المؤلفون: Kotaro Sugimoto, Toshiki Murakami, Akira Ojima, Tetsuju Sekiryu

المصدر: Journal of General and Family Medicine, Vol 25, Iss 3, Pp 154-157 (2024)

مصطلحات موضوعية: gait disorder, medical communication, neurology, others, sensory disorder, weakness, Medicine (General), R5-920

الوصف: Abstract A 38‐year‐old pathologist developed multiple evanescent white dot syndrome (MEWDS). He documented his visual impairment in detail utilizing a light microscope for pathological diagnosis. Notably, the subjective defects illustrated by the patient were in good spatiotemporal agreement with diagnostic outcomes. The present report enhances the understanding of visual impairment associated with MEWDS through a comparative analysis of subjective experiences and objective clinical findings.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2189-7948Test

الوصول الحر: https://doaj.org/article/a9b0c96407dc4c1a9e66942f30409b1cTest

المؤلفون: Tatsurou Doi

المصدر: Romanian Journal of Neurology, Vol 22, Iss 4, Pp 304-307 (2023)

مصطلحات موضوعية: degenerative cervical myelopathy, gait disorder, lower extremities, hyperreflexia, women of older age, Medicine, Neurology. Diseases of the nervous system, RC346-429

الوصف: Background. Degenerative cervical myelopathy (DCM) is poorly recognized and infrequently diagnosed. Objectives. To identify symptoms or signs in the lower extremities physically and radiologically in outpatients with DCM. Methods. In 2023, a retrospective cohort study was performed to review the medical records from 2016 to 2020. A total of 28 (24 women) patients were included. All patients were physically examined. Sagittal magnetic resonance imaging (MRI) of the cervical spinal canal was performed and its anteroposterior diameter was calculated in patients with hyperreflexia and/or gait disorder. Results. Sixteen (13 women) patients presented with symptoms or signs in the lower extremities only (group A) and 12 patients (11 women) presented with those in the upper and lower extremities (group B). The mean [SD] ages were 70.06 [17.49] and 58.67 [11.80] years, respectively. Pseudo-polyneuropathic patterns of sensory dysfunction in the lower extremities were identified in 14 patients (88%) of group A and 11 patients (92%) of group B. Also, 16 patients (100%) of group A and 11 patients (92%) of group B presented with hyperreflexia of the triceps and/or patellar tendons. Sagittal MRI showed a minimum value of stenosis at the C5-6 level in 9 patients (56%) of group A and 7 patients (58%) of group B. The mean [SD] anteroposterior diameters at the most stenotic level in patients of groups A and B were 9.63 [2.02] and 10.17 [1.23] mm, respectively. Conclusion. Hyperreflexia of the triceps and/or patellar tendons is one of the most important neurological findings to suspect DCM.

وصف الملف: electronic resource

العلاقة: https://rjn.com.ro/articles/2023.4/RJN_2023_4_Art-11.pdfTest; https://doaj.org/toc/1843-8148Test; https://doaj.org/toc/2069-6094Test

الوصول الحر: https://doaj.org/article/fb047b4cb93348a29a03fbc370a9a614Test

المؤلفون: Hongyin Tang, Xianglian Liao, Jian Yao, Yilan Xing, Xin Zhao, Weibin Cheng, Tianxiang Gu, Yan Huang, Guang Xu, Ping Luan, Junzhang Tian, Guihua Li

المصدر: Brain and Behavior, Vol 14, Iss 4, Pp n/a-n/a (2024)

مصطلحات موضوعية: Parkinson's disease, postural instability and gait disorder dominant (PIGD), related factors, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571

الوصف: Abstract Background Postural instability and gait disorder dominant (PIGD) is one of the most common disabling symptoms of Parkinson's disease (PD), which seriously affects patients’ quality of life. Therefore, it is essential to identify PIGD and develop targeted interventions to reduce the risk of PIGD in PD patients. Aim: This study aimed to investigate the gait characteristics of PD patients based on wearable devices and to establish a predictive model for their related influencing factors. Methods The retrospective medical records of patients from January 2020 to September 2023 were collected, including 159 patients with PD (divided into PIGD [n = 73] and non‐PIGD [n = 86] groups) and 200 healthy patients (as the healthy control group). Information from social demographic data, a blood test, scale scores, gait analysis based on wearable devices, white matter lesions, and the Fazekas scale was extracted and analyzed. Results Compared with the healthy control group, the mean step length, mean rate, mean angular velocity, and step length were lower in the PD group, while the mean steps were higher in the turning test. The incidence of PIGD was 46% in PD patients, and PD patients with the non‐tremor onset mode were more likely to develop PIGD than those with the tremor onset mode. Compared to the non‐PIGD group, the PIGD group showed more serious gait problems in different experimental tasks and had a higher Hoehn and Yahr (H‐Y) stage, Hamilton Anxiety Scale (HAMA) score, Hamilton Depression Scale score, periventricular white matter (PVWM) score, deep white matter score, and Fazekas scale score, but they had lower hemoglobin levels, D‐dimer levels, Tinetti Balance scores, Tinetti Gait scores, Berg Balance Scale scores, and Mini‐Mental State Examination (MMSE) scores. Logistic regression analysis showed that the MMSE score was negatively correlated with the occurrence of PIGD, while the HAMA score, H‐Y stage, PVWM score, and non‐tremor form of onset were positively correlated with the occurrence of PIGD Conclusion The incidence of gait disorder in PD patients is higher than that in the normal population. Moreover, cognitive dysfunction, anxiety state, H‐Y stage, PVWM score, and the non‐tremor mode of onset can be considered independent risk factors for PIGD.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2162-3279Test

