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Factors Influencing Obstacle Crossing Performance in Patients with Parkinson's Disease

BACKGROUND: Tripping over obstacles is the major cause of falls in community-dwelling patients with Parkinson's disease (PD). Understanding the factors associated with the obstacle crossing behavior may help to develop possible training programs for crossing performance. This study aimed to ide...

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Autores principales: Liao, Ying-Yi, Yang, Yea-Ru, Wu, Yih-Ru, Wang, Ray-Yau
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890269/
https://www.ncbi.nlm.nih.gov/pubmed/24454723
http://dx.doi.org/10.1371/journal.pone.0084245
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author Liao, Ying-Yi
Yang, Yea-Ru
Wu, Yih-Ru
Wang, Ray-Yau
author_facet Liao, Ying-Yi
Yang, Yea-Ru
Wu, Yih-Ru
Wang, Ray-Yau
author_sort Liao, Ying-Yi
collection PubMed
description BACKGROUND: Tripping over obstacles is the major cause of falls in community-dwelling patients with Parkinson's disease (PD). Understanding the factors associated with the obstacle crossing behavior may help to develop possible training programs for crossing performance. This study aimed to identify the relationships and important factors determining obstacle crossing performance in patients with PD. METHODS: Forty-two idiopathic patients with PD (Hoehn and Yahr stages I to III) participated in this study. Obstacle crossing performance was recorded by the Liberty system, a three-dimensional motion capture device. Maximal isometric strength of the lower extremity was measured by a handheld dynamometer. Dynamic balance and sensory integration ability were assessed using the Balance Master system. Movement velocity (MV), maximal excursion (ME), and directional control (DC) were obtained during the limits of stability test to quantify dynamic balance. The sum of sensory organization test (SOT) scores was used to quantify sensory organization ability. RESULTS: Both crossing stride length and stride velocity correlated significantly with lower extremity muscle strength, dynamic balance control (forward and sideward), and sum of SOT scores. From the regression model, forward DC and ankle dorsiflexor strength were identified as two major determinants for crossing performance (R(2) = .37 to.41 for the crossing stride length, R(2) = .43 to.44 for the crossing stride velocity). CONCLUSIONS: Lower extremity muscle strength, dynamic balance control and sensory integration ability significantly influence obstacle crossing performance. We suggest an emphasis on muscle strengthening exercises (especially ankle dorsiflexors), balance training (especially forward DC), and sensory integration training to improve obstacle crossing performance in patients with PD.
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spelling pubmed-38902692014-01-21 Factors Influencing Obstacle Crossing Performance in Patients with Parkinson's Disease Liao, Ying-Yi Yang, Yea-Ru Wu, Yih-Ru Wang, Ray-Yau PLoS One Research Article BACKGROUND: Tripping over obstacles is the major cause of falls in community-dwelling patients with Parkinson's disease (PD). Understanding the factors associated with the obstacle crossing behavior may help to develop possible training programs for crossing performance. This study aimed to identify the relationships and important factors determining obstacle crossing performance in patients with PD. METHODS: Forty-two idiopathic patients with PD (Hoehn and Yahr stages I to III) participated in this study. Obstacle crossing performance was recorded by the Liberty system, a three-dimensional motion capture device. Maximal isometric strength of the lower extremity was measured by a handheld dynamometer. Dynamic balance and sensory integration ability were assessed using the Balance Master system. Movement velocity (MV), maximal excursion (ME), and directional control (DC) were obtained during the limits of stability test to quantify dynamic balance. The sum of sensory organization test (SOT) scores was used to quantify sensory organization ability. RESULTS: Both crossing stride length and stride velocity correlated significantly with lower extremity muscle strength, dynamic balance control (forward and sideward), and sum of SOT scores. From the regression model, forward DC and ankle dorsiflexor strength were identified as two major determinants for crossing performance (R(2) = .37 to.41 for the crossing stride length, R(2) = .43 to.44 for the crossing stride velocity). CONCLUSIONS: Lower extremity muscle strength, dynamic balance control and sensory integration ability significantly influence obstacle crossing performance. We suggest an emphasis on muscle strengthening exercises (especially ankle dorsiflexors), balance training (especially forward DC), and sensory integration training to improve obstacle crossing performance in patients with PD. Public Library of Science 2014-01-13 /pmc/articles/PMC3890269/ /pubmed/24454723 http://dx.doi.org/10.1371/journal.pone.0084245 Text en © 2014 Liao et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Liao, Ying-Yi
Yang, Yea-Ru
Wu, Yih-Ru
Wang, Ray-Yau
Factors Influencing Obstacle Crossing Performance in Patients with Parkinson's Disease
title Factors Influencing Obstacle Crossing Performance in Patients with Parkinson's Disease
title_full Factors Influencing Obstacle Crossing Performance in Patients with Parkinson's Disease
title_fullStr Factors Influencing Obstacle Crossing Performance in Patients with Parkinson's Disease
title_full_unstemmed Factors Influencing Obstacle Crossing Performance in Patients with Parkinson's Disease
title_short Factors Influencing Obstacle Crossing Performance in Patients with Parkinson's Disease
title_sort factors influencing obstacle crossing performance in patients with parkinson's disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890269/
https://www.ncbi.nlm.nih.gov/pubmed/24454723
http://dx.doi.org/10.1371/journal.pone.0084245
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