Gait and balance in apolipoprotein Ɛ4 allele carriers in older adults and Parkinson's disease.

Background: Gait and balance impairments are among the most troublesome and heterogeneous in Parkinson's disease (PD). This heterogeneity may, in part, reflect genetic variation. The apolipoprotein E () gene has three major allelic variants (ε2, ε3 and ε4).

Simple and effective immobilization for radiation treatment of choroidal melanoma.

At our institution, patients diagnosed with choroidal melanoma requiring external beam radiation therapy are treated with two 6 MV volumetric-modulated arcs delivering 50 Gy over 5 daily fractions. The patient is immobilized using an Orfit head and neck mask and is directed to look at a light emitting diode (LED) during CT simulation and treatment to minimize eye movement. Patient positioning is checked with cone beam computed tomography (CBCT) daily.

Development of an item bank for measuring prosthetic mobility in people with lower limb amputation: The Prosthetic Limb Users Survey of Mobility (PLUS-M).

Background: Achieving mobility with a prosthesis is a common post-amputation rehabilitation goal and primary outcome in prosthetic research studies. Patient-reported outcome measures (PROMs) available to measure prosthetic mobility have practical and psychometric limitations that inhibit their use in clinical care and research.

Objective: To develop a brief, clinically meaningful, and psychometrically robust PROM to measure prosthetic mobility.

Exploring the effects of dopamine on sensorimotor inhibition and mobility in older adults.

Dopaminergic activity decreases in older adults (OAs) with normal aging and is further reduced in Parkinson's disease (PD), affecting cortical motor and sensorimotor pathways. Levodopa is the prevailing therapy to counter dopamine loss in PD, though not all PD motor signs improve with levodopa. The purpose of this preliminary study was to explore the effects of levodopa on sensorimotor inhibition, gait and quiet standing in OAs and to investigate the relationships between sensorimotor inhibition and both gait and standing balance both OFF- and ON-levodopa.

Cognition as a mediator for gait and balance impairments in GBA-related Parkinson's disease.

The extent to which the heterogeneity of gait and balance problems in PD may be explained by genetic variation is unknown. Variants in the glucocerebrosidase (GBA) gene are the strongest known genetic risk factor for PD and are associated with greater motor and cognitive severity. However, the impact of GBA variants on comprehensive measures of gait and balance and their relationship to cognition remains unknown.

Virtual reality doorway and hallway environments alter gait kinematics in people with Parkinson disease and freezing.

Background: Many people with Parkinson disease (PD) experience freezing of gait (FoG), a transient gait disturbance associated with increased fall risk and reduced quality of life. Head-mounted virtual reality (VR) systems allow overground walking and can create immersive simulations of physical environments that induce FoG.

Research Question: For people with PD who experience FoG (PD+FoG), are kinematic gait changes observed in VR simulations of FoG-provoking environments?

Methods: In a cross-sectional experiment, people with PD+FoG walked at their self-selected speed in a physical laboratory and virtual laboratory, doorway, and hallway environments.

Validity of Instrumented 360° Turn Test in Older Adults with Cognitive Impairment.

Aims: To examine concurrent and construct validity of inertial sensor 360°turn measures in relation with motion capture and mobility assessments in cognitively impaired older adults.

Methods: Data was collected in 31 participants, mean age 85.2 ( 5.

The association between sleep deficits and sedentary behavior in people with mild Parkinson disease.

Sleep deficits are a common nonmotor symptom of Parkinson disease (PD). People with mild PD also achieve less physical activity (PA) than healthy older adults (HOA), but the relationship between sleep and PA in PD is unclear. This study examined associations between sleep and PA in participants with PD and HOA.

Smartphone-Based VO2max Measurement With Heart Snapshot in Clinical and Real-world Settings With a Diverse Population: Validation Study.

Background: Maximal oxygen consumption (VOmax) is one of the most predictive biometrics for cardiovascular health and overall mortality. However, VOmax is rarely measured in large-scale research studies or routine clinical care because of the high cost, participant burden, and requirement for specialized equipment and staff.

Objective: To overcome the limitations of clinical VOmax measurement, we aim to develop a digital VOmax estimation protocol that can be self-administered remotely using only the sensors within a smartphone.

Effects of virtual reality environments on overground walking in people with Parkinson disease and freezing of gait.

Background: Freezing of gait (FoG) is a common target of rehabilitative interventions for people with Parkinson disease (PD). Virtual reality (VR) holds potential for advancing research and clinical management of FoG through flexible creation of FoG-provoking environments that are not easily or safely replicated in the clinic.

Objective: The aim of this study was to investigate whether VR environments that replicate FoG-provoking situations would exacerbate gait impairments associated with FoG compared to unobstructed VR and physical laboratory environments.

Sensorimotor Inhibition and Mobility in Genetic Subgroups of Parkinson's Disease.

Mobility and sensorimotor inhibition impairments are heterogeneous in Parkinson's disease (PD). Genetics may contribute to this heterogeneity since the apolipoprotein () ε4 allele and glucocerebrosidase () gene variants have been related to mobility impairments in otherwise healthy older adult (OA) and PD cohorts. The purpose of this study is to determine if or genetic status affects sensorimotor inhibition and whether the relationship between sensorimotor inhibition and mobility differs in genetic sub-groups of PD.

Cognitive associations with comprehensive gait and static balance measures in Parkinson's disease.