الوصول الحر: https://doaj.org/article/e4cc363050754d6a83b79850ffb87225Test

المؤلفون: Bawa, A, Banitsas, K, Abbod, M

مصطلحات موضوعية: gait disorder, polymyalgia rheumatica, classifiers, pattern

الوصف: Data Availability Statement: Data can be made available upon request to the relevant institution. ; Gait disorder is common among people with neurological disease and musculoskeletal disorders. The detection of gait disorders plays an integral role in designing appropriate rehabilitation protocols. This study presents a clinical gait analysis of patients with polymyalgia rheumatica to determine impaired gait patterns using machine learning models. A clinical gait assessment was conducted at KATH hospital between August and September 2022, and the 25 recruited participants comprised 18 patients and 7 control subjects. The demographics of the participants follow: age 56 years ± 7, height 175 cm ± 8, and weight 82 kg ± 10. Electromyography data were collected from four strained hip muscles of patients, which were the rectus femoris, vastus lateralis, biceps femoris, and semitendinosus. Four classification models were used—namely, support vector machine (SVM), rotation forest (RF), k-nearest neighbors (KNN), and decision tree (DT)—to distinguish the gait patterns for the two groups. SVM recorded the highest accuracy of 85% among the classifiers, while KNN had 75%, RF had 80%, and DT had the lowest accuracy of 70%. Furthermore, the SVM classifier had the highest sensitivity of 92%, while RF had 86%, DT had 90%, and KNN had the lowest sensitivity of 84%. The classifiers achieved significant results in discriminating between the impaired gait pattern of patients with polymyalgia rheumatica and control subjects. This information could be useful for clinicians designing therapeutic exercises and may be used for developing a decision support system for diagnostic purposes. ; This research received no external funding.

وصف الملف: 1 - 15; Electronic

العلاقة: Sensors; ORCiD: Anthony Bawa orcid:0000-0002-0127-4949; ORCiD: Konstantinos Banitsas orcid:0000-0003-2658-3032; ORCiD: Maysam Abbod orcid:0000-0002-8515-7933; 1500; Bawa, A., Banitsas, K. and Abbod, M. (2024) 'A Movement Classification of Polymyalgia Rheumatica Patients Using Myoelectric Sensors', Sensors, 24 (5), 1500, pp. 1 - 15. doi:10.3390/s24051500.; https://bura.brunel.ac.uk/handle/2438/28422Test; https://doi.org/10.3390/s24051500Test

الإتاحة: https://doi.org/10.3390/s24051500Test
https://bura.brunel.ac.uk/handle/2438/28422Test

المؤلفون: Ramtin Pourahmad, Kiarash Saleki, Mohammadreza Esmaili, Arian Abdollahi, Parsa Alijanizadeh, Mehrad Zare Gholinejad, Mohammad Banazadeh, Mona Ahmadi

المصدر: IBRO Neuroscience Reports, Vol 14, Iss , Pp 507-513 (2023)

مصطلحات موضوعية: Deep brain stimulation, Gait disorder, Gait imbalance, Neurosciences, Neurodegeneration, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571

الوصف: Gait deficits are found in various degenerative central nervous system conditions, and are particularly a hallmark of Parkinson’s disease (PD). While there is no cure for such neurodegenerative disorders, Levodopa is considered as the standard medication in PD patients. Often times, the therapy of severe PD consists of deep brain stimulation (DBS) of the subthalamic nucleus. Earlier research exploring the effect of gait have reported contradictory results or insufficient efficacy. A change in gait includes various parameters, such as step length, cadence, Double-stance phase duration which may be positively affected by DBS. DBS could also be effective in correcting the levodopa-induced postural sway abnormalities. Moreover, during normal walking, interaction among the subthalamic nucleus and cortex —essential regions which exert a role in locomotion— are coupled. However, during the freezing of gait, the activity is desynchronized. The mechanisms underlying DBS-induced neurobehavioral improvements in such scenarios requires further study. The present review discusses DBS in the context of gait, the benefits associated with DBS compared to standard pharmacotherapy options, and provides insights into future research.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2667242123000465Test; https://doaj.org/toc/2667-2421Test

