10 research outputs found
Effects of a Multimodal Exercise Program on Clinical, Functional Mobility and Cognitive Parameters of Idiopathic Parkinson\u27s Disease Patients
Long-Term Multimodal Exercise Program Improves Motor and Non-Motor Parameters of People with Parkinsonâs Disease
Lateral asymmetries in the kick movement and the soccer and futsal performance
For proficiency, on soccer and futsal, is necessary that the athlete has similar performance between contralateral limbs. However, few athletes show this level of behavior. The aim of this study was to review in the literature the side asymmetry on soccer and futsal kick and what its effects on performance. The study used a systematic review to answer the questions. The results showed asymmetries between contralateral limbs with respect to the ability to kick, requiring proper and equality training between the sides to develop similarly limbs. Moreover, the similarity should be at the highest level, in other words, on performance level of the dominant limb. In the training, greater emphasis to aspects of the kick kinematic than the aspects related to the strength should be performed as much the kick limb as the support limb. We conclude that the asymmetries between the sides in the kicks affect the athletesâ performance during the game, but this issue is not yet solved, requiring further studies with respect to training and the differences between the sides
A Controlled Clinical Trial On The Effects Of Exercise On Neuropsychiatric Disorders And Instrumental Activities In Women With Alzheimer's Disease [efeitos Do ExercĂcio FĂsico Sobre DistĂșrbios NeuropsiquiĂĄtricos E Atividades Instrumentais Da Vida DiĂĄria Em Mulheres Com Doença De Alzheimer: Um Ensaio ClĂnico Controlado]
Objective: To analyze the influence of a six-month exercise program on neuropsychiatric disorders and on the performance of instrumental activities in elderly patients with Alzheimer's disease (AD). Methods: The study included 20 patients with AD in the mild to moderate stages of the Clinical Dementia Rating (CDR) divided into two groups: the experimental group, composed of 10 women who participated in the six-month exercise program, and the control group, composed of the 10 remaining AD patients who did not take part in an exercise program during the same period. All participants were evaluated using the Mini-Mental State Exam for global cognitive function, the Neuropsychiatric Inventory Questionnaire for neuropsychiatric disorders, and the Pfeffer Functional Activities Questionnaire for the degree of functional impairment. Results: The control group showed functional and neuropsychiatric deterioration in the comparisons between pre- and post-intervention times and between groups. Conclusion: The experimental group showed a propensity for less deterioration in neuropsychiatric disorders and performance of instrumental activities compared to the sedentary group. Trial registration RBR-4qzm6s.163197204Nitrini, R., Caramelli, P., Herrera Jr., E., Bahia, V.S., Caixeta, L.F., Radanovic, M., Incidence of dementia in a community-dwelling Brazilian population (2004) Alzheimer Dis Assoc Disord., 18 (4), pp. 241-246Lyketsos, C.G., Neuropsychiatric symptoms (behavioral and psychological symptoms of dementia) and the development of dementia treatments (2007) Int Psychogeriatr., 19 (3), pp. 409-420Teipel, S.J., Flatz, W.H., Heinsen, H., Bokde, A.L., Schoenberg, S.O., Stöckel, S., Measurement of basal forebrain atrophy in Alzheimer's disease using MRI (2005) Brain., 128 (PART 11), pp. 2626-2644Roach, K.E., Tappen, R.M., Kirk-Sanchez, N., Williams, C.L., Loewenstein, D., A randomized controlled trial of an activity specific exercise program for individuals with Alzheimer Disease in long-term care settings (2011) J Geriatr Phys Ther., 34 (2), pp. 50-56Scarmeas, N., Luchsinger, J.A., Brickman, A.M., Cosentino, S., Schupf, N., Xin-Tang, M., Physical activity and Alzheimer disease course (2011) Am J Geriatr Psychiatry., 19 (5), pp. 471-481Larson, E.B., Physical activity for older adults at risk for Alzheimer disease (2008) JAMA., 300 (9), pp. 1077-1079Nitrini, R., Caramelli, P., Bottino, C.M., Damasceno, B.P., Brucki, S.M., Anghinah, R., Diagnosis of Alzheimer's disease in Brazil: Diagnostic criteria and auxiliary tests. 