Tags

Type your tag names separated by a space and hit enter

Objective Gait and Balance Impairments Relate to Balance Confidence and Perceived Mobility in People With Parkinson Disease.
Phys Ther. 2016 Nov; 96(11):1734-1743.PT

Abstract

BACKGROUND

Body-worn, inertial sensors can provide many objective measures of balance and gait. However, the objective measures that best reflect patient perception of mobility disability and clinician assessment of Parkinson disease (PD) are unknown.

OBJECTIVE

The purposes of this study were: (1) to determine which objective measures of balance and gait are most related to patient perception of mobility disability and disease severity in people with PD and (2) to examine the effect of levodopa therapy on these correlates.

DESIGN

This was an experimental correlation study.

METHODS

One hundred four people with idiopathic PD performed 3 trials of the Instrumented Stand and Walk Test (ISAW) in the "on" and "off" medication states. The ISAW consists of quiet standing (30 seconds), gait initiation, straight walking (7 m), and turning (180°), yielding 34 objective measures of mobility from body-worn inertial sensors. Patient perception of mobility disability was assessed with the Activities-specific Balance Confidence (ABC) scale and the mobility subscale of the Parkinson's Disease Questionnaire (PDQ-39). Disease severity was assessed with the Unified Parkinson's Disease Rating Scale, part III (motor UPDRS). Spearman correlations were used to relate objective measures of mobility to patient perception and disease severity.

RESULTS

Turning speed, gait speed, and stride length were most highly correlated to severity of disease and patient perception of mobility disability. The objective measures of mobility in the off-medication state were more indicative of patient perception of mobility disability and balance confidence compared with on-medication state measures.

LIMITATIONS

Causation is an inherent problem of correlation studies.

CONCLUSION

Physical therapists should evaluate mobility in people with PD in the off-medication state because the off-medication state is more related to disease severity and patient perception of mobility disability than the on-medication state mobility. Assessment and treatment of mobility in people with PD should target specific measures (ie, turning, gait speed, and stride length) because these measures best reflect patients' quality of life and balance confidence.

Authors+Show Affiliations

C. Curtze, PhD, Department of Neurology, School of Medicine, Oregon Health & Science University, 3181 Sam Jackson Park Rd, Portland, OR 97239-3098 (USA). curtze@ohsu.edu.J.G. Nutt, MD, Department of Neurology, School of Medicine, Oregon Health & Science University.P. Carlson-Kuhta, PhD, Department of Neurology, School of Medicine, Oregon Health & Science University.M. Mancini, PhD, Department of Neurology, School of Medicine, Oregon Health & Science University.F.B. Horak, PhD, Department of Neurology, School of Medicine, Oregon Health & Science University, and Veterans Affairs Portland Health Care System, Portland, Oregon.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27149959

Citation

Curtze, Carolin, et al. "Objective Gait and Balance Impairments Relate to Balance Confidence and Perceived Mobility in People With Parkinson Disease." Physical Therapy, vol. 96, no. 11, 2016, pp. 1734-1743.
Curtze C, Nutt JG, Carlson-Kuhta P, et al. Objective Gait and Balance Impairments Relate to Balance Confidence and Perceived Mobility in People With Parkinson Disease. Phys Ther. 2016;96(11):1734-1743.
Curtze, C., Nutt, J. G., Carlson-Kuhta, P., Mancini, M., & Horak, F. B. (2016). Objective Gait and Balance Impairments Relate to Balance Confidence and Perceived Mobility in People With Parkinson Disease. Physical Therapy, 96(11), 1734-1743.
Curtze C, et al. Objective Gait and Balance Impairments Relate to Balance Confidence and Perceived Mobility in People With Parkinson Disease. Phys Ther. 2016;96(11):1734-1743. PubMed PMID: 27149959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Objective Gait and Balance Impairments Relate to Balance Confidence and Perceived Mobility in People With Parkinson Disease. AU - Curtze,Carolin, AU - Nutt,John G, AU - Carlson-Kuhta,Patricia, AU - Mancini,Martina, AU - Horak,Fay B, Y1 - 2016/05/05/ PY - 2015/12/01/received PY - 2016/04/27/accepted PY - 2016/11/3/pubmed PY - 2017/5/4/medline PY - 2016/5/7/entrez SP - 1734 EP - 1743 JF - Physical therapy JO - Phys Ther VL - 96 IS - 11 N2 - BACKGROUND: Body-worn, inertial sensors can provide many objective measures of balance and gait. However, the objective measures that best reflect patient perception of mobility disability and clinician assessment of Parkinson disease (PD) are unknown. OBJECTIVE: The purposes of this study were: (1) to determine which objective measures of balance and gait are most related to patient perception of mobility disability and disease severity in people with PD and (2) to examine the effect of levodopa therapy on these correlates. DESIGN: This was an experimental correlation study. METHODS: One hundred four people with idiopathic PD performed 3 trials of the Instrumented Stand and Walk Test (ISAW) in the "on" and "off" medication states. The ISAW consists of quiet standing (30 seconds), gait initiation, straight walking (7 m), and turning (180°), yielding 34 objective measures of mobility from body-worn inertial sensors. Patient perception of mobility disability was assessed with the Activities-specific Balance Confidence (ABC) scale and the mobility subscale of the Parkinson's Disease Questionnaire (PDQ-39). Disease severity was assessed with the Unified Parkinson's Disease Rating Scale, part III (motor UPDRS). Spearman correlations were used to relate objective measures of mobility to patient perception and disease severity. RESULTS: Turning speed, gait speed, and stride length were most highly correlated to severity of disease and patient perception of mobility disability. The objective measures of mobility in the off-medication state were more indicative of patient perception of mobility disability and balance confidence compared with on-medication state measures. LIMITATIONS: Causation is an inherent problem of correlation studies. CONCLUSION: Physical therapists should evaluate mobility in people with PD in the off-medication state because the off-medication state is more related to disease severity and patient perception of mobility disability than the on-medication state mobility. Assessment and treatment of mobility in people with PD should target specific measures (ie, turning, gait speed, and stride length) because these measures best reflect patients' quality of life and balance confidence. SN - 1538-6724 UR - https://www.unboundmedicine.com/medline/citation/27149959/Objective_Gait_and_Balance_Impairments_Relate_to_Balance_Confidence_and_Perceived_Mobility_in_People_With_Parkinson_Disease_ L2 - https://academic.oup.com/ptj/article-lookup/doi/10.2522/ptj.20150662 DB - PRIME DP - Unbound Medicine ER -