Utilizing three dimensional clinical gait analysis to optimize mobility outcomes in incomplete spinal cord damage.

Background: Three-dimensional gait analysis (3DGA) has not previously been considered by consensus panels of spinal cord experts for use in studies of patients with spinal cord damage (SCD), yet it is frequently used in other neurological populations, such as stroke and cerebral palsy.

Research Question: How does 3DGA impairment based reporting guide individualised clinical decision-making in people with incomplete SCD?

Methods: Retrospective open cohort case series recruited 48 adults with incomplete SCD (traumatic or non-traumatic spinal cord dysfunction) referred to the Clinical Gait Analysis Service (CGAS), Melbourne, Australia. Three-dimensional gait data were used to identify gait impairments by the multidisciplinary clinical team.

Full length foot orthoses have an immediate treatment effect and modify gait of children with idiopathic toe walking.

Background: There remains a substantial lack of evidence to support the use of foot orthoses as a conservative treatment option for idiopathic toe walking (ITW). Encouraging heel contact during gait is one of the primary goals of most interventions in paediatric ITW.

Research Question: Does the combined treatment of high-top boots and orthoses increase the number of heel contacts during gait and change spatio-temporal gait parameters?

Methods: This within subject designed randomised controlled trial recruited fifteen children diagnosed with ITW (n = 10 males).

Cost of Living with Parkinson's Disease over 12 Months in Australia: A Prospective Cohort Study.

. Parkinson disease (PD) is a costly chronic condition in terms of managing both motor and nonmotor symptoms. The burden of disease is high for individuals, caregivers, and the health system.

Cathodal Transcranial Direct Current Stimulation (tDCS) to the Right Cerebellar Hemisphere Affects Motor Adaptation During Gait.

The cerebellum appears to play a key role in the development of internal rules that allow fast, predictive adjustments to novel stimuli. This is crucial for adaptive motor processes, such as those involved in walking, where cerebellar dysfunction has been found to increase variability in gait parameters. Motor adaptation is a process that results in a progressive reduction in errors as movements are adjusted to meet demands, and within the cerebellum, this seems to be localised primarily within the right hemisphere.

Whole-Body Vibration Results in Short-Term Improvement in the Gait of Children With Idiopathic Toe Walking.

This study aimed to determine the impact of multiple doses of whole-body vibration on heel strike, spatial and temporal gait parameters, and ankle range of motion of children with idiopathic toe walking. Whole-body vibration was applied for 5 sets of 1 minute vibration/1 minute rest. Gait measures were collected pre intervention, 1, 5, 10, and 20 minutes postintervention with the GaitRite(®) electronic walkway.

Effect of footwear on minimum foot clearance, heel slippage and spatiotemporal measures of gait in older women.

Footwear has been implicated as a factor in falls, which is a major issue affecting the health of older adults. This study investigated the effect of footwear with dorsal fixation, slippers and bare feet on minimum foot clearance, heel slippage and spatiotemporal variables of gait in community dwelling older women. Thirty women participated (mean age (SD) 69.

A Randomized Controlled Trial to Reduce Falls in People With Parkinson's Disease.

Background: Falls are common and disabling in people with Parkinson's disease (PD). There is a need to quantify the effects of movement rehabilitation on falls in PD.

Objective: To evaluate 2 physical therapy interventions in reducing falls in PD.

Obstacle crossing in Parkinson's disease: mediolateral sway of the centre of mass during level-ground walking and obstacle crossing.

Background: Falls are common in idiopathic Parkinson's disease (PD) and frequently occur when walking and crossing obstacles.

Objective: To determine whether people with mild to moderately severe PD have abnormal centre of mass (CoM) motion in response to the perturbations of level-ground walking and obstacle crossing.

Method: Mediolateral excursion and velocity of the CoM were measured using three-dimensional motion analysis and force platforms in 20 people with mild to moderately severe PD at the peak dose of their PD medication, and 20 age and sex matched healthy control participants.

