Does Motor Freezing Affect Gait and Balance Functions in Parkinson's Patients?

Ayşegül Usta; Ayla Fil Balkan; Yeliz Salcı; Semra Topuz; Gül Çakmaklı; Songül Aksoy; Kadriye Armutlu; Bülent Elibol

doi:10.21020/husbfd.932935

Araştırma Makalesi

Motor Donma Parkinson Hastalarında Yürüme ve Denge Fonksiyonlarını Etkiler mi?

Yıl 2021, Cilt: 8 Sayı: 3, 556 - 572, 31.12.2021

Ayşegül Usta Ayla Fil Balkan Yeliz Salcı Semra Topuz Gül Çakmaklı Songül Aksoy Kadriye Armutlu Bülent Elibol

Öz

Amaç: Parkinson hastalarında motor donma, hareketin beklenmedik bir anında aniden gerçekleşmesi sebebiyle hastalarda denge kaybı, yürüyüş bozuklukları ve düşmeye neden olmaktadır. Bu nedenle çalışmamızın amacı, Motor donması olan parkinson hastalarında denge ve yürüyüşü değerlendirmektir.

Gereç Yöntem: Çalışmaya, 10 motor donması olan Parkinson hastası, 10 motor donması olmayan hasta ile yaş ve cinsiyet bakımından benzer 10 sağlıklı birey dahil edilmiştir. Bireylerin demografik özellikleri kaydedilmiştir. Statik denge değerlendirmesi için Tandem Duruş Testi; Dinamik denge değerlendirmesi için Bilgisayarlı Dinamik Postürografi (BDP) ve Zamanlı Kalk Yürü Testi (ZKYT) uygulanmıştır. Bireylerin yürüyüşleri ise GaitRite elektronik yürüme yolu ve 10 m yürüme testi ile değerlendirilmiştir.

Bulgular: Gruplar arasında statik ve dinamik denge testleri ile yürüyüş testleri bakımından anlamlı farklılık bulunmuştur (p<0,005). Gruplar ikişerli olarak karşılaştırıldığında motor donması olan grup ile donması olmayan grup arasında denge ve yürüyüş bakımından fark görülmemiştir. Statik ve dinamik denge testleri bakımından her iki Parkinson grubu ile sağlıklı kontroller arasında farklılık varken (p<0,05); yürüyüş parametreleri açısından motor donması olan hastalar ile sağlıklı kontroller arasında fark mevcutken (p<0,05), donması olmayan hastalar ile sağlıklı kontroller arasında fark görülmemiştir (p>0,05).

Sonuç: Parkinson hastalarında motor donma, sağlıklı kontrollere kıyasla statik ve dinamik denge ile yürüyüşü olumsuz etkilemektedir. Yürüyüş değişkenleri, sağlıklı grupla kıyaslandığında motor donması olan grupta motor donması olmayan gruba göre daha fazla etkilenmiştir

Anahtar Kelimeler

Parkinson hastalığı, Motor Donma, Denge, Yürüyüş

Destekleyen Kurum

Bulunmamaktadır.