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Association AP, editor. Washington: The AssociationHughes, C.P., Berg, L., Danziger, W.L., Coben, L.A., Martin, R.L., A new clinical scale for the staging of dementia (1982) Br J Psychiatry., 140, pp. 566-572Folstein, M.F., Folstein, S.E., McHugh, P.R., Mini-mental state (1975) A practical method for grading the cognitive state of patients for the clinician. 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(2005) Arq Neuropsiquiatr., 63 (2 A), pp. 207-212PaixĂŁo Jr., C.M., Reichenheim, M.E., A review of functional status evaluation instruments in the elderly (2005) Cad SaĂșde PĂșblica., 21 (1), pp. 7-19Herrera Jr., E., Caramelli, P., Silveira, A.S., Nitrini, R., Epidemiologic survey of dementia in a community-dwelling Brazilian population (2002) Alzheimer Dis Assoc Disord., 16 (2), pp. 103-108Bouwens, S.F., van Heugten, C.M., Aalten, P., Wolfs, C.A., Baarends, E.M., van Menxel, D.A., Relationship between measures of dementia severity and observation of daily life functioning as measured with the Assessment of Motor and Process Skills (AMPS) (2008) Dement Geriatr Cogn Disord., 25 (1), pp. 81-87Avila, R., Bottino, C.M.C., Carvalho, I.A.M., Santos, C.B., Seral, C., Miotto, E.C., Neuropsychological rehabilitation of memory deficits and activities of daily living in patients with Alzheimer's disease: A pilot study (2004) Braz J Med Biol Res., 37 (11), pp. 1721-1729Teri, L., Gibbons, L.E., McCurry, S.M., Logsdon, R.G., Buchner, D.M., Barlow, W.E., Exercise plus behavioral management in patients with Alzheimer disease: A randomized controlled trial (2003) JAMA., 290 (15), pp. 2015-2022Davis, R.N., Massman, P.J., Doody, R.S., Cognitive intervention in Alzheimer disease: A randomized placebo-controlled study (2001) Alzheimer Dis Assoc Disord., 15 (1), pp. 1-9Zec, R.F., Burkett, N.R., Non-pharmacological and pharmacological treatment of the cognitive and behavioral symptoms of Alzheimer disease (2008) NeuroRehabilitation., 23 (5), pp. 425-438Meuleman, J.R., Brechue, W.F., Kubilis, P.S., Lowenthal, D.T., Exercise training in the debilitated aged: Strength and functional outcomes (2000) Arch Phys Med Rehabil., 81 (3), pp. 312-318Farlow, M., Potkin, S., Koumaras, B., Veach, J., Mirski, D., Analysis of outcome in retrieved dropout patients in a rivastigmine vs placebo, 26-week, Alzheimer disease trial (2003) Arch Neurol., 60 (6), pp. 843-848Castro, C.M., Wilcox, S., O'Sullivan, P., Baumann, K., King, A.C., An exercise program for women who are caring for relatives with dementia (2002) Psychosom Med., 64 (3), pp. 458-468Forbes, D., Forbes, S., Morgan, D.G., Markle-Reid, M., Wood, J., Culum, I., Physical activity programs for persons with dementia (2008) Cochrane Database Syst ver., 3, pp. CD006489Shin, I.S., Carter, M., Masterman, D., Fairbanks, L., Cummings, J.L., Neuropsychiatric symptoms and quality of life in Alzheimer disease (2005) Am J Geriatr Psychiatry., 13 (6), pp. 469-474Mega, M.S., Cummings, J.L., Fiorello, T., Gornbein, J., The spectrum of behavioral changes in Alzheimer's disease (1996) Neurology., 46 (1), pp. 130-135Mok, W.Y., Chu, L.W., Chung, C.P., Chan, N.Y., Hui, S.L., The