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  • 1
    Online Resource
    Online Resource
    World guidelines for falls prevention and management for older adults: a global initiative
    Oxford University Press (OUP) ; 2022
    In:  Age and Ageing Vol. 51, No. 9 ( 2022-09-02)
    Details
    In: Age and Ageing, Oxford University Press (OUP), Vol. 51, No. 9 ( 2022-09-02)
    Abstract: falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. Objectives to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries. Methods a steering committee and a worldwide multidisciplinary group of experts and stakeholders, including older adults, were assembled. Geriatrics and gerontological societies were represented. Using a modified Delphi process, recommendations from 11 topic-specific working groups (WGs), 10 ad-hoc WGs and a WG dealing with the perspectives of older adults were reviewed and refined. The final recommendations were determined by voting. Recommendations all older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for community-dwelling older adults. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations. Conclusions the core set of recommendations provided will require flexible implementation strategies that consider both local context and resources.
    Type of Medium: Online Resource
    ISSN: 0002-0729 , 1468-2834
    URL: Article
    DOI: 10.1093/ageing/afac205
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2065766-3
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  • 2
    Online Resource
    Online Resource
    Towards understanding neural network signatures of motor skill learning in Parkinson’s disease and healthy aging
    British Institute of Radiology ; 2019
    In:  The British Journal of Radiology Vol. 92, No. 1101 ( 2019-09), p. 20190071-
    Details
    In: The British Journal of Radiology, British Institute of Radiology, Vol. 92, No. 1101 ( 2019-09), p. 20190071-
    Abstract: In the past decade, neurorehabilitation has been shown to be an effective therapeutic supplement for patients with Parkinson’s disease (PD). However, patients still experience severe problems with the consolidation of learned motor skills. Knowledge on the neural correlates underlying this process is thus essential to optimize rehabilitation for PD. This review investigates the existing studies on neural network connectivity changes in relation to motor learning in healthy aging and PD and critically evaluates the imaging methods used from a methodological point of view. The results indicate that despite neurodegeneration there is still potential to modify connectivity within and between motor and cognitive networks in response to motor training, although these alterations largely bypass the most affected regions in PD. However, so far training-related changes are inferred and possible relationships are not substantiated by brain–behavior correlations. Furthermore, the studies included suffer from many methodological drawbacks. This review also highlights the potential for using neural network measures as predictors for the response to rehabilitation, mainly based on work in young healthy adults. We speculate that future approaches, including graph theory and multimodal neuroimaging, may be more sensitive than brain activation patterns and model-based connectivity maps to capture the effects of motor learning. Overall, this review suggests that methodological developments in neuroimaging will eventually provide more detailed knowledge on how neural networks are modified by training, thereby paving the way for optimized neurorehabilitation for patients.
    Type of Medium: Online Resource
    ISSN: 0007-1285 , 1748-880X
    URL: Article
    DOI: 10.1259/bjr.20190071
    RVK:
    XA 34700
    Language: English
    Publisher: British Institute of Radiology
    Publication Date: 2019
    detail.hit.zdb_id: 1468548-6
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  • 3
    Online Resource
    Online Resource
    External Cueing Improves Motor Imagery Quality in Patients With Parkinson Disease
    SAGE Publications ; 2012
    In:  Neurorehabilitation and Neural Repair Vol. 26, No. 1 ( 2012-01), p. 27-35
    Details
    In: Neurorehabilitation and Neural Repair, SAGE Publications, Vol. 26, No. 1 ( 2012-01), p. 27-35
    Abstract: Background. Patients with Parkinson disease (PD) are often profoundly slow in their performance of physical tasks, as well as in motor imagery (MI). This may limit the implementation and potential benefits of MI practice during rehabilitation. Objective. The authors investigated whether the quality of MI could be improved by external cueing. Methods. Fourteen patients with PD and 14 healthy controls physically executed and visually imagined a goal-directed aiming task and a box-and-block task, both in the presence and absence of visual and auditory cues. Mental chronometry and eye movement recording allowed objective evaluation of the temporal and spatial characteristics of MI when compared with physical execution. Visual analogue scales were used to assess imagery vividness. Results. The presence of visual cues significantly reduced the patients’ bradykinesia during MI and increased their imagery vividness. Conclusions. Visual cueing optimizes MI quality for PD patients and is a potential tool to increase the efficacy of MI practice in PD rehabilitation.