Kaynakça

1. Corcos, D.M., Strategies underlying the control of disordered movement. Physical therapy, 1991. 71(1): p. 25-38.
2. Reichmann, H., Clinical criteria for the diagnosis of Parkinson’s disease. Neurodegenerative diseases, 2010. 7(5): p. 284-290.
3. Mancini, M., J.G. Nutt, and F.B. Horak, Balance Dysfunction in Parkinson’s Disease: Basic Mechanisms to Clinical Management. 2019: Academic Press.
4. Okuma, Y., Freezing of gait in Parkinson’s disease. Journal of neurology, 2006. 253(7): p. vii27-vii32.
5. Tan, D.M., et al., Freezing of gait and activity limitations in people with Parkinson's disease. Archives of physical medicine and rehabilitation, 2011. 92(7): p. 1159-1165.
6. Moore, O., C. Peretz, and N. Giladi, Freezing of gait affects quality of life of peoples with Parkinson's disease beyond its relationships with mobility and gait. Movement disorders: official journal of the Movement Disorder Society, 2007. 22(15): p. 2192-2195.
7. Metman, L.V., Encyclopedia of movement disorders. 2010: Elsevier Acad. Press.
8. Mancini, M., et al. Quantifying freezing of gait in Parkinson's disease during the instrumented timed up and go test. in 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 2012. IEEE.
9. Nanhoe-Mahabier, W., et al., Walking patterns in Parkinson's disease with and without freezing of gait. Neuroscience, 2011. 182: p. 217-224.
10. Vervoort, G., et al., Progression of postural control and gait deficits in Parkinson's disease and freezing of gait: A longitudinal study. Parkinsonism & related disorders, 2016. 28: p. 73-79.
11. Duncan, R.P., et al., Balance differences in people with Parkinson disease with and without freezing of gait. Gait & posture, 2015. 42(3): p. 306-309.
12. Vervoort, G., et al., Which aspects of postural control differentiate between patients with Parkinson’s disease with and without freezing of gait? Parkinson’s Disease, 2013. 2013.
13. Cutlip, R.G., et al., Evaluation of an instrumented walkway for measurement of the kinematic parameters of gait. Gait & posture, 2000. 12(2): p. 134-138.
14. Mitchell, T., D. Conradsson, and C. Paquette, Gait and trunk kinematics during prolonged turning in Parkinson's disease with freezing of gait. Parkinsonism & related disorders, 2019. 64: p. 188-193.
15. Okada, Y., et al., Abnormalities of the first three steps of gait initiation in patients with Parkinson's disease with freezing of gait. Parkinson’s disease, 2011. 2011.
16. Candan, S.A., A. Çatıker, and T.Ş. Özcan, Psychometric properties of the Turkish version of the freezing of gait questionnaire for patients with Parkinson’s disease. Neurol Sci Neurophysiology, 2019. 36(1): p. 44.
17. Smithson, F., M.E. Morris, and R. Iansek, Performance on clinical tests of balance in Parkinson's disease. Physical therapy, 1998. 78(6): p. 577-592.
18. Morris, S., M.E. Morris, and R. Iansek, Reliability of measurements obtained with the Timed “Up & Go” test in people with Parkinson disease. Physical therapy, 2001. 81(2): p. 810-818.
19. Lang, J.T., et al., Test-retest reliability and minimal detectable change for the 10-meter walk test in older adults with Parkinson's disease. Journal of geriatric physical therapy, 2016. 39(4): p. 165-170.
20. Lindholm, B., et al., The clinical significance of 10-m walk test standardizations in Parkinson’s disease. Journal of neurology, 2018. 265(8): p. 1829-1835.
21. Rossi, M., et al., A prospective study of alterations in balance among patients with Parkinson’s Disease. European neurology, 2009. 61(3): p. 171-176.
22. Nelson, A.J., et al., The validity of the GaitRite and the Functional Ambulation Performance scoring system in the analysis of Parkinson gait. NeuroRehabilitation, 2002. 17(3): p. 255-262.
23. Brusse, K.J., et al., Testing functional performance in people with Parkinson disease. Physical therapy, 2005. 85(2): p. 134-141.
24. Dibble, L.E. and M. Lange, Predicting falls in individuals with Parkinson disease: a reconsideration of clinical balance measures. Journal of Neurologic Physical Therapy, 2006. 30(2): p. 60-67.
25. Campbell, C.M., et al., The effect of cognitive demand on timed up and go performance in older adults with and without Parkinson disease. pre, 2003. 27(1): p. 2-7.
26. Frazzitta, G., et al., Asymmetry and freezing of gait in parkinsonian patients. Journal of Neurology, 2013. 260(1): p. 71-76.
27. Weiss, A., et al., Can an accelerometer enhance the utility of the Timed Up & Go Test when evaluating patients with Parkinson's disease? Medical engineering & physics, 2010. 32(2): p. 119-125.
28. Duncan, R.P., et al., Are the average gait speeds during the 10 meter and 6 minute walk tests redundant in Parkinson disease? Gait & posture, 2017. 52: p. 178-182.
29. Geerse, D., et al. The sudden stop-and-start test of the Interactive Walkway affords an innovative evaluation of freezing of gait in Parkinson’s disease patients. in International Society of Posture & Gait Research World Congress. 2017.
30. Peterson, D.S., et al., Evidence for a relationship between bilateral coordination during complex gait tasks and freezing of gait in Parkinson's disease. Parkinsonism & related disorders, 2012. 18(9): p. 1022-1026.
31. Lee, Y.-Y., et al., Corticomotor Excitability Changes Associated With Freezing of Gait in People With Parkinson Disease. Frontiers in Human Neuroscience, 2020. 14.
32. Nonnekes, J., et al., Short rapid steps to provoke freezing of gait in Parkinson’s disease. Journal of neurology, 2014. 261(9): p. 1763-1767.
33. Colnat-Coulbois, S., et al., Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease. Journal of Neurology, Neurosurgery & Psychiatry, 2005. 76(6): p. 780-787.
34. Huh, Y.E., et al., Postural sensory correlates of freezing of gait in Parkinson's disease. Parkinsonism & related disorders, 2016. 25: p. 72-77.
35. Colnat-Coulbois, S., et al., Management of postural sensory conflict and dynamic balance control in late-stage Parkinson's disease. Neuroscience, 2011. 193: p. 363-369.
36. Willems, A.M., et al., The use of rhythmic auditory cues to influence gait in patients with Parkinson's disease, the differential effect for freezers and non-freezers, an explorative study. Disability and rehabilitation, 2006. 28(11): p. 721-728.
37. Almeida, Q.J. and C.A. Lebold, Freezing of gait in Parkinson's disease: a perceptual cause for a motor impairment? Journal of Neurology, Neurosurgery & Psychiatry, 2010. 81(5): p. 513-518.
38. Knobl, P., L. Kielstra, and Q. Almeida, The relationship between motor planning and freezing of gait in Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry, 2012. 83(1): p. 98-101.