الوصول الحر: https://doaj.org/article/4aa29350f4e54c01b5298887ce2532eeTest

المؤلفون: Anthony Bawa, Konstantinos Banitsas, Maysam Abbod

المصدر: Sensors, Vol 24, Iss 5, p 1500 (2024)

مصطلحات موضوعية: gait disorder, polymyalgia rheumatica, classifiers, pattern, Chemical technology, TP1-1185

الوصف: Gait disorder is common among people with neurological disease and musculoskeletal disorders. The detection of gait disorders plays an integral role in designing appropriate rehabilitation protocols. This study presents a clinical gait analysis of patients with polymyalgia rheumatica to determine impaired gait patterns using machine learning models. A clinical gait assessment was conducted at KATH hospital between August and September 2022, and the 25 recruited participants comprised 18 patients and 7 control subjects. The demographics of the participants follow: age 56 years ± 7, height 175 cm ± 8, and weight 82 kg ± 10. Electromyography data were collected from four strained hip muscles of patients, which were the rectus femoris, vastus lateralis, biceps femoris, and semitendinosus. Four classification models were used—namely, support vector machine (SVM), rotation forest (RF), k-nearest neighbors (KNN), and decision tree (DT)—to distinguish the gait patterns for the two groups. SVM recorded the highest accuracy of 85% among the classifiers, while KNN had 75%, RF had 80%, and DT had the lowest accuracy of 70%. Furthermore, the SVM classifier had the highest sensitivity of 92%, while RF had 86%, DT had 90%, and KNN had the lowest sensitivity of 84%. The classifiers achieved significant results in discriminating between the impaired gait pattern of patients with polymyalgia rheumatica and control subjects. This information could be useful for clinicians designing therapeutic exercises and may be used for developing a decision support system for diagnostic purposes.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/1424-8220/24/5/1500Test; https://doaj.org/toc/1424-8220Test

الوصول الحر: https://doaj.org/article/965c0092a65243c089538144c3fd2980Test

المؤلفون: Koray Yarız, Cansu Pınar Yavaş, Hakan Kumbasar

المصدر: Klinik Psikiyatri Dergisi, Vol 25, Iss 2, Pp 229-233 (2022)

مصطلحات موضوعية: functional gait disorder, functional movement disorder, conversion, psychogenic gait disorder, Psychiatry, RC435-571, Therapeutics. Psychotherapy, RC475-489

الوصف: Functional gait disorder is a common disorder seen in 8-10% of patients with psychogenic movement disorder. Many functional gait disturbances mimic neurological diseases. Astasis-abhasia, which is the most easily detected finding, is frequently observed in these patients. Patients stumble, balance momentarily and even though they seem to be in danger of falling, they always rescue themselves at the last moment and generally do not get hurt. Like all functional disorders, gait disorders can occur acutely following a psychosocial stressor. Some clues such as the fluctuating course of symptoms, abnormal slowing of movements, sudden bends in the knees and psychogenic Romberg are helpful in terms of differential diagnosis. Although the functional nature of the disorder can be recognized with careful examination, appropriate treatment of these patients requires sufficient time and effort. It is very important to establish a therapeutic relationship with the patient, to explain the relationship between symptoms and diagnosis in a plain and non-aggressive language. This functional disorder requires an individualized treatment approach. In this article, a 23-year-old female patient with mild mental retardation who presented for evaluation of complaints such as inability to stand up and walk, jerk-like movements in both arms and legs, and an abnormal posture due to continuous lateral bending is described. Clinical symptoms, possible underlying factors, treatment attempts, clinical follow-up and factors affecting the treatment success of the patient who had a complete recovery with the treatment applied in our clinic are discussed in this article.

وصف الملف: electronic resource

العلاقة: https://jag.journalagent.com/z4/download_fulltext.asp?pdir=kpd&un=KPD-35651Test; https://doaj.org/toc/1302-0099Test

الوصول الحر: https://doaj.org/article/429dd98b3e144b2ba893c0b9915019afTest

المؤلفون: Diana Bogdanova

المصدر: Heliyon, Vol 9, Iss 5, Pp e15864- (2023)

مصطلحات موضوعية: Unipolar depression, Bipolar depression, Psychomotor skills gait disorder, Science (General), Q1-390, Social sciences (General), H1-99