    Type of Medium: Online Resource
    ISSN: 1545-9683 , 1552-6844
    URL: Article
    DOI: 10.1177/1545968311411055
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
    detail.hit.zdb_id: 2100545-X
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  • 4
    Online Resource
    Online Resource
    Comparison of the Effect of Two Driving Retraining Programs on On-Road Performance After Stroke
    SAGE Publications ; 2009
    In:  Neurorehabilitation and Neural Repair Vol. 23, No. 7 ( 2009-09), p. 699-705
    Details
    In: Neurorehabilitation and Neural Repair, SAGE Publications, Vol. 23, No. 7 ( 2009-09), p. 699-705
    Abstract: Background. Several driving retraining programs have been developed to improve driving skills after stroke. Those programs rely on different rehabilitation concepts. Objectives. The current study sought to examine the specific carryover effect of driving skills of a comprehensive training program in a driving simulator when compared with a cognitive training program. Methods. Further analysis from a previous randomized controlled trial that investigated the effect of simulator training on driving after stroke. Forty-two participants received simulator-based driving training, whereas 41 participants received cognitive training for 15 hours. Overall performance in the on-road test and each of its 13 items were compared between groups immediately posttraining and at 6 months poststroke. Results. Generalized estimating equation analysis showed that the total score on the on-road test and each item score improved significantly over time for both groups. Those who received driving simulator training achieved better results when compared with the cognitive training group in the overall on-road score and the items of anticipation and perception of signs, visual behavior and communication, quality of traffic participation, and turning left. Most of the differences in improvement between the 2 interventions were observed at 6 months poststroke. Conclusions . Contextual training in a driving simulator appeared to be superior to cognitive training to treat impaired on-road driving skills after stroke. The effects were primarily seen in visuointegrative driving skills. Our results favor the implementation of driving simulator therapy in the conventional rehabilitation program of subacute stroke patients with mild deficits.
    Type of Medium: Online Resource
    ISSN: 1545-9683 , 1552-6844
    URL: Article
    DOI: 10.1177/1545968309334208
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2100545-X
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  • 5
    Online Resource
    Online Resource
    Freezing of Gait in Parkinson Disease Is Associated With Impaired Conflict Resolution
    SAGE Publications ; 2011
    In:  Neurorehabilitation and Neural Repair Vol. 25, No. 8 ( 2011-10), p. 765-773
    Details
    In: Neurorehabilitation and Neural Repair, SAGE Publications, Vol. 25, No. 8 ( 2011-10), p. 765-773
    Abstract: Background. Freezing of gait (FOG) in Parkinson disease (PD) may involve executive dysfunction. This study examined whether executive functioning and attention are more affected in patients with FOG compared with those without and determined whether these processes are influenced by anti-Parkinson medication. Methods. A total of 11 PD patients with FOG, 11 without FOG, and 10 healthy control subjects, matched for age, gender, and education, participated. General motor, mental and cognitive screening tests, as well as specific neuropsychological assessment of executive functions and the Attention Network Test (ANT) were administered. The ANT was conducted in both ON and OFF phases in a counterbalanced design to determine medication-specific effects. Results. FOG showed a clear association with impairment in the executive control network for conflict resolution (inhibition of unwanted responses and impaired response selection), compared with nonfreezers and healthy controls, F(2, 28) = 5.41, P = .01. Orienting and alerting function did not differ between groups, F 〈 1. Other executive functions, such as abstract problem solving and mental flexibility were not associated with FOG ( P 〉 .10). Anti-Parkinson medication did not ameliorate conflict resolution ( P 〉 .10), although orienting attention improved with medication, F(1, 17) = 9.81, P 〈 .01. Conclusions. This study shows an association between impaired conflict resolution and FOG, important in understanding the interplay between cognitive and motor problems, which can lead to specific rehabilitation strategies.
    Type of Medium: Online Resource
    ISSN: 1545-9683 , 1552-6844
    URL: Article
    DOI: 10.1177/1545968311403493
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2100545-X
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  • 6
    Online Resource
    Online Resource
    Freezing of gait: moving forward on a mysterious clinical phenomenon
    Elsevier BV ; 2011
    In:  The Lancet Neurology Vol. 10, No. 8 ( 2011-08), p. 734-744
    Details
    In: The Lancet Neurology, Elsevier BV, Vol. 10, No. 8 ( 2011-08), p. 734-744
    Type of Medium: Online Resource
    ISSN: 1474-4422
    URL: Article
    DOI: 10.1016/S1474-4422(11)70143-0
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2011
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  • 7
    Online Resource
    Online Resource
    Freezing of gait and levodopa
    Elsevier BV ; 2021
    In:  The Lancet Neurology Vol. 20, No. 7 ( 2021-07), p. 505-506
    Details
    In: The Lancet Neurology, Elsevier BV, Vol. 20, No. 7 ( 2021-07), p. 505-506
    Type of Medium: Online Resource
    ISSN: 1474-4422
    URL: Article
    DOI: 10.1016/S1474-4422(21)00175-7
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
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  • 8
