Cognitive parameters can predict change of walking performance in advanced Parkinson's disease - Chances and limits of early rehabilitation.
Introduction: Links between cognition and walking performance in patients with Parkinson's disease (PD), which both decline with disease progression, are well known. There is lack of knowledge regarding the predictive value of cognition for changes in walking performance after individualized therapy...
| Publicado en: | Frontiers in Aging Neuroscience Vol. 14; pp. 1 - 18 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Frontiers Media S.A.
12/22/2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=161171221&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 161171221 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16634365 BG2U jtl: Frontiers in Aging Neuroscience issn: 16634365 maglogo: N pubinfo: dt: 12/22/2022 vid: 14 pid: 40038 pub: Frontiers Media S.A. artinfo: ui: 161171221 161171221 161171221 10.3389/fnagi.2022.1070093 161171221 ppf: 1 ppct: 17 formats: tig: atl: Cognitive parameters can predict change of walking performance in advanced Parkinson's disease - Chances and limits of early rehabilitation. aug: au: Geritz, Johanna Welzel, Julius Hansen, Clint Maetzler, Corina Hobert, Markus A. Elshehabi, Morad Knacke, Henrike Aleknonytė-Resch, Milda Kudelka, Jennifer Bunzeck, Nico Maetzler, Walter affil: Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany sug: subj: Parkinson Disease Prognosis Walking Physiology Parkinson Disease Rehabilitation Rehabilitation, Geriatric Task Performance and Analysis Affective Symptoms Physiopathology Cognition Disorders Physiopathology Human Inpatients Depression Risk Factors Accidental Falls Risk Factors Regression Descriptive Statistics Wearable Sensors Aged Neuropsychological Tests Aged: 65+ years ab: Introduction: Links between cognition and walking performance in patients with Parkinson's disease (PD), which both decline with disease progression, are well known. There is lack of knowledge regarding the predictive value of cognition for changes in walking performance after individualized therapy. The aim of this study is to identify relevant predictive cognitive and affective parameters, measurable in daily clinical routines, for change in quantitative walking performance after early geriatric rehabilitation. Methods: Forty-seven acutely hospitalized patients with advanced PD were assessed at baseline (T1) and at the end (T2) of a 2-week early rehabilitative geriatric complex treatment (ERGCT). Global cognitive performance (Montreal Cognitive Assessment, MoCA), EF and divided attention (Trail Making Test B minus A, delta TMT), depressive symptoms, and fear of falling were assessed at T1. Change in walking performance was determined by the difference in quantitative walking parameters extracted from a sensor-based movement analysis over 20 m straight walking in single (ST, fast and normal pace) and dual task (DT, with secondary cognitive, respectively, motor task) conditions between T1 and T2. Bayesian regression (using Bayes Factor BF10) and multiple linear regression models were used to determine the association of nonmotor characteristics for change in walking performance. Results: Under ST, there was moderate evidence (BF10 = 7.8, respectively, BF10 = 4.4) that lower performance in the ΔTMT at baseline is associated with lower reduction of step time asymmetry after treatment (R2 adj = 0.26, p ≤ 0.008, respectively, R2 adj = 0.18, p ≤ 0.009). Under DT walking-cognitive, there was strong evidence (BF10 = 29.9, respectively, BF10 = 27.9) that lower performance in the ΔTMT is associated with more reduced stride time and double limb support (R2 adj = 0.62, p ≤ 0.002, respectively, R2 adj = 0.51, p ≤ 0.009). There was moderate evidence (BF10 = 5.1) that a higher MoCA total score was associated with increased gait speed after treatment (R2 adj = 0.30, p ≤ 0.02). Discussion: Our results indicate that the effect of ERGT on change in walking performance is limited for patients with deficits in EF and divided attention. However, these patients also seem to walk more cautiously after treatment in walking situations with additional cognitive demand. Therefore, future development of individualized treatment algorithms is required, which address individual needs of these vulnerable patients. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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