Introduction: Gait and balance impairments are cardinal features of Parkinson's disease (PD) that require cognitive input. However, the extent to which specific gait and balance characteristics relate to cognition in PD is unclear. In addition, independent models of gait and balance have not been developed from the same cohort.

Quantifying physical activity in early Parkinson disease using a commercial activity monitor.

Introduction: Physical inactivity in Parkinson disease (PD) has an impact on motor and non-motor symptoms of the disease. It is unclear whether this decline in physical activity occurs early in the disease, in addition to any decline due to aging, and whether commercial activity monitors can be used to self-monitor physical activity levels in this population.

Objective: To compare the quantity and intensity of physical activity (PA), as measured by commercial activity monitors, in people with mild PD and healthy older adults (HOA).

Impact of Immobilization on Interfractional Errors for Upper Extremity Soft Tissue Sarcoma Radiation Therapy.

Introduction/background: Owing to the rare nature and presentation of upper extremity soft tissue sarcomas (STSs) and the high mobility of associated anatomy, various patient positioning strategies are used for radiation therapy. The purpose of this study is to measure the interfractional setup errors associated with upper extremity sarcomas using different immobilization methods through cone-beam computed tomography (CBCT) images.

Methods: All patients treated with daily CBCT guidance for upper extremity STSs during 2014-2015 were identified and triaged based on type of immobilization.

Overview of the cholinergic contribution to gait, balance and falls in Parkinson's disease.

Mobility deficits, including gait disturbance, balance impairments and falls, are common features of Parkinson's disease (PD) that negatively impact quality of life. Mobility deficits respond poorly to dopaminergic medications, indicating a role for additional neurotransmitters. Due to the critical role of cortical input to gait and balance, acetylcholine-an essential neurotransmitter system for attention-has become an area of interest for mobility.

"Look, Your Muscles Are Firing!": A Qualitative Study of Clinician Perspectives on the Use of Surface Electromyography in Neurorehabilitation.

Objective: To examine the perceived value, benefits, drawbacks, and ideas for technology development and implementation of surface electromyography recordings in neurologic rehabilitation practice from clinical stakeholder perspectives.

Design: A qualitative, phenomenological study was conducted. In-depth, semistructured interviews and focus groups were completed.

Dual-task standing and walking in people with lower limb amputation: A structured review.

Background:: People with lower limb amputation report the need to concentrate on walking. Dual-task paradigms are often used to study such interactions between cognition and the control of balance and gait in people with lower limb amputation.

Objectives:: To summarize evidence related to dual-task standing and walking in people with lower limb amputation and discuss implications for future research.

Limbic and Basal Ganglia Neuroanatomical Correlates of Gait and Executive Function: Older Adults With Mild Cognitive Impairment and Intact Cognition.

Objective: This study aimed to examine differences in spatiotemporal gait parameters between older adults with amnestic mild cognitive impairment and normal cognition and to examine limbic and basal ganglia neural correlates of gait and executive function in older adults without dementia.

Design: This was a cross-sectional study of 46 community-dwelling older adults, ages 70-95 yrs, with amnestic mild cognitive impairment (n = 23) and normal cognition (n = 23). Structural magnetic resonance imaging was used to attain volumetric measures of limbic and basal ganglia structures.

Muscle recruitment and coordination during upper-extremity functional tests.

Performance-based tests, such as the Jebsen Taylor Hand Function Test or Chedoke Arm and Hand Activity Inventory, are commonly used to assess functional performance after neurologic injury. However, the muscle activity required to execute these tasks is not well understood, even for unimpaired individuals. The purpose of this study was to evaluate unimpaired muscle recruitment and coordination of the dominant and non-dominant limbs during common clinical tests.

Dual-task walking over a compliant foam surface: A comparison of people with transfemoral amputation and controls.

People with lower limb amputation are unable to reliably sense ground characteristics due to compromised sensory inputs from the missing limb. As a result, they may rely on compensatory strategies, such as use of cognitive resources, when walking over complex surfaces. This study examined interactions between cognition and walking over a compliant surface in 14 people with transfemoral amputation (TFA) and 14 controls using a dual-task paradigm.

11β-HSD1 suppresses cardiac fibroblast CXCL2, CXCL5 and neutrophil recruitment to the heart post MI.

We have previously demonstrated that neutrophil recruitment to the heart following myocardial infarction (MI) is enhanced in mice lacking 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) that regenerates active glucocorticoid within cells from intrinsically inert metabolites. The present study aimed to identify the mechanism of regulation. In a mouse model of MI, neutrophil mobilization to blood and recruitment to the heart were higher in 11β-HSD1-deficient ( ) relative to wild-type (WT) mice, despite similar initial injury and circulating glucocorticoid.

Long-term effects of systemic gene therapy in a canine model of myotubular myopathy.

Introduction: X-linked myotubular myopathy (XLMTM), a devastating pediatric disease caused by the absence of the protein myotubularin, results from mutations in the MTM1 gene. While there is no cure for XLMTM, we previously reported effects of MTM1 gene therapy using adeno-associated virus (AAV) vector on muscle weakness and pathology in MTM1-mutant dogs. Here, we followed 2 AAV-infused dogs over 4 years.

Systemic AAV8-Mediated Gene Therapy Drives Whole-Body Correction of Myotubular Myopathy in Dogs.

X-linked myotubular myopathy (XLMTM) results from MTM1 gene mutations and myotubularin deficiency. Most XLMTM patients develop severe muscle weakness leading to respiratory failure and death, typically within 2 years of age. Our objective was to evaluate the efficacy and safety of systemic gene therapy in the p.