    Online Resource
    Online Resource
    The hemiplegic arm: Interrater reliability and concurrent validity of passive range of motion measurements
    Informa UK Limited ; 2007
    In:  Disability and Rehabilitation Vol. 29, No. 18 ( 2007-01), p. 1442-1448
    Details
    In: Disability and Rehabilitation, Informa UK Limited, Vol. 29, No. 18 ( 2007-01), p. 1442-1448
    Type of Medium: Online Resource
    ISSN: 0963-8288 , 1464-5165
    URL: Article
    DOI: 10.1080/09638280601056145
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2007
    detail.hit.zdb_id: 1475605-5
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  • 9
    Online Resource
    Online Resource
    Multicentre, randomised controlled trial of PDSAFE, a physiotherapist-delivered fall prevention programme for people with Parkinson’s
    BMJ ; 2019
    In:  Journal of Neurology, Neurosurgery & Psychiatry Vol. 90, No. 7 ( 2019-07), p. 774-782
    Details
    In: Journal of Neurology, Neurosurgery & Psychiatry, BMJ, Vol. 90, No. 7 ( 2019-07), p. 774-782
    Abstract: To estimate the effect of a physiotherapist-delivered fall prevention programme for people with Parkinson’s (PwP). Methods People at risk of falls with confirmed Parkinson’s were recruited to this multicentre, pragmatic, investigator blind, individually randomised controlled trial with prespecified subgroup analyses. 474 PwP (Hoehn and Yahr 1–4) were randomised: 238 allocated to a physiotherapy programme and 236 to control. All participants had routine care; the control group received a DVD about Parkinson’s and single advice session at trial completion. The intervention group (PDSAFE) had an individually tailored, progressive home-based fall avoidance strategy training programme with balance and strengthening exercises. The primary outcome was risk of repeat falling, collected by self-report monthly diaries, 0–6 months after randomisation. Secondary outcomes included Mini-BESTest for balance, chair stand test, falls efficacy, freezing of gait, health-related quality of life (EuroQol EQ-5D), Geriatric Depression Scale, Physical Activity Scale for the Elderly and Parkinson’s Disease Questionnaire, fractures and rate of near falling. Results Average age is 72 years and 266 (56%) were men. By 6 months, 116 (55%) of the control group and 125 (61.5%) of the intervention group reported repeat falls (controlled OR 1.21, 95% CI 0.74 to 1.98, p=0.447). Secondary subgroup analyses suggested a different response to the intervention between moderate and severe disease severity groups. Balance, falls efficacy and chair stand time improved with near falls reduced in the intervention arm. Conclusion PDSAFE did not reduce falling in this pragmatic trial of PwP. Other functional tasks improved and reduced fall rates were apparent among those with moderate disease. Trial registration number ISRCTN48152791 .
    Type of Medium: Online Resource
    ISSN: 0022-3050 , 1468-330X
    URL: Article
    DOI: 10.1136/jnnp-2018-319448
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 1480429-3
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  • 10
    Online Resource
    Online Resource
    Digital Mobility Measures: A Window into Real‐World Severity and Progression of Parkinson's Disease
    Wiley ; 2024
    In:  Movement Disorders Vol. 39, No. 2 ( 2024-02), p. 328-338
    Details
    In: Movement Disorders, Wiley, Vol. 39, No. 2 ( 2024-02), p. 328-338
    Abstract: Real‐world monitoring using wearable sensors has enormous potential for assessing disease severity and symptoms among persons with Parkinson's disease (PD). Many distinct features can be extracted, reflecting multiple mobility domains. However, it is unclear which digital measures are related to PD severity and are sensitive to disease progression. Objectives The aim was to identify real‐world mobility measures that reflect PD severity and show discriminant ability and sensitivity to disease progression, compared to the Movement Disorder Society‐Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) scale. Methods Multicenter real‐world continuous (24/7) digital mobility data from 587 persons with PD and 68 matched healthy controls were collected using an accelerometer adhered to the lower back. Machine learning feature selection and regression algorithms evaluated associations of the digital measures using the MDS‐UPDRS (I–III). Binary logistic regression assessed discriminatory value using controls, and longitudinal observational data from a subgroup (n = 33) evaluated sensitivity to change over time. Results Digital measures were only moderately correlated with the MDS‐UPDRS (part II‐r = 0.60 and parts I and III‐r = 0.50). Most associated measures reflected activity quantity and distribution patterns. A model with 14 digital measures accurately distinguished recently diagnosed persons with PD from healthy controls (81.1%, area under the curve: 0.87); digital measures showed larger effect sizes (Cohen's d: [0.19–0.66]), for change over time than any of the MDS‐UPDRS parts (Cohen's d: [0.04–0.12] ). Conclusions Real‐world mobility measures are moderately associated with clinical assessments, suggesting that they capture different aspects of motor capacity and function. Digital mobility measures are sensitive to early‐stage disease and to disease progression, to a larger degree than conventional clinical assessments, demonstrating their utility, primarily for clinical trials but ultimately also for clinical care. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
    Type of Medium: Online Resource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    URL: Article
    DOI: 10.1002/mds.v39.2
    DOI: 10.1002/mds.29689
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2041249-6
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