Does Motor Freezing Affect Gait and Balance Functions in Parkinson's Patients?

Yıl 2021, Cilt: 8 Sayı: 3, 556 - 572, 31.12.2021

Ayşegül Usta Ayla Fil Balkan Yeliz Salcı Semra Topuz Gül Çakmaklı Songül Aksoy Kadriye Armutlu Bülent Elibol

Öz

Objective: Motor freezing in Parkinson's Disease (PD) causes loss of balance, gait disturbances and falls due to the sudden occurrence of movement at an unexpected moment. Therefore, the aim of our study is to evaluate balance and gait in Parkinson's patients with motor freezing.

Materials and Methods: 10 PD patients with motor freezing, 10 PD patients without motor freezing and 10 healthy individuals with similar age and gender were included in the study.. Demographic characteristics of the individuals were recorded. Tandem Stance Test for static balance assessment; Computed Dynamic Posturography (CDP) and Timed Up and Go Test were used for dynamic balance assessment. The gait was evaluated with the GaitRite electronic walkway and 10 m walking test.

Results: A significant difference was found between the groups in terms of static and dynamic balance and walking tests (p <0.005). When the groups were compared in pairs, there was no difference between the motor freezers and non-motor freezers in terms of balance and gait. While there was significant difference between both Parkinson’s groups and healthy controls in terms of static and dynamic balance tests (p <0.05); the difference between patients with freezers and healthy controls in terms of gait parameters (p <0.05) was not observed non-freezers and healthy controls (p> 0.05).

Conclusion: Motor freezing affects static and dynamic balance and also gait negatively in Parkinson's patients compared to healthy controls. Gait variables were affected more in the group with motor freeze compared to the healthy group than in the group without motor freeze.

