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Improving Walking in Individuals with Parkinson's Disease through Wearable Technology.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Improving Walking in Individuals with Parkinson's Disease through Wearable Technology./
作者:	Thompson, Elizabeth D.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2018,
面頁冊數:	133 p.
附註:	Source: Dissertations Abstracts International, Volume: 80-07, Section: B.
Contained By:	Dissertations Abstracts International80-07B.
標題:	Physical therapy. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10936360
ISBN:	9780438802384

Improving Walking in Individuals with Parkinson's Disease through Wearable Technology.
Thompson, Elizabeth D.

Improving Walking in Individuals with Parkinson's Disease through Wearable Technology. - Ann Arbor : ProQuest Dissertations & Theses, 2018 - 133 p.

Source: Dissertations Abstracts International, Volume: 80-07, Section: B.

Thesis (Ph.D.)--Temple University, 2018.

This item must not be sold to any third party vendors.

Movement problems related to Parkinson's disease (PD) have been shown to have a profound effect on functional independence and reported quality of life. Within the constellation of movement signs of PD (tremor, muscle rigidity, bradykinesia/hypokinesia, and postural instability), impaired arm swing is often the earliest-recognized symptom. It is also a strong independent predictor of greater fall risk and morbidity/mortality risk. Early treatment for movement problems such as impaired arm swing is associated with the greatest improvement in these impairments. However, movement problems often coincide with impaired processing of sensory information, leaving many people with PD with inadequate awareness of their posture and limb position. Thus, PD-related gait deficits are difficult for people to correct by themselves. External cueing techniques (such as visual cues in the environment or auditory cues for pacing and rhythm) have shown promise in improving parameters such as gait speed, step length, and freezing incidence for people with PD. To date, techniques such as these have not been applied to improving arm swing. Considering the prevalence of arm swing deficits and their strong association with global function, arm swing provides a compelling target for external cueing strategies that may help normalize movement patterns in individuals with PD. Therefore, the primary objective of this project was to determine how cues for increased arm swing may affect gait parameters within a single session of training, as well as after a longer training period with arm swing cues. This series of studies included work involving neurotypical young volunteers, multiple groups of individuals with Parkinson's disease, and neurotypical volunteers age-matched to the volunteers with Parkinson's disease. Arm swing cues for all studies were delivered using a novel wireless wrist-worn device developed by our group (ArmSense, patented) to measure arm swing and deliver cues for larger, more mechanically normal movement. All studies involved an assessment of baseline walking parameters, training with individualized arm swing cues (or dose-matched walking without cues), and a post-training assessment. Gait parameters of interest included gait velocity, cadence, step length, lateral trunk sway, anterior-posterior trunk sway, interlimb coordination, and surface electromyography (sEMG) characteristics of muscle activation in the anterior deltoid, posterior deltoid, gluteus medius, gastrocnemius (medial head), and peroneus longus. In addition to gait parameters, one study (Chapter 5) involved a month-long training program and measured volunteers at the beginning and end on the Activities-specific Balance Confidence Scale (ABC), the Functional Gait Assessment (FGA), the Timed Up-and-Go (TUG), and the 39-item Parkinson's Disease Questionnaire (PDQ-39). Chapter 2 provides results of single-session testing of ArmSense in young neurotypical adults. Ten volunteers participated in this study as a single group, wore an ArmSense device on each wrist, and walked at comfortable speed. Walking before ArmSense training was assessed both on a 20-foot walkway and on a self-paced treadmill. Subjects were then provided with individualized arm swing targets in the form of vibratory cues elicited when their anterior arm swing amplitude reached 120% of baseline amplitude. They completed a bout of treadmill walking with the cues in place, instructed only to swing each arm high enough on each step that they got the vibratory feedback. After treadmill training, subjects completed post-test over-ground and treadmill walking bouts with no cues. As a group, subjects were able to respond to the arm swing cues and showed several changes to their gait pattern with arm swing feedback, including faster walking, increased step length and postural extension, and increased activity in the anterior deltoids and peroneus longii bilaterally. Velocity, step length, and arm swing amplitude remained significantly above baseline during the post-test conditions. Changes across multiple body segments are of note since the only instruction the subjects were given was to "try to swing your arm enough to feel the vibration on every swing." This study, though a preliminary proof-of-concept for the ArmSense device, demonstrates that multisegment changes in kinematics and muscle activation can be elicited in young neurotypical individuals solely through cues for a larger arm swing. Chapter 3 provides results of single-session testing of ArmSense versus floor-based visual cues in a cohort of individuals with PD. Twelve individuals with PD participated as a single group, wore an ArmSense device on each wrist and walked under five conditions: baseline, visual cues, retention of visual cues (no cues), ArmSense cues, and retention of ArmSense cues (no cues). A balanced crossover design was used (half of the subjects received the visual cue and retention conditions before ArmSense, while half received the ArmSense cue and retention conditions first). (Abstract shortened by ProQuest.).

