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Ataxia or Gait Instability

WeiJing Zhao, Hong You, Shangrong Jiang, Hongxia Zhang, Yanling Yang, Min Zhang
Due to the indistinct nature of symptoms for Cerebral Small Vessel Disease (CSVD), diagnosis is often missed. With significant deterioration of movement disorder, risk of falls increases dramatically.Comparison study was conducted to explore the association between balance function and gait instability, and the treatment effectiveness of visual feedback balance training on the gait disorder in CSVD patients.Fifty-six patients with CSVD were studied. They were randomly divided into observation and control groups, and were given conventional gait rehabilitation training, including single-leg weight, shift of the center of gravity, step and hip extension training, stepping up and down on stairs with the affected leg, standing up with hip extension and support of the leg, lateral walking, and in situ walking...
February 2019: Medicine (Baltimore)
Felipe J Núñez, Flor M Mendez, Padma Kadiyala, Mahmoud S Alghamri, Masha G Savelieff, Maria B Garcia-Fabiani, Santiago Haase, Carl Koschmann, Anda-Alexandra Calinescu, Neha Kamran, Meghna Saxena, Rohin Patel, Stephen Carney, Marissa Z Guo, Marta Edwards, Mats Ljungman, Tingting Qin, Maureen A Sartor, Rebecca Tagett, Sriram Venneti, Jacqueline Brosnan-Cashman, Alan Meeker, Vera Gorbunova, Lili Zhao, Daniel M Kremer, Li Zhang, Costas A Lyssiotis, Lindsey Jones, Cameron J Herting, James L Ross, Dolores Hambardzumyan, Shawn Hervey-Jumper, Maria E Figueroa, Pedro R Lowenstein, Maria G Castro
Patients with glioma whose tumors carry a mutation in isocitrate dehydrogenase 1 (IDH1R132H ) are younger at diagnosis and live longer. IDH1 mutations co-occur with other molecular lesions, such as 1p/19q codeletion, inactivating mutations in the tumor suppressor protein 53 (TP53 ) gene, and loss-of-function mutations in alpha thalassemia/mental retardation syndrome X-linked gene ( ATRX ). All adult low-grade gliomas (LGGs) harboring ATRX loss also express the IDH1R132H mutation. The current molecular classification of LGGs is based, partly, on the distribution of these mutations...
February 13, 2019: Science Translational Medicine
Ho-Jin Shin, Sung-Hyeon Kim, Eun-Tae Jeon, Min-Goo Lee, Sung Jae Lee, Hwi-Young Cho
BACKGROUND: Chronic ankle instability (CAI) is a common disease following ankle sprain and appears balance and gait problems, pain, and fatigue. This study aimed to examine the effect of therapeutic exercise performed on sea sand on pain, fatigue, and balance ability in patients with CAI. METHODS: This study was designed as a randomized controlled trial. Subjects with a Cumberland Ankle Instability Tool (CAIT) score of less than 27 were selected. 22 subjects were randomly assigned to the sea sand (SS) group (n=11) or the self-management (SM) group (n=11)...
February 12, 2019: Journal of Sports Medicine and Physical Fitness
Rachel L Usala, Stephen J Fernandez, Mihriye Mete, Nawar M Shara, Joseph G Verbalis
Context: Patients with diabetes mellitus are at increased risk for bone fragility fracture secondary to multiple mechanisms. Hyperglycemia can induce true dilutional hyponatremia. Hyponatremia is associated with gait instability, osteoporosis, and increased falls and bone fractures, and studies suggest that compromised bone quality with hyponatremia may be independent of plasma osmolality. We performed a case-control study of patients with diabetes mellitus matched by median glycated hemoglobin (HbA1c) to assess whether hyponatremia was associated with increased risk of osteoporosis and/or fragility fracture...
February 1, 2019: Journal of the Endocrine Society
Denise Anastasi, Ilaria Carpinella, Elisa Gervasoni, Patricia N Matsuda, Gabriele Bovi, Maurizio Ferrarin, Davide Cattaneo
BACKGROUND: Gait instability is common in adults with neurological disorders and the modified Dynamic Gait Index (mDGI) was recently introduced to assess dynamic balance. However, instrumental assessment is needed to provide quantitative measures. OBJECTIVE: to develop and validate an instrumented version of the mDGI. DESIGN: cross sectional study. SETTING: clinical setting PARTICIPANTS: 30 adults with neurological disorders (10 with multiple sclerosis, 10 with Parkinson disease and 10 with stroke) and 20 healthy volunteers...
February 8, 2019: PM & R: the Journal of Injury, Function, and Rehabilitation
Janina A Müßig, Torsten Brauner, Inga Kröger, Patrick A Varady, Andreas Brand, Isabella Klöpfer-Krämer, Stefan Simmel, Thomas Horstmann, Peter Augat
Gait variability is often associated with reduced coordination and increased instability during walking. Especially for patients with musculoskeletal conditions, variability in gait might be associated with the level of daily activity. Therefore, this study examines kinematic variability during walking and the association with daily activity in patients with transfemoral amputation. Therefore, 15 transfemoral amputees, using the C-leg prosthesis of Otto Bock, between 18 and 65 years were recruited during their hospital stay...
