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Assessment of dynamic balance during step initiation in Parkinson’s disease patients and elderly – a validity study

Juras Grzegorz, Kamieniarz Anna, Michalska Justyna, Słomka Kajetan

Acta of Bioengineering and Biomechanics

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2020

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Vol. 22, no. 1

3--10

EN

The aim of this study was to evaluate the reliability of the novel posturographic procedure and to investigate the relationships between parameters of this procedure and clinical tests. We hypothesised the proposed step initiation procedure to be reliable method of balance and motor disability assessment, especially in patients with neurological deficits. Also, we assumed high significant correlation between parameters of step initiation procedures and clinical tests. Methods: The 35 subjects with idiopathic PD and 35 agedmatched healthy controls participated in this study. The gait initiation was measured using two force platforms. The procedure consisted of three phases: (1) quiet standing on a first platform (2) crossing on the second platform, (3) quiet standing on a second platform. Testing was carried out in four conditions: unperturbed trial, obstacle crossing, step-up and step-down. Results: In the proposed gait initiation procedure, the vCOP, raCOP and rmsCOP showed an excellent reliability (ICC > 0.80). For transit phase, reliability of all variables in all conditions also was excellent (ICC = 0.8–0.9). There were only a few associations between Tinetti scores and posturographic variables in controls, but in PD patients the significant correlations were found between the proposed measures and the UPDRS, Tinetti, FRT, TUG and with the BBS. Conclusions: The proposed gait initiation procedure is reliable and very suitable for the assessment of patients with Parkinson’s disease. It can be used as an objective assessment of the clinical condition and dynamic balance, and help in the designing and programming of the appropriate rehabilitation and treatment.

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Zmiany inwolucyjne narządu ruchu a ryzyko złamań

Skrzek A., Ignasiak Z., Domaradzki J.

Acta Bio-Optica et Informatica Medica. Inżynieria Biomedyczna

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2011

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Vol. 17, nr 3

179-183

PL

W badaniach nad urazami kości i stawów analizuje się najistotniejsze czynniki ryzyka upadków i złamań. Efektem procesów inwolucyjnych może być utrata stabilności postawy ciała człowieka, obniżona siła mięśniowa, zmniejszony zakres ruchomości stawów oraz obniżona gęstość tkanki kostnej z pogorszeniem jej wytrzymałości. Zmiany te wyraźnie ograniczają możliwości ruchowe i lokomocyjne osób starszych. Celem niniejszej pracy była analiza wybranych czynników ryzyka złamań i częstotliwości ich występowania u dorosłych i starszych kobiet. Przebadano 193 kobiety, które podzielono na 3 grupy wiekowe: osoby 50-letnie (N = 46, średnia wieku 55,6 ± 3,1), 60-letnie (N = 90, średnia wieku 64,8 ± 2,9) oraz 70-letnie (N = 57, średnia wieku 74,9 ± 3,2). Wykonano podstawowe pomiary somatyczne, badania densytometryczne za pomocą aparatu EXA-3000 firmy Mar-Med, pomiary siły mięśniowej z wykorzystaniem wielofunkcyjnego fotela rehabilitacyjno-diagnostycznego do analizy momentów sił mięśni stawu kolanowego w warunkach pracy izometrycznej oraz przeprowadzono badanie stabilności postawy ciała z wykorzystaniem platformy dynamograficznej ACCU GAIT firmy Technomex. W badaniach obserwowano charakterystyczne dla wieku zmiany cech somatycznych, czyli obniżanie wysokości ciała i zwiększanie względnej masy ciała (BMI - Body Mass Index). Wyniki badań wykazały spadek gęstości tkanki kostnej wraz z wiekiem (BMD - Body Mass Density) oraz zmniejszenie momentów siły mięśnia czworogłowego i zginaczy stawu kolanowego. Parametry równowagi (pole powierzchni stabilogramu oraz długość całkowita stabilogramu) były większe w kolejnych grupach wiekowych. Przeprowadzona analiza wykazała istotne związki między wiekiem a badanymi parametrami. W badaniach ankietowych z ostatnich 3 lat wykazano wzrastającą częstość złamań w tych grupach kobiet, odpowiednio 20, 28 i 35%. Wyniki badań potwierdzają, że ryzyko złamania rośnie nie tylko wraz z wiekiem, ze zmniejszaniem się masy kostnej, lecz także w następstwie fizjologicznych zmian pozaszkieletowych dotyczących układu nerwowo-mięśniowego.

EN

In the examinations of bones and joints injuries in elderly people the main reasons of the risk of collapse and fractures, including involution processes, are analysed. The body involution processes may lead to the loss of the stability of the body, lower muscular power and mobility of joints, lower density of bones tissue. The aim of the current work is the analysis of some aspects of fractures risk and their frequency in adult and elderly women. In the study 193 women were examined. They were divided into three groups according to the age: 1st group consisted women aged 50 (N = 46, mean of age - 55,6 ± 3,1), 2nd group - women aged 60 (N = 90, mean of age - 64,8 ± 2,9), 3rd group - women aged 70 (N = 57, mean of age - 74,9 ± 3,2). Basic somatic traits (body height and weight), densitometry using EXA-3000 apparatus, isometric muscular force of knee joint using multifunctional rehabilitation-diagnostic armchair and body balance using ACCU GAIT platform, were measured. Characteristic changes in somatic features like decrease in the body height and increase of BMI, were observed. Decrease of bone mass density, as well as the muscles power of flexion and extension in knee joints, was demonstrated. The vertical stability parameters (area and path length of the stabilogram) increase with the age. There is a correlation between above mentioned parameters and the person age. The questionnaire analysis revealed the fractures tendency in the three groups of women, respectively of 20, 28 and 35%. The performed examination proved that the risk of fractures is positively correlated not only with the age and the decrease of bone mass, but also with the physiological changes in the neuro-muscular system.

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Problems specific to the postreproductive stage of human life in the aging society

Togawa T.

Biocybernetics and Biomedical Engineering

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2007

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Vol. 27, no. 1-2

15-25

EN

The average human life span has significantly increased in majority of developed countries since the latter half of the last century. As a consequence, people can expect to enjoy life for longer than before. However, many problems have emerged in aging societies, making later life more difficult. It is obvious that an aging population causes economic problems such as the difficulty of maintaining pension and medical insurance systems. While such problems are serious and will not be solved easily, more serious and essential problems have emerged because of the changes in social and cultural environments of elderly people. The elderly are now so common that they are not as respected as they once were in former days. They no longer carry the social prestige of wise leaders. Lifestyle changes are occurring so rapidly that the elderly cannot effectively utilize their own experiences, and they experience difficulties adapting to the latest way of life. Cultural maturity, by which the elderly can comfortably spend their later life, might be expected. However, the decline of physical function in the postreproductive stage of life due to aging seriously restricts their activities. In this paper, problems that have emerged in the postreproductive stage of human life in an aging society are discussed from biological and cultural points of view.