Determinants of health-related quality of life in people with Parkinson's disease: a path analysis.

Purpose: To identify the demographic factors, impairments and activity limitations that contribute to health-related quality of life (HRQOL) in people with idiopathic Parkinson's disease (PD).

Method: Two hundred and ten individuals with idiopathic PD who participated in the baseline assessment of a randomized clinical trial were included. The Parkinson's Disease Questionnaire-39 summary index was used to quantify HRQOL.

Health-related quality of life and strain in caregivers of Australians with Parkinson's disease: an observational study.

Background: The relationship between health-related quality of life (HRQoL) in people with Parkinson's disease and their caregivers is little understood and any effects on caregiver strain remain unclear. This paper examines these relationships in an Australian sample.

Methods: Using the generic EuroQol (EQ-5D) and disease-specific Parkinson's Disease Questionnaire-39 Item (PDQ-39), HRQoL was evaluated in a sample of 97 people with PD and their caregivers.

Feasibility, safety, and compliance in a randomized controlled trial of physical therapy for Parkinson's disease.

Both efficacy and clinical feasibility deserve consideration in translation of research outcomes. This study evaluated the feasibility of rehabilitation programs within the context of a large randomized controlled trial of physical therapy. Ambulant participants with Parkinson's disease (PD) (n = 210) were randomized into three groups: (1) progressive strength training (PST); (2) movement strategy training (MST); or (3) control ("life skills").

Falls and mobility in Parkinson's disease: protocol for a randomised controlled clinical trial.

Background: Although physical therapy and falls prevention education are argued to reduce falls and disability in people with idiopathic Parkinson's disease, this has not yet been confirmed with a large scale randomised controlled clinical trial. The study will investigate the effects on falls, mobility and quality of life of (i) movement strategy training combined with falls prevention education, (ii) progressive resistance strength training combined with falls prevention education, (iii) a generic life-skills social program (control group).

Methods/design: People with idiopathic Parkinson's disease who live at home will be recruited and randomly allocated to one of three groups.

Obstacle crossing in people with Parkinson's disease: foot clearance and spatiotemporal deficits.

This study investigates the effects of Parkinson's disease (PD) on foot trajectories and spatiotemporal gait adaptations when approaching and stepping over a ground-based obstacle. Twenty people with mild-moderate PD and 20 age and sex matched controls walked 10 steps at their preferred speed along a walkway and stepped over an obstacle (height 10% of leg length × 600 mm × 10 mm). Control participants also performed trials at the same speed and step length as their matched PD participant.

Obstacle crossing deficits in older adults: a systematic review.

This systematic review and critical evaluation of the literature investigates whether advanced age compromises obstacle crossing for unconstrained and time-constrained conditions. Eight electronic databases were searched for articles with terms relating to obstacle crossing during walking in their title, abstract or keywords. 15 articles were reviewed from an initial yield of 727 articles.

Quantifying the profile and progression of impairments, activity, participation, and quality of life in people with Parkinson disease: protocol for a prospective cohort study.

Background: Despite the finding that Parkinson disease (PD) occurs in more than one in every 1000 people older than 60 years, there have been few attempts to quantify how deficits in impairments, activity, participation, and quality of life progress in this debilitating condition. It is unclear which tools are most appropriate for measuring change over time in PD.

Methods And Design: This protocol describes a prospective analysis of changes in impairments, activity, participation, and quality of life over a 12 month period together with an economic analysis of costs associated with PD.

Cost effectiveness of preventing falls and improving mobility in people with Parkinson disease: protocol for an economic evaluation alongside a clinical trial.

Background: Cost of illness studies show that Parkinson disease (PD) is costly for individuals, the healthcare system and society. The costs of PD include both direct and indirect costs associated with falls and related injuries.

Methods: This protocol describes a prospective economic analysis conducted alongside a randomised controlled trial (RCT).