relationship between non-cognitive symptoms and functional impairment in Alzheimer's disease (2004) Int J Geriatr Psychiatry., 19 (11), pp. 1040-1046Trudeau, S.A., Enhanced ambulation and quality of life in advanced Alzheimer's disease (2003) J Am Geriatr Soc., 51 (3), pp. 429-431Selwood, A., Johnston, K., Katona, C., Lyketsos, C., Livingston, G., Systematic review of the effect of psychological interventions on family caregivers of people with dementia (2007) J Affect Disord., 101 (1-3), pp. 75-89Baum, E.E., Jarjoura, D., Polen, A.E., Faur, D., Rutecki, G., Effectiveness of a group exercise program in a long-term care facility: A randomized pilot trial (2003) J Am Med Dir Assoc., 4 (2), pp. 74-80McRae, P.G., Asplund, L.A., Schnelle, J.F., Ouslander, J.G., Abrahamse, A., Morris, C., A walking program for nursing home residents: Effects on walk endurance, physical activity, mobility, and quality of life (1996) J Am Geriatr Soc., 44 (2), pp. 175-180Cott, C.A., Dawson, P., Sidani, S., Wells, D., The effects of a walking/talking program on communication, ambulation, and functional status in residents with Alzheimer disease (2002) Alzheimer Dis Assoc Disord., 16 (2), pp. 81-87Landreville, P., BĂ©dard, A., Verreault, R., Desrosiers, J., Champoux, N., Monette, J., Non-pharmacological interventions for aggressive behavior in older adults living in long-term care facilities (2006) Int Psychogeriatr., 18 (1), pp. 47-73Landi, F., Onder, G., Cattel, C., Gambassi, G., Lattanzio, F., Cesari, M., Functional status and clinical correlates in cognitively impaired community-living older people (2001) J Geriatr Psychiatry Neurol., 14 (1), pp. 21-27Gauthier, S., Managing discontinuation syndrome in patients with dementia (2006) J Psychiatry Neurosci., 31 (1), p. 72Ramos, L.R., Simoes, E.J., Albert, M.S., Dependence in activities of daily living and cognitive impairment strongly predicted mortality in older urban residents in Brazil: A 2-year follow-up (2001) J Am Geriatr Soc., 49 (9), pp. 1168-1175Jönsson, L., Andreasen, N., Kilander, L., Soininen, H., Waldemar, G., Nygaard, H., Patient-and proxy-reported utility in Alzheimer disease using the EuroQoL (2006) Alzheimer Dis Assoc Disord., 20 (11), pp. 49-5
Exercise Programs Improve Mobility And Balance In People With Parkinson's Disease
Compromised balance and loss of mobility are among the major consequences of Parkinson's disease (PD). The literature documents numerous effective interventions for improving balance and mobility. The purpose of this study was to verify the effectiveness of two exercise programs on balance and mobility in people with idiopathic PD. Thirty-four participants, with idiopathic PD that ranged from Stage I to Stage III on the Hoehn & Yahr (H&Y) scale, were assigned to two groups. Group 1 (n = 21; 67±9 years old) was engaged in an intensive exercise program (aerobic capacity, flexibility, strength, motor coordination and balance) for 6 months: 72 sessions, 3 times a week, 60 minutes per session; while Group 2 (n = 13; 69±8 years old) participated in an adaptive program (flexibility, strength, motor coordination and balance) for 6 months: 24 sessions, once a week, 60 minutes per session. Balance and basic functional mobility were assessed in pre- and post-tests by means of the Berg Balance Scale and the Timed Up and Go Test. Before and after the interventions, groups were similar in clinical conditions (H&Y, UPDRS, and Mini-Mental). A MANOVA 2 (programs) by 2 (moments) revealed that both groups were affected by the exercise intervention. Univariate analyses showed that participants improved their mobility and balance from pre- to post-test. There were no differences between groups in either mobility or balance results. Both the intensive and adaptive exercise programs improved balance and mobility in patients with PD. © 2009 Elsevier Ltd. All rights reserved.15SUPPL. 