February 4, 2019: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Heiko Gaßner, Cecilia Raccagni, Bjoern M Eskofier, Jochen Klucken, Gregor K Wenning
Background: Differentiating idiopathic Parkinson's disease (IPD) from atypical Parkinsonian disorders (APD) is challenging, especially in early disease stages. Postural instability and gait difficulty (PIGD) are substantial motor impairments of IPD and APD. Clinical evidence implies that patients with APD have larger PIGD impairment than IPD patients. Sensor-based gait analysis as instrumented bedside test revealed more gait deficits in APD compared to IPD. However, the diagnostic value of instrumented bedside tests compared to clinical assessments in differentiating APD from IPD patients have not been evaluated so far...
2019: Frontiers in Neurology
Nicolaas I Bohnen, Prabesh Kanel, Zhi Zhou, Robert A Koeppe, Kirk A Frey, William T Dauer, Roger L Albin, Martijn L T M Müller
OBJECTIVE: Postural instability and gait difficulties (PIGD) represent debilitating disturbances in Parkinson's disease (PD). Prior acetylcholinesterase PET imaging studies implicate cholinergic changes as significant contributors to PIGD features. These studies were limited in quantification of striatal cholinergic synapse integrity. Vesicular acetylcholine transporter (VAChT) PET ligands are better suited for evaluation of high binding areas. We examined associations between regional VAChT expression and freezing of gait (FoG) and falls...
February 5, 2019: Annals of Neurology
Carrie Johnson, Shaun Mohan
No abstract text is available yet for this article.
February 2019: Pediatrics in Review
Rory Durcan, Louise Wiblin, Rachael A Lawson, Tien K Khoo, Alison J Yarnall, Gordon W Duncan, David J Brooks, Nicola Pavese, David J Burn
BACKGROUND: The prevalence and duration of NMS in prodromal PD has not been extensively studied. The aim of this study was to determine the prevalence and duration of prodromal NMS (pNMS) in a cohort of recently diagnosed PD patients. METHODS: We evaluated the prevalence and duration of prodromal NMS in early PD patients (n= 154). NMS were screened for using the Nonmotor Symptom Questionnaire (NMS Quest). We subtracted the duration of the presence of each individual NMS reported from the duration of earliest motor symptom...
January 31, 2019: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Natasha Aparecida Grande de França, Lavanya Srinivasa Murthy, Steven Phu, Elizabeth Liberts, Sara Vogrin, Ligia Araujo Martini, Gustavo Duque
OBJECTIVES: A high level of parathyroid hormone (PTH) was recently identified as a risk factor for falling. As balance instability is one of the major risk factors for falls, we aimed to investigate whether high PTH concentrations are associated with poor balance in older persons. STUDY DESIGN: Cross-sectional study with 127 community-dwelling older adults (75% female), aged 65-96 years, at the Falls and Fracture Clinic, Western Health-Sunshine Hospital, Melbourne, Australia...
March 2019: Maturitas
Sakkadech Limmahakhun, Hayden N Box, Paul Arauz, David W Hennessy, Christian Klemt, Young-Min Kwon
Anterior instability after total hip arthroplasty (THA) has been described in patients with thoracolumbar kyphotic deformity. Although compensatory posterior pelvic tilt with subsequent increased functional anteversion has been described as the mechanism, there is a paucity of in-vivo data. The purpose of our study was to compare pelvic tilt, anteversion, inclination, and position of head-cup contact points in patients with lumbar degenerative disc disease (DDD) and a matched patient cohort without DDD. A total of 50 THA, 18 hips with lumbar DDD and 32 hips without DDD, underwent CT imaging for 3D hip reconstruction...
January 28, 2019: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Wei Zeng, Chengzhi Yuan, Qinghui Wang, Fenglin Liu, Ying Wang
Parkinson's disease (PD) is a common neurodegenerative disorder that affects human's quality of life, especially leading to locomotor deficits such as postural instability and gait disturbances. Gait signal is one of the best features to characterize and detect movement disorders caused by a malfunction in parts of the brain and nervous system of the patients with PD. Various classification approaches using spatiotemporal gait variables have been presented earlier to classify Parkinson's gait. In this study we propose a novel method for gait pattern classification between patients with PD and healthy controls, based upon phase space reconstruction (PSR), empirical mode decomposition (EMD) and neural networks...