ISBN: 9780438802384Subjects--Topical Terms:

588713
Physical therapy.
Subjects--Index Terms:

Arm swing

Improving Walking in Individuals with Parkinson's Disease through Wearable Technology.
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520 $a Movement problems related to Parkinson's disease (PD) have been shown to have a profound effect on functional independence and reported quality of life. Within the constellation of movement signs of PD (tremor, muscle rigidity, bradykinesia/hypokinesia, and postural instability), impaired arm swing is often the earliest-recognized symptom. It is also a strong independent predictor of greater fall risk and morbidity/mortality risk. Early treatment for movement problems such as impaired arm swing is associated with the greatest improvement in these impairments. However, movement problems often coincide with impaired processing of sensory information, leaving many people with PD with inadequate awareness of their posture and limb position. Thus, PD-related gait deficits are difficult for people to correct by themselves. External cueing techniques (such as visual cues in the environment or auditory cues for pacing and rhythm) have shown promise in improving parameters such as gait speed, step length, and freezing incidence for people with PD. To date, techniques such as these have not been applied to improving arm swing. Considering the prevalence of arm swing deficits and their strong association with global function, arm swing provides a compelling target for external cueing strategies that may help normalize movement patterns in individuals with PD. Therefore, the primary objective of this project was to determine how cues for increased arm swing may affect gait parameters within a single session of training, as well as after a longer training period with arm swing cues. This series of studies included work involving neurotypical young volunteers, multiple groups of individuals with Parkinson's disease, and neurotypical volunteers age-matched to the volunteers with Parkinson's disease. Arm swing cues for all studies were delivered using a novel wireless wrist-worn device developed by our group (ArmSense, patented) to measure arm swing and deliver cues for larger, more mechanically normal movement. All studies involved an assessment of baseline walking parameters, training with individualized arm swing cues (or dose-matched walking without cues), and a post-training assessment. Gait parameters of interest included gait velocity, cadence, step length, lateral trunk sway, anterior-posterior trunk sway, interlimb coordination, and surface electromyography (sEMG) characteristics of muscle activation in the anterior deltoid, posterior deltoid, gluteus medius, gastrocnemius (medial head), and peroneus longus. In addition to gait parameters, one study (Chapter 5) involved a month-long training program and measured volunteers at the beginning and end on the Activities-specific Balance Confidence Scale (ABC), the Functional Gait Assessment (FGA), the Timed Up-and-Go (TUG), and the 39-item Parkinson's Disease Questionnaire (PDQ-39). Chapter 2 provides results of single-session testing of ArmSense in young neurotypical adults. Ten volunteers participated in this study as a single group, wore an ArmSense device on each wrist, and walked at comfortable speed. Walking before ArmSense training was assessed both on a 20-foot walkway and on a self-paced treadmill. Subjects were then provided with individualized arm swing targets in the form of vibratory cues elicited when their anterior arm swing amplitude reached 120% of baseline amplitude. They completed a bout of treadmill walking with the cues in place, instructed only to swing each arm high enough on each step that they got the vibratory feedback. After treadmill training, subjects completed post-test over-ground and treadmill walking bouts with no cues. As a group, subjects were able to respond to the arm swing cues and showed several changes to their gait pattern with arm swing feedback, including faster walking, increased step length and postural extension, and increased activity in the anterior deltoids and peroneus longii bilaterally. Velocity, step length, and arm swing amplitude remained significantly above baseline during the post-test conditions. Changes across multiple body segments are of note since the only instruction the subjects were given was to "try to swing your arm enough to feel the vibration on every swing." This study, though a preliminary proof-of-concept for the ArmSense device, demonstrates that multisegment changes in kinematics and muscle activation can be elicited in young neurotypical individuals solely through cues for a larger arm swing. Chapter 3 provides results of single-session testing of ArmSense versus floor-based visual cues in a cohort of individuals with PD. Twelve individuals with PD participated as a single group, wore an ArmSense device on each wrist and walked under five conditions: baseline, visual cues, retention of visual cues (no cues), ArmSense cues, and retention of ArmSense cues (no cues). A balanced crossover design was used (half of the subjects received the visual cue and retention conditions before ArmSense, while half received the ArmSense cue and retention conditions first). (Abstract shortened by ProQuest.).
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