3S49S52Christofoletti, G., Oliani, M.M., Gobbi, L.T.B., Gobbi, S., Stella, F., Risco de quedas em idosos com doença de Parkinson e demĂȘncia de Alzheimer: um estudo transversal (2006) Rev Bras Fisioter, 10, pp. 429-433Grimbergen, Y., Munneke, M., Bloem, B.R., Falls in Parkinson's disease (2004) Curr Opin Neurol, 17, pp. 405-415Hirayama, M.S., Gobbi, S., Gobbi, L.T.B., Stella, F., Quality of life (QoL) in relation to disease severity in Brazilian Parkinson's patients as measured using the WHOQOL-BREF (2008) Arch Gerontol Geriatr, 46, pp. 147-160Morris, M.E., Iansek, R., Kirkwood, B., A randomized control trial of movement strategies compared with exercise for people with Parkinson's disease (2009) Mov Disord, 24, pp. 64-71Crizzle, A.M., Newhouse, I.J., Is physical exercise beneficial for persons with Parkinson's disease? (2006) Clin J Sport Med, 16, pp. 422-425Reuter, I., Engelhardt, K.S., Baas, H., Therapeutic value of exercise training in Parkinson's disease (1999) Med Sci Sports Exerc, 31, pp. 1544-1549Miyai, I., Fujimoto, Y., Ueda, Y., Yamamoto, H., Nozaki, S., Saito, T., Treadmill training with body weight support: its effect on Parkinson's disease (2000) Arch Phys Med Rehabil, 81, pp. 849-852Scandalis, T.A., Bosak, A., Berliner, J.C., Heiman, L.L., Wells, M.R., Resistance training and gait function in patients with Parkinson's disease (2001) Am J Phys Med Rehabil, 80, pp. 38-43Dibble, L.E., Hale, T.F., Marcus, R.L., Gerber, J.P., LaStayo, P.C., High intensity eccentric resistance training decreases bradykinesia and improves quality of life in persons with Parkinson's disease: A preliminary study (2009) Parkinsonism Relat Disord, , 10.1016/j.parkreldis.2009.04.009Bergen, J.L., Toole, T., Elliott III, R.G., Wallace, B., Robinson, K., Maitland, C.G., Aerobic exercise intervention improves aerobic capacity and movement initiation in Parkinson's disease patients (2002) NeuroRehabil, 17, pp. 161-168Hackney, M.E., Earhart, G.M., Health-related quality of life and alternative forms of exercise in Parkinson disease (2009) Parkinsonism Relat Disord, 15, pp. 644-648Nocera, J., Horvat, M., Ray, C.T., Effects of home-based exercise on postural control and sensory organization in individuals with Parkinson disease (2009) Parkinsonism Relat Disord, , 10.1016/j.parkreldis.2009.07.002Miyamoto, S.T., Lombardi, J.I., Berg, K.O., Ramos, L.R., Natour, J., Brazilian version of the Berg Balance Scale (2004) Braz J Med Biol Res, 37, pp. 1411-1421Podsiadlo, D., Richardson, S., The Timed "Up & Go": A test of basic functional mobility for frail elderly persons (1991) J Am Geriatr Soc, 39, pp. 142-148Bogle Thorbahn, L.D., Newton, R.A., Use of the Berg balance test to predict falls in elderly persons (1996) Phys Ther, 76, pp. 576-585Nova, I., Perracini, M.R., Ferraz, H.B., Levodopa effect upon functional balance of Parkinson's disease patients (2004) Parkinsonism Relat Disord, 10, pp. 411-415Qutubuddin, A.A., Pegg, P.O., Cifu, D.X., Brown, R., McNamee, S., Carne, W., Validating the Berg Balance Scale for patients with Parkinson's disease: a key to rehabilitation evaluation (2005) Arch Phys Med Rehabil, 86, pp. 789-792Wall, J.C., Bell, C., Campbell, S., Davis, J., The timed get-up-and-go test revisited: measurement of the component tasks (2000) J Rehab Res Dev, 37, pp. 109-114Morris, S., Morris, M.E., Iansek, R., Reliability of measurements obtained with the timed "up & go" test in people with Parkinson disease (2001) Phys Ther, 81, pp. 810-818Fahn, S., Elton, R., Members of the UPDRS Development Comitee, The Unified Parkinson's Disease Rating Scale (1987) Recent developments in Parkinson's disease, 2, pp. 153-163. , Fahn S., Marsden C.D., Calne D.B., and Goldstein M. 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Adaptive Walking In Alzheimer's Disease
The aim of this study is to analyze dual-task effects on free and adaptive gait in Alzheimer's disease (AD) patients. Nineteen elders with AD participated in the study. A veteran neuropsychiatrist established the degree of AD in the sample. To determine dual-task effects on free and adaptive gait, patients performed five trials for each experimental condition: free and adaptive gait with and without a dual-task (regressive countdown). Spatial and temporal parameters were collected through an optoelectronic tridimensional system. The central stride was analyzed in free gait, and the steps immediately before (approaching phase) and during the obstacle crossing were analyzed in adaptive gait. Results indicated that AD patients walked more slowly during adaptive gait and free gait, using conservative strategies when confronted either with an obstacle or a secondary task. Furthermore, patients sought for stability to perform the tasks, particularly for adaptive gait with dual task, who used anticipatory and online adjustments to perform the task. Therefore, the increase of task complexity enhances cognitive load and risk of falls for AD patients. © 2012 Diego Orcioli-Silva et al.Cocchini, G., Della Sala, S., Logie, R.H., Pagani, R., Sacco, L., Spinnler, H., Dual task effects of walking when talking in Alzheimer's disease (2004) Revue Neurologique, 160 (1), pp. 74-80Della Sala, S., Spinnler, H., Venneri, A., Walking difficulties in patients with Alzheimer's disease might originate from gait apraxia (2004) Journal of Neurology, Neurosurgery and Psychiatry, 75 (2), pp. 196-201Pettersson, A.F., Olsson, E., Wahlund, L.-O., Effect of divided attention on gait in subjects with and without cognitive impairment (2007) Journal of Geriatric Psychiatry and Neurology, 20 (1), pp. 58-62. , DOI 10.1177/0891988706293528Maquet, D., Lekeu, F., Warzee, E., Gillain, S., Wojtasik, V., Salmon, E., Petermans, J., Croisier, J.L., Gait analysis in elderly adult patients with mild cognitive impairment and patients with mild Alzheimer's disease: Simple versus dual task: A preliminary report (2010) Clinical Physiology and Functional Imaging, 30 (1), pp. 51-56. , 2-s2.0-72549083959 10.1111/j.1475-097X.2009.00903.xImamura, T., Hirono, N., Hashimoto, M., Kazui, H., Tanimukai, S., Hanihara, T., Takahara, A., Mori, E., Fall-related injuries in dementia with Lewy bodies (DLB) and Alzheimer's disease (2000) European Journal of Neurology, 7 (1), pp. 77-79. , DOI 10.1046/j.1468-1331.2000.00021.xCamicioli, R., Licis, L., Motor impairment predicts falls in specialized Alzheimer care units (2004) Alzheimer Disease and Associated Disorders, 18 (4), pp. 214-218Van Dijk, P.T.M., Meulenberg, O.G.R.M., Van De Sande, H.J., Habbema, J.D.F., Falls in dementia patients (1993) Gerontologist, 33 (2), pp. 200-204Siu, K.C., Lugade, V., Chou, L.S., Van Donkelaar, P., Woollacott, M.H., Dual-task interference during obstacle clearance in healthy and balance-impaired older adults (2008) AgingClinical and Experimental Research, 20 (4), pp. 349-354. , 2-s2.0-56249114879Sheridan, P.L., Solomont, J., Kowall, N., Hausdorff, J.M., Influence of executive function on locomotor function: Divided attention increases gait variability in alzheimer's disease (2003) Journal of the American Geriatrics Society, 51 (11), pp. 1633-1637. , DOI 10.1046/j.1532-5415.2003.51516.xBle, A., Volpato, S., Zuliani, G., Guralnik, J.M., Bandinelli, S., Lauretani, F., Bartali, B., Ferrucci, L., Executive function correlates with walking speed in older persons: The InCHIANTI study (2005) Journal of the American Geriatrics Society, 53 (3), pp. 410-415. , DOI 10.1111/j.1532-5415.2005.53157.xPersad, C.C., Jones, J.L., Ashton-Miller, J.A., Alexander, N.B., Giordani, B., Executive function and gait in older adults with cognitive impairment (2008) Journals of Gerontology A, 63 (12), pp. 1350-1355. , 2-s2.0-62149152018(2000) Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TRed, , American Psychiatric Association, 4th Amer PsychiatricHughes, C.P., Berg, L., Danziger, W.L., A new clinical scale for the staging of dementia (1982) British Journal of Psychiatry, 140 (6), pp. 566-572Cummings, J.L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D.A., Gornbein, J., The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia (1994) Neurology, 44 (12), pp. 2308-2314Folstein, M.F., Folstein, S.E., McHugh, P.R., 'Mini mental state. 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Gait Spatial And Temporal Predictors For Functional Capacity Tests In Parkinson's Disease Patients
Objective: To determine which spatial and temporal parameters are predictors of the gait pattern of individuals with idiopathic Parkinson's disease, for the aerobic endurance and agility tests included in the battery of tests of the AAHPERD protocol. Methods: Six men and six women with mild and moderate impairment and disease stage were selected. They performed agility and aerobic endurance test accordance with the AAHPERD protocol, and walked 8 m on a walkway. A digital video camera recorded one central stride. Markers were attached to the fifth metatarsal and lateral face of the calcaneus of the right leg and to the first metatarsal and medial face of the calcaneus of the left leg. The dependent variables selected were the time taken in the agility and endurance tests and the kinematic variables: stride length (SL), cadence (CAD), stride time (ST), double support time (DS), single support time (SS), swing time (SW) and stride velocity (SV). Results: For agility, Pearson's test showed statistically significant correlations with SL (r=-0.70; pâ€0.05), CAD (r=-0.72; pâ€0.01), SV (r=-0.83; pâ€0.01), ST (r=0.71; pâ€0.01) and DS (r=0.90; pâ€0.01). For endurance, there were correlations with SL (r=-0.67; pâ€0.05), CAD (r=-0.72; pâ€0.01), SV (r=-0.82; pâ€0.01), ST (r=0.71; pâ€0.01), and DS (r=0.90; pâ€0.01). Multiple regression analysis revealed that DS was the only variable that predicted performance in both the agility (R2=0.82; pâ€0.01) and the endurance (R2=0.81; pâ€0.01) tests. Conclusions: It was observed that DS measure has a potential use as a kinematic parameter of gait that predicts the performance in agility and aerobic endurance tests in patients with idiopathic Parkinson's disease.125359365Christofoletti, G., Oliani, M.M., Gobbi, L.T.B., Gobbi, S., Stella, F., Risco de quedas em idosos com doença de Parkinson e demĂȘncia de Alzheimer: Um estudo transversal. 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Norwalk, Connecticut: Apleton & Lange;Giladi, N., Shabtai, H., Rozenberg, E., Shabtai, E., Gait festination in Parkinson's disease (2001) Parkinsonism Relat Disord, 7 (2), pp. 135-138Berardelli, A., Rothwell, J.C., Thompson, P.D., Hallet, M., Pathophysiology of bradykinesia in Parkinson's disease (2001) Brain, 124 (PART 11), pp. 2131-2146Grillner, S., Hellgren, J., MĂ©nard, A., Saitoh, K., Wikström, M.A., Mechanisms for selection of basic motor programs - roles for the striatum and pallidum (2005) Trends Neurosci, 28 (7), pp. 364-370Brown, L.A., Cooper, S.A., Doan, J.B., Dickin, D.C., Whishaw, I.Q., Pellis, S.M., Parkinsonian deficits in sensory integration for postural control: Temporal response to changes in visual input (2006) Parkinsonism Relat Disord, 12 (6), pp. 