Anahtar Kelimeler

Parkinson Disease, Motor Freezing, Balance, Gait

Kaynakça

1. Corcos, D.M., Strategies underlying the control of disordered movement. Physical therapy, 1991. 71(1): p. 25-38.
2. Reichmann, H., Clinical criteria for the diagnosis of Parkinson’s disease. Neurodegenerative diseases, 2010. 7(5): p. 284-290.
3. Mancini, M., J.G. Nutt, and F.B. Horak, Balance Dysfunction in Parkinson’s Disease: Basic Mechanisms to Clinical Management. 2019: Academic Press.
4. Okuma, Y., Freezing of gait in Parkinson’s disease. Journal of neurology, 2006. 253(7): p. vii27-vii32.
5. Tan, D.M., et al., Freezing of gait and activity limitations in people with Parkinson's disease. Archives of physical medicine and rehabilitation, 2011. 92(7): p. 1159-1165.
6. Moore, O., C. Peretz, and N. Giladi, Freezing of gait affects quality of life of peoples with Parkinson's disease beyond its relationships with mobility and gait. Movement disorders: official journal of the Movement Disorder Society, 2007. 22(15): p. 2192-2195.
7. Metman, L.V., Encyclopedia of movement disorders. 2010: Elsevier Acad. Press.
8. Mancini, M., et al. Quantifying freezing of gait in Parkinson's disease during the instrumented timed up and go test. in 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 2012. IEEE.
9. Nanhoe-Mahabier, W., et al., Walking patterns in Parkinson's disease with and without freezing of gait. Neuroscience, 2011. 182: p. 217-224.
10. Vervoort, G., et al., Progression of postural control and gait deficits in Parkinson's disease and freezing of gait: A longitudinal study. Parkinsonism & related disorders, 2016. 28: p. 73-79.
11. Duncan, R.P., et al., Balance differences in people with Parkinson disease with and without freezing of gait. Gait & posture, 2015. 42(3): p. 306-309.
12. Vervoort, G., et al., Which aspects of postural control differentiate between patients with Parkinson’s disease with and without freezing of gait? Parkinson’s Disease, 2013. 2013.
13. Cutlip, R.G., et al., Evaluation of an instrumented walkway for measurement of the kinematic parameters of gait. Gait & posture, 2000. 12(2): p. 134-138.
14. Mitchell, T., D. Conradsson, and C. Paquette, Gait and trunk kinematics during prolonged turning in Parkinson's disease with freezing of gait. Parkinsonism & related disorders, 2019. 64: p. 188-193.
15. Okada, Y., et al., Abnormalities of the first three steps of gait initiation in patients with Parkinson's disease with freezing of gait. Parkinson’s disease, 2011. 2011.
16. Candan, S.A., A. Çatıker, and T.Ş. Özcan, Psychometric properties of the Turkish version of the freezing of gait questionnaire for patients with Parkinson’s disease. Neurol Sci Neurophysiology, 2019. 36(1): p. 44.
17. Smithson, F., M.E. Morris, and R. Iansek, Performance on clinical tests of balance in Parkinson's disease. Physical therapy, 1998. 78(6): p. 577-592.
18. Morris, S., M.E. Morris, and R. Iansek, Reliability of measurements obtained with the Timed “Up & Go” test in people with Parkinson disease. Physical therapy, 2001. 81(2): p. 810-818.
19. Lang, J.T., et al., Test-retest reliability and minimal detectable change for the 10-meter walk test in older adults with Parkinson's disease. Journal of geriatric physical therapy, 2016. 39(4): p. 165-170.
20. Lindholm, B., et al., The clinical significance of 10-m walk test standardizations in Parkinson’s disease. Journal of neurology, 2018. 265(8): p. 1829-1835.
21. Rossi, M., et al., A prospective study of alterations in balance among patients with Parkinson’s Disease. European neurology, 2009. 61(3): p. 171-176.
22. Nelson, A.J., et al., The validity of the GaitRite and the Functional Ambulation Performance scoring system in the analysis of Parkinson gait. NeuroRehabilitation, 2002. 17(3): p. 255-262.
23. Brusse, K.J., et al., Testing functional performance in people with Parkinson disease. Physical therapy, 2005. 85(2): p. 134-141.
24. Dibble, L.E. and M. Lange, Predicting falls in individuals with Parkinson disease: a reconsideration of clinical balance measures. Journal of Neurologic Physical Therapy, 2006. 30(2): p. 60-67.
25. Campbell, C.M., et al., The effect of cognitive demand on timed up and go performance in older adults with and without Parkinson disease. pre, 2003. 27(1): p. 2-7.
26. Frazzitta, G., et al., Asymmetry and freezing of gait in parkinsonian patients. Journal of Neurology, 2013. 260(1): p. 71-76.
27. Weiss, A., et al., Can an accelerometer enhance the utility of the Timed Up & Go Test when evaluating patients with Parkinson's disease? Medical engineering & physics, 2010. 32(2): p. 119-125.
28. Duncan, R.P., et al., Are the average gait speeds during the 10 meter and 6 minute walk tests redundant in Parkinson disease? Gait & posture, 2017. 52: p. 178-182.
29. Geerse, D., et al. The sudden stop-and-start test of the Interactive Walkway affords an innovative evaluation of freezing of gait in Parkinson’s disease patients. in International Society of Posture & Gait Research World Congress. 2017.
30. Peterson, D.S., et al., Evidence for a relationship between bilateral coordination during complex gait tasks and freezing of gait in Parkinson's disease. Parkinsonism & related disorders, 2012. 18(9): p. 1022-1026.
31. Lee, Y.-Y., et al., Corticomotor Excitability Changes Associated With Freezing of Gait in People With Parkinson Disease. Frontiers in Human Neuroscience, 2020. 14.
32. Nonnekes, J., et al., Short rapid steps to provoke freezing of gait in Parkinson’s disease. Journal of neurology, 2014. 261(9): p. 1763-1767.
33. Colnat-Coulbois, S., et al., Bilateral subthalamic nucleus stimulation improves balance control in Parkinson’s disease. Journal of Neurology, Neurosurgery & Psychiatry, 2005. 76(6): p. 780-787.
34. Huh, Y.E., et al., Postural sensory correlates of freezing of gait in Parkinson's disease. Parkinsonism & related disorders, 2016. 25: p. 72-77.
35. Colnat-Coulbois, S., et al., Management of postural sensory conflict and dynamic balance control in late-stage Parkinson's disease. Neuroscience, 2011. 193: p. 363-369.
36. Willems, A.M., et al., The use of rhythmic auditory cues to influence gait in patients with Parkinson's disease, the differential effect for freezers and non-freezers, an explorative study. Disability and rehabilitation, 2006. 28(11): p. 721-728.
37. Almeida, Q.J. and C.A. Lebold, Freezing of gait in Parkinson's disease: a perceptual cause for a motor impairment? Journal of Neurology, Neurosurgery & Psychiatry, 2010. 81(5): p. 513-518.
38. Knobl, P., L. Kielstra, and Q. Almeida, The relationship between motor planning and freezing of gait in Parkinson's disease. Journal of Neurology, Neurosurgery & Psychiatry, 2012. 83(1): p. 98-101.

Toplam 38 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Sağlık Kurumları Yönetimi
Bölüm	Makaleler
Yazarlar	Ayşegül Usta 0000-0002-1965-3939 Ayla Fil Balkan 0000-0002-2721-0222 Yeliz Salcı 0000-0002-3728-7194 Semra Topuz 0000-0002-9090-3937 Gül Çakmaklı 0000-0001-8545-7939 Songül Aksoy 0000-0002-4922-1002 Kadriye Armutlu 0000-0001-6283-1211 Bülent Elibol Bu kişi benim 0000-0001-5015-0152
Erken Görünüm Tarihi	25 Eylül 2021
Yayımlanma Tarihi	31 Aralık 2021
Gönderilme Tarihi	6 Mayıs 2021
Yayımlandığı Sayı	Yıl 2021 Cilt: 8 Sayı: 3

Kaynak Göster

APA	Usta, A., Fil Balkan, A., Salcı, Y., Topuz, S., vd. (2021). Does Motor Freezing Affect Gait and Balance Functions in Parkinson’s Patients?. Hacettepe University Faculty of Health Sciences Journal, 8(3), 556-572. https://doi.org/10.21020/husbfd.932935

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