkway). Balance and gait measures were compared between patients and 27 healthy age‐matched controls. Twenty‐seven patients (60%) reported two or more falls in the previous year and were classified as fallers. During prospective follow‐up 40% reported at least one fall. A high proportion of falls (72.5%) caused minor injuries. Compared to nonfallers, fallers showed significantly higher scores for chorea, bradykinesia and aggression, as well as lower cognitive scores. Compared to controls, Huntington patients had a decreased gait velocity (1.15 m/s versus 1.45 m/s, <i>P</i> < 0.001) and a decreased stride length (1.29 m versus 1.52 m, <i>P</i> < 0.001). These abnormalities were all significantly greater in fallers compared to nonfallers. In addition, fallers had an increased stride length variability and a significantly greater trunk sway in medio‐lateral direction compared to nonfallers. We conclude that falls are common in Huntington's disease. Contributing factors include a combination of “motor” deficits (mainly gait bradykinesia, stride variability and chorea, leading to excessive trunk sway), as well as cognitive decline and perhaps behavioral changes. These factors should be considered as future targets for therapies that aim to reduce falls in Huntington's disease. © 2008 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Falls and gait disturbances in Huntington's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Falls and Gait Disturbances in Huntington's Disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Falls and gait disturbances in Huntington's disease</title></titleInfo><name type="personal"><namePart type="given">Yvette A.M.</namePart><namePart type="family">Grimbergen</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mirjam J.</namePart><namePart type="family">Knol</namePart><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</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, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</affiliation><description>Correspondence: Parkinson Center Nijmegen (ParC), Department of Neurology (935), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Berry P.H.</namePart><namePart type="family">Kremer</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Raymund A.C.</namePart><namePart type="family">Roos</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marten</namePart><namePart type="family">Munneke</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2008-05-15</dateIssued><dateCaptured encoding="w3cdtf">2007-09-06</dateCaptured><dateValid encoding="w3cdtf">2008-02-02</dateValid><copyrightDate encoding="w3cdtf">2008</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="figures">2</extent><extent unit="tables">2</extent><extent unit="references">35</extent><extent unit="words">4328</extent></physicalDescription><abstract lang="en">Falls are common in patients with Huntington's disease, but the incidence, falling circumstances and contributing factors have never been examined. We recorded falls in 45 early to midstage Huntington's disease patients, both retrospectively (12 months) and prospectively (3 months). Fall rates were related to relevant baseline measures, including the Unified Huntington's Disease Rating Scale (UHDRS) and quantitative measures of balance (using angular velocity sensors) and gait (using a pressure‐sensitive walkway). Balance and gait measures were compared between patients and 27 healthy age‐matched controls. Twenty‐seven patients (60%) reported two or more falls in the previous year and were classified as fallers. During prospective follow‐up 40% reported at least one fall. A high proportion of falls (72.5%) caused minor injuries. Compared to nonfallers, fallers showed significantly higher scores for chorea, bradykinesia and aggression, as well as lower cognitive scores. Compared to controls, Huntington patients had a decreased gait velocity (1.15 m/s versus 1.45 m/s, P < 0.001) and a decreased stride length (1.29 m versus 1.52 m, P < 0.001). These abnormalities were all significantly greater in fallers compared to nonfallers. In addition, fallers had an increased stride length variability and a significantly greater trunk sway in medio‐lateral direction compared to nonfallers. We conclude that falls are common in Huntington's disease. Contributing factors include a combination of “motor” deficits (mainly gait bradykinesia, stride variability and chorea, leading to excessive trunk sway), as well as cognitive decline and perhaps behavioral changes. These factors should be considered as future targets for therapies that aim to reduce falls in Huntington's disease. © 2008 Movement Disorder Society</abstract><note type="funding">NWO VIDI - No. 016.076.352; </note><subject lang="en"><genre>Keywords</genre><topic>Huntington's disease</topic><topic>gait</topic><topic>balance</topic><topic>falls</topic><topic>epidemiology</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><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>2008</date><detail type="volume"><caption>vol.</caption><number>23</number></detail><detail type="issue"><caption>no.</caption><number>7</number></detail><extent unit="pages"><start>970</start><end>976</end><total>7</total></extent></part></relatedItem><identifier type="istex">CE1208958625921B38B05AB9CC4B76C789E524A5</identifier><identifier type="DOI">10.1002/mds.22003</identifier><identifier type="ArticleID">MDS22003</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2008 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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