الوصف: Objectives: Bipolar and unipolar depressions have a similar clinical picture, but different neurological and psychological mechanisms. These misleading similarities can lead to overdiagnosis and increased suicide risk. Recent studies show that gait is a sensitive objective marker for distinguishing the type of depression. The present study aims to compare psychomotor reactivity disorders and gait activity in unipolar and bipolar depression. Methods: A total of 636 people aged 40.7 ± 11.2 years are studied with an ultrasound cranio-corpo-graph. They are divided into three groups - patients with unipolar depression, with bipolar depression and healthy controls. Each person performs three psychomotor tasks - a classic Unterberger task, a simplified version with open eyes and a complex version with an additional cognitive task. Results: We find significant differences in psychomotor activity and reactivity between the three groups. Bipolar patients have more inhibited psychomotor skills than unipolar and they are both more inhibited than the norms. The simplified variant of the equilibriometric task is the most sensitive one and psychomotor reactivity is a more precise marker than psychomotor activity. Conclusion: Both psychomotor activity and reactivity in gait could be sensitive markers for distinguishing similar psychiatric conditions. The application of the cranio-corpo-graph and the possible development of similar devices could lead to new diagnostic and therapeutic approaches, including early detection and prediction of the type of depression.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2405844023030712Test; https://doaj.org/toc/2405-8440Test

الوصول الحر: https://doaj.org/article/fccb04df85be476184aca9f6fef60cbfTest

المؤلفون: Shun Igarashi, Takashi Kobayashi, Hiroaki Kijima, Naohisa Miyakoshi

المصدر: Journal of Medical Case Reports, Vol 16, Iss 1, Pp 1-5 (2022)

مصطلحات موضوعية: Sacral fracture, Fragility fracture, Sacral nerve root, Gait disorder, Fecal incontinence, Sacral laminectomy, Medicine

الوصف: Abstract Background Owing to the aging population, fragility fractures of the pelvis are occurring more frequently. Fixation of the fracture and stabilization of the pelvic ring usually provide good clinical results. A case of distal sacral nerve roots severed by a fragility fracture of the sacrum is presented. Case presentation A 62-year-old Japanese woman with schizophrenia with low back pain, gait disorder, dysuria, and fecal incontinence presented to an emergency department, and plain X-rays showed no findings. She also complained of dysuria, and neurogenic bladder and cystitis were diagnosed. One month later, she was admitted to a psychiatric hospital for exacerbation of schizophrenia. In hospital, she had a urethral catheter inserted and spent 3 months in bed. She was referred to our orthopedic department because a gait disorder was discovered after her mental condition improved and she was permitted to walk. On examination, she could not walk and had decreased sensation from the buttocks to both posterior thighs and around the anus and perineum. Manual muscle testing of her lower limbs showed mild weakness of about 4 in bilateral flexor hallucis longus and gastrocnemius, and bilateral Achilles tendon reflexes were lost. Her anal sphincter did not contract, and urinary retention continued after urethral catheter removal. Imaging examinations showed an H-shaped sacral fracture consisting of a transverse fracture with displacement of the third sacral vertebra and vertical fractures of the bilateral sacral wings, with severe stenosis of the spinal canal at the site of the transverse fracture. The patient was diagnosed as having bladder and rectal dysfunction due to a displaced, unstable sacral fracture. First to third sacral laminectomy and alar–iliac fixation using percutaneous pedicle screws and sacral alar–iliac screws were then performed. The bilateral distal sacral nerve roots (S3, S4, S5) were completely severed at the second to third sacral levels, but bilateral second sacral nerve roots were not compressed from the bifurcation to the sacral foramen. Postoperatively, bladder and rectal dysfunction remained, but the low back pain was alleviated. Two weeks postoperatively, she could walk with a walker and was discharged. Three months after the operation, bone fusion of the fracture was observed. Conclusions In cases of bladder–rectal dysfunction with low back pain, the possibility of sacral fracture should be considered, and computed tomography, magnetic resonance imaging, and X-ray examinations should be performed. Even sacral fractures without displacement require attention because they can cause serious injury in the event of a nerve root being severed if not diagnosed early and given appropriate treatment.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1752-1947Test

الوصول الحر: https://doaj.org/article/562f8e2de0ab4832bf594bc24cb32fd3Test

المؤلفون: Badea, Doina Ioana¹ dr.doina.badea@gmail.com, Ciobanu, Ileana², Seiciu, Petre Lucian³, Berteanu, Mihai^1,2

المصدر: Health, Sports & Rehabilitation Medicine. Jan-Mar2021, Vol. 22 Issue 1, p26-35. 10p.

مصطلحات موضوعية: *HUMAN-robot interaction, *PELVIC physiology, GAIT disorder treatment

مستخلص: Pelvis mobility plays a big role during normal walking. There are six pelvic movements that allow natural gait patterns and center of mass trajectories. The pelvis mechanism is an underdeveloped component in gait rehabilitation systems. Mobility constraints and human-robot joint misalignment appear during gait if pelvis motion is restricted or not actuated. This is why systