Skip to main content
  • Other Publications
  • Subscribe
  • Contact Us
Advertisement
JCORE Reference
this is the JCORE Reference site slogan
  • Home
  • Most Read
  • About Us
    • About Us
    • Editorial Board
  • More
    • Advertising
    • Alerts
    • Feedback
    • Folders
    • Help
  • Patients
  • Reference Site Links
    • View Regions
  • Archive

Balance and Gait Represent Independent Domains of Mobility in Parkinson Disease

Fay B. Horak, Martina Mancini, Patricia Carlson-Kuhta, John G. Nutt, Arash Salarian
DOI: 10.2522/ptj.20150580 Published 1 September 2016
Fay B. Horak
F.B. Horak, PT, PhD, Veterans Affairs Portland Health Care System (VAPORHCS), Portland, Oregon; Department of Neurology, Oregon Health & Science University, Portland, Oregon.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Martina Mancini
M. Mancini, PhD, Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Rd, Portland, OR 97239 (USA).
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Patricia Carlson-Kuhta
P. Carlson-Kuhta, PhD, Department of Neurology, Oregon Health & Science University.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John G. Nutt
J.G. Nutt, MD, Department of Neurology, Oregon Health & Science University.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Arash Salarian
A. Salarian, PhD, Department of Neurology, Oregon Health & Science University.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Abstract

Background The Instrumented Stand and Walk (ISAW) test, which includes 30 seconds of stance, step initiation, gait, and turning, results in many objective balance and gait metrics from body-worn inertial sensors. However, it is not clear which metrics provide independent information about mobility.

Objective It was hypothesized that balance and gait represent several independent domains of mobility and that not all domains would be abnormal in individuals with Parkinson disease (PD) or would change with levodopa therapy.

Design This was a cross-sectional study.

Methods A factor analysis approach was used to identify independent measures of mobility extracted from the ISAW in 100 participants with PD and 21 control participants. First, a covariance analysis showed that postural sway measures were independent of gait measures. Then, the factor analysis revealed 6 independent factors (mobility domains: sway area, sway frequency, arm swing asymmetry, trunk motion during gait, gait speed, and cadence) that accounted for 87% of the variance of performance across participants.

Results Sway area, gait speed, and trunk motion differed between the PD group in the off-levodopa state and the control group, but sway frequency (but not sway area) differed between the PD group in the off-levodopa state and the control group. Four of the 6 factors changed significantly with levodopa (off to on): sway area, sway frequency, trunk motion during gait, and cadence. When participants were on levodopa, the sway area increased compared with off levodopa, becoming more abnormal, whereas the other 3 significant metrics moved toward, but did not reach, the healthy control values.

Limitations Exploratory factor analysis was limited to the PD population.

Conclusions The different sensitivity various balance and gait domains to PD and to levodopa also support neural control of at least 6 independent mobility domains, each of which warrants clinical assessment for impairments in mobility.

Footnotes

  • All authors provided concept/idea/research design. Dr Horak, Dr Mancini, Dr Carlson-Kuhta, and Dr Salarian provided writing. Dr Horak, Dr Carlson-Kuhta, and Dr Salarian provided data collection. Dr Mancini and Dr Salarian provided data analysis. Dr Horak and Dr Carlson-Kuhta provided project management. Dr Horak provided fund procurement, facilities/equipment, and institutional liaisons. Dr Nutt provided participants. Dr Horak, Dr Nutt, and Dr Salarian provided consultation (including review of manuscript before submission).

  • This study was approved by the Institutional Review Board of Oregon Health & Science University.

  • This publication was made possible with support from a grant from the National Institute on Aging (AG006457); a Challenge Grant from the National Institute of Neurological Disorders and Stroke (RC1 NS068678) and from the Oregon Clinical and Translational Research Institute at Oregon Health & Science University; and grant number UL1 RR024140 from the National Center for Research Resources, a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research.

  • Oregon Health & Science University and Dr Horak have a significant financial interest in APDM, a company that may have a commercial interest in the results of this research and technology. This potential institutional and individual conflict has been reviewed and managed by OHSU.