January 6, 2019: Neural Networks: the Official Journal of the International Neural Network Society
Alexandre Carneiro Bitar, Caio Oliveira D'Elia, Breno Schor, Jefferson Bertoni, Zan Mustacchi, Patricia Moreno Grangeiro
Introduction: We attended three skeletally immature patients with Down syndrome (DS) with complaints of severe patellofemoral instability and dislocated patella (preoperatively, Dugdale classification IV or V), in addition to low functional capacity, with falls during gait. The technique (lateral release, medial capsulectomy, reconstruction of the medial patellofemoral ligament (MPFL) with the patellar ligament and associated techniques, and some knees) and results in three children with DS and bilaterally dislocated patella were revealed...
July 2018: Journal of Orthopaedic Case Reports
Jung-Ah Lim, Soon-Tae Lee, Jangsup Moon, Jin-Sun Jun, Tae-Joon Kim, Yong-Won Shin, Suhailah Abdullah, Jung-Ick Byun, Jun-Sang Sunwoo, Keun Tae Kim, Tae-Won Yang, Woo-Jin Lee, Hye-Jin Moon, Dong Wook Kim, Byung Chan Lim, Yong Won Cho, Tae-Ho Yang, Hee Jin Kim, Young-Soo Kim, Yong Seo Koo, Byeongsu Park, Keun-Hwa Jung, Manho Kim, Kyung-Il Park, Ki-Young Jung, Kon Chu, Sang Kun Lee
OBJECTIVE: There is no scale for rating the severity of autoimmune encephalitis (AE). In this study, we aimed to develop a novel scale for rating severity in patients with diverse AE syndromes and to verify the reliability and validity of the developed scale. METHODS: The key items were generated by a panel of experts and selected according to content validity ratios. The developed scale was initially applied to 50 patients with AE (development cohort) to evaluate its acceptability, reproducibility, internal consistency, and construct validity...
January 24, 2019: Annals of Neurology
Kirstyn Gardner, Barry J A Laird, Marie T Fallon, Tonje A Sande
INTRODUCTION: Cancer frequently spreads to bone, causing cancer-induced bone pain (CIBP) which affects quality of life. The best treatment is radiotherapy (XRT), but response is variable. The aim of this systematic review was to identify factors that predict analgesic response. MATERIALS AND METHODS: Using PRISMA guidelines, Medline (1946-2018), Embase Classic + Embase (1947-2018) and Cochrane (setup-2018) databases were searched. Eligible studies examined adult patients receiving external beam XRT for CIBP with clinical marker and/or biomarkers evaluated...
January 2019: Critical Reviews in Oncology/hematology
A J M Boulton
A series of clinical research projects conducted over the past 40 years, all of which were informed by clinical observation or discussions with people with diabetes and staff colleagues are described in this review. A study of necrobiosis lipoidica iabeticorum confirmed that this rare skin complication occurs predominantly in young women with Type 1 diabetes and other microvascular complications. Biopsies of necrobiotic lesions showed destruction of superficial nerve fibres by inflammatory tissue, which likely causes the sensory loss in lesions that is pathognomonic of the condition...
January 19, 2019: Diabetic Medicine: a Journal of the British Diabetic Association
Kaan Yagmurlu, Pedro Norat, Min Park, M Yashar S Kalani
This video illustrates the case of a patient with familial cerebral cavernous malformation syndrome with a history of multiple symptomatic hemorrhages attributable to a medullary malformation. The patient had swallowing difficulties and gait instability that was progressively worsening. Informed consent was obtained for surgical exploration. The lesion was noted to abut the floor of the fourth ventricle and was approached using a suboccipital craniotomy. Several safe-entry zones on the floor of the fourth ventricle have been described...
January 10, 2019: Operative Neurosurgery (Hagerstown, Md.)
Chao Zhang, Fei-Xia Zhan, Wo-Tu Tian, Yang-Qi Xu, Ze-Yu Zhu, Yan Wang, Xing-Wang Song, Li Cao
OBJECTIVES: To describe the clinical and genetic features of a Chinese peroxisome biogenesis disorder 6B patient with PEX10 mutations and review PEX10-related peroxisomal disorders. PATIENTS AND METHODS: The proband is a 7-year-old boy with mild mental retardation and gait instability, intention tremor and nystagmus. An extensive clinical and laboratory evaluation including molecular genetic studies was performed. Genomic DNA was extracted from peripheral blood using the standardized phenol/chloroform extraction method, and the coding region of the PEX10 gene was sequenced in three family members...
February 2019: Clinical Neurology and Neurosurgery
Victor Spiandor Beretta, Rodrigo Vitório, Paulo Cezar Rocha Dos Santos, Diego Orcioli-Silva, Lilian Teresa Bucken Gobbi
Different clinical subtypes of Parkinson's disease (PD) have long been recognized. Recent studies have focused on two PD subtypes: Postural Instability and Gait Difficulty (PIGD) and Tremor Dominant (TD). PIGD patients have greater difficulties in postural control in relation to TD. However, knowledge about the differences in reactive adjustment mechanisms following a perturbation in TD and PIGD is limited. This study aimed to compare reactive postural adjustments under unexpected external perturbation in TD, PIGD, and control group (CG) subjects...
January 9, 2019: Human Movement Science
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