376-381Qutubuddin, A.A., Pegg, P.O., Cifu, D.X., Brown, R., McNamee, S., Carne, W., Validating the Berg Balance Scale for patients with Parkinson's disease: A key to rehabilitation evaluation (2005) Arch Phys Med Rehabil, 86 (4), pp. 789-792Franchignoni, F., Martignoni, E., Ferriero, G., Pasetti, C., Balance and fear of falling in Parkinson's disease (2005) Parkinsonism Relat Disord, 11 (7), pp. 427-433Zijlstra, W., Rutgers, A.W., Van Weerden, T.W., Voluntary and involuntary adaptation of gait in Parkinson's disease (1998) Gait Posture, 7 (1), pp. 53-63Schubert, M., Prokop, T., Brocke, F., Berger, W., Visual kinesthesia and locomotion in Parkinson's disease (2005) Mov Disord, 20 (2), pp. 141-15
Obstacle Crossing With Dual Tasking Is A Danger For Individuals With Alzheimer's Disease And For Healthy Older People
Background/Objective: The aim of this study was to analyze the effects of dual tasking on obstacle crossing during walking by individuals with Alzheimer's disease (AD) and by healthy older people. Methods: Thirty four elderly individuals (16 healthy subjects and 18 individuals with AD) were recruited to participate in this study. Three AD individuals and one control participant were excluded due to exclusion criteria. The participants were instructed to walk barefoot at their own speed along an 8 m long pathway. Each participant performed five trials for each condition (unobstructed walking, unobstructed walking with dual tasking, and obstacle crossing during walking with dual tasking). The trials were completely randomized for each participant. The mid-pathway stride was measured in the unobstructed walking trials and the stride that occurred during the obstacle avoidance was measured in the trials that involved obstacle crossing. Results/Conclusion: The behavior of the healthy elderly subjects and individuals with AD was similar for obstacle crossing during walking with dual tasking. Both groups used the 'posture first' strategy to prioritize stability and showed decreased attention to executive tasking while walking. Additionally, AD had a strong influence on the modifications that are made by the elderly while walking under different walking conditions.432435441Maquet, D., Lekeu, F., Warzee, E., Gillain, S., Wojtasik, V., Salmon, E., Petermans, J., Croisier, J.L., Gait analysis inelderly adult patients with mild cognitive impairment andpatients with mild Alzheimer's disease: Simple versus dualtask: A preliminary report (2010) Clin Physiol Funct Imaging, 30, pp. 51-56Sheridan, P.L., Solomont, J., Kowall, N., Hausdorff, J.M., Influence of executive function on locomotor function:Divided attention increases gait variability in Alzheimer'sdisease (2003) J Am Geriatr Soc, 51, pp. 1633-1637Orcioli-Silva, D., Simieli, L., Barbieri, F.A., Stella, F., Gobbi, L.T., Adaptive walking in Alzheimer's disease (2012) Int J Alzheimers Dis, 2012, p. 674589Coelho, F.G., Stella, F., De Andrade, L.P., Barbieri, F.A., Santos-Galduroz, R.F., Gobbi, S., Costa, J.L., Gobbi, L.T., Gait andrisk of falls associated with frontal cognitive functions at differentstages of Alzheimer's disease (2012) Neuropsychol Dev CognB Aging Neuropsychol Cogn, 19, pp. 644-656Persad, C.C., Jones, J.L., Ashton-Miller, J.A., Alexander, N.B., Giordani, B., Executive function and gait in older adultswith cognitive impairment (2008) J Gerontol A Biol Sci Med Sci, 63, pp. 1350-1355Cocchini, G., Della Sala, S., Logie, R.H., Pagani, R., Sacco, L., Spinnler, H., Dual task effects of walking when talkingin Alzheimer's disease (2004) Rev Neurol (Paris), 160, pp. 74-80Imamura, T., Hirono, N., Hashimoto, M., Kazui, H., Tanimukai, S., Hanihara, T., Takahara, A., Mori, E., Fall-related injuries indementia with Lewy bodies (DLB) and Alzheimer's disease (2000) Eur J Neurol, 7, pp. 77-79Nadkarni, N.K., Mawji, E., McIlroy, W.E., Black, S.E., Spatialand temporal gait parameters in Alzheimer's disease andaging (2009) Gait Posture, 30, pp. 452-454Suttanon, P., Hill, K.D., Said, C.M., Logiudice, D., Lautenschlager, N.T., Dodd, K.J., Balance and mobility dysfunction andfalls risk in older people with mild to moderate Alzheimerdisease (2012) Am J Phys Med Rehabil, 91, pp. 12-23Campbell, A.J., Borrie, M.J., Spears, G.F., Jackson, S.L., Brown, J.S., Fitzgerald, J.L., Circumstances and consequences of fallsexperienced by a community population 70 years and overduring a prospective study (1990) Age Ageing, 19, pp. 136-141Stolze, H., Klebe, S., Zechlin, C., Baecker, C., Friege, L., Deuschl, G., Falls in frequent neurological diseases-prevalence, risk factors and aetiology (2004) J Neurol, 251, pp. 79-84Vitorio, R., Pieruccini-Faria, F., Stella, F., Gobbi, S., Gobbi, L.T., Effects of obstacle height on obstacle crossing in mildParkinson's disease (2010) Gait Posture, 31, pp. 143-146Patla, A.E., Strategies for dynamic stability during adaptivehuman locomotion (2003) IEEE Eng Med Biol Mag, 22, pp. 48-52Chou, L.S., Kaufman, K.R., Hahn, M.E., Brey, R.H., Mediolateralmotion of the center of mass during obstacle crossingdistinguishes elderly individuals with imbalance (2003) Gait Posture, 18, pp. 125-133Alexander, N.B., Mollo, J.M., Giordani, B., Ashton-Miller, J.A., Schultz, A.B., Grunawalt, J.A., Foster, N.L., Maintenance ofbalance, gait patterns, and obstacle clearance in Alzheimer'sdisease (1995) Neurology, 45, pp. 908-914Ble, A., Volpato, S., Zuliani, G., Guralnik, J.M., Bandinelli, S., Lauretani, F., Bartali, B., Ferrucci, L., Executive function correlates with walking speed inolder persons: The InCHIANTI study (2005) J Am Geriatr Soc, 53, pp. 410-415Persad, C.C., Giordani, B., Chen, H.C., Ashton-Miller, J.A., Alexander, N.B., Wilson, C.S., Berent, S., Schultz, A.B., Neuropsychological predictors of complex obstacle avoidancein healthy older adults (1995) J Gerontol B Psychol Sci SocSci, 50, pp. P272-P277Yogev-Seligmann, G., Hausdorff, J.M., Giladi, N., Do wealways prioritize balance when walking? 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de Parkinsone DemĂȘncia de Alzheimer: Um estudo transversal (2006) Rev Bras Fisioter, 10, pp. 429-43
Variability In Obstacle Clearance May (not) Indicate Cognitive Disorders In Alzheimer Disease
The aim of this study was to investigate obstacle clearance and its variability in individuals with Alzheimer dementia (AD) as well as healthy elderly individuals while they approached and crossed an obstacle in their path. Fifteen people with AD and 15 age-matched/sex-matched healthy individuals (control group) participated in this study. Clinical assessment of both groups was performed by a neuropsychiatrist. Spatial-temporal parameters of 5 trials of unobstructed walking and 5 trials of obstacle crossing during walking (approach and crossing phases) were measured using a 3-dimensional optoelectronic system. The results indicated that individuals with AD showed higher variability in the approach phase for stride length and the horizontal distance from their trailing limb foot to the obstacle. However, their gait variability in the crossing phase was similar to the control group. In addition, the individuals with AD were found to walk slowly and with a short stride length in both conditions. In conclusion, individuals with AD had increased gait variability while approaching an obstacle during walking, indicating a deficit in planning to avoid obstacles that could be related to cognitive disorders. However, gait variability during the crossing phase may not be indicative of cognitive disorders in AD