  • Received October 17, 2015.
  • Accepted March 28, 2016.
  • © 2016 American Physical Therapy Association
View Full Text
PreviousNext
Back to top
Vol 96 Issue 9 Table of Contents
Physical Therapy: 96 (9)

Issue highlights

  • Experiences of Physical Therapists Working in the Acute Hospital Setting: Systematic Review
  • Physician Impressions of Physical Therapist Practice in the Emergency Department: Descriptive, Comparative Analysis Over Time
  • Simulated Patients in Physical Therapy Education: Systematic Review and Meta-Analysis
  • Physical Therapists' Perceptions and Use of Exercise in the Management of Subacromial Shoulder Impingement Syndrome: Focus Group Study
  • Balance and Gait Represent Independent Domains of Mobility in Parkinson Disease
  • Client Perspectives on Reclaiming Participation After a Traumatic Spinal Cord Injury in South Africa
  • Inpatient Rehabilitation Outcomes in Patients With Stroke Aged 85 Years or Older
  • Physical Activity Levels and Their Associations With Postural Control in the First Year After Stroke
  • Patient Perspectives on Participation in Cognitive Functional Therapy for Chronic Low Back Pain
  • Effectiveness of Global Postural Re-education in Patients With Chronic Nonspecific Neck Pain: Randomized Controlled Trial
  • Development and Integration of Professional Core Values Among Practicing Clinicians
  • Translation, Validation, and Reliability of the Dutch Late-Life Function and Disability Instrument Computer Adaptive Test
  • Coactivation During Dynamometry Testing in Adolescents With Spastic Cerebral Palsy
  • Cohort Study Comparing the Berg Balance Scale and the Mini-BESTest in People Who Have Multiple Sclerosis and Are Ambulatory
  • Use of Six-Minute Walk Test to Measure Functional Capacity After Liver Transplantation
  • Feasibility of the Six-Minute Walk Test for Patients Who Have Cystic Fibrosis, Are Ambulatory, and Require Mechanical Ventilation Before Lung Transplantation
Email

Thank you for your interest in spreading the word on JCORE Reference.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Balance and Gait Represent Independent Domains of Mobility in Parkinson Disease
(Your Name) has sent you a message from JCORE Reference
(Your Name) thought you would like to see the JCORE Reference web site.
Print
Balance and Gait Represent Independent Domains of Mobility in Parkinson Disease
Fay B. Horak, Martina Mancini, Patricia Carlson-Kuhta, John G. Nutt, Arash Salarian
Physical Therapy Sep 2016, 96 (9) 1364-1371; DOI: 10.2522/ptj.20150580

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Download Powerpoint
Save to my folders

Share
Balance and Gait Represent Independent Domains of Mobility in Parkinson Disease
Fay B. Horak, Martina Mancini, Patricia Carlson-Kuhta, John G. Nutt, Arash Salarian
Physical Therapy Sep 2016, 96 (9) 1364-1371; DOI: 10.2522/ptj.20150580
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Article
    • Abstract
    • Method
    • Results
    • Discussion
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Reliability and Validity of Force Platform Measures of Balance Impairment in Individuals With Parkinson Disease
  • Predictors of Reduced Frequency of Physical Activity 3 Months After Injury: Findings From the Prospective Outcomes of Injury Study
  • Effects of Locomotor Exercise Intensity on Gait Performance in Individuals With Incomplete Spinal Cord Injury
Show more Neurology

Subjects

  • Examination/Evaluation
    • Tests and Measurements
  • Musculoskeletal System/Orthopedic
    • Kinesiology/Biomechanics
    • Gait Disorders
  • Neurology/Neuromuscular System
    • Parkinson Disease and Parkinsonian Disorders
    • Balance

Footer Menu 1

  • menu 1 item 1
  • menu 1 item 2
  • menu 1 item 3
  • menu 1 item 4

Footer Menu 2

  • menu 2 item 1
  • menu 2 item 2
  • menu 2 item 3
  • menu 2 item 4

Footer Menu 3

  • menu 3 item 1
  • menu 3 item 2
  • menu 3 item 3
  • menu 3 item 4

Footer Menu 4

  • menu 4 item 1
  • menu 4 item 2
  • menu 4 item 3
  • menu 4 item 4
footer second
footer first
Copyright © 2013 The HighWire JCore Reference Site | Print ISSN: 0123-4567 | Online ISSN: 1123-4567
advertisement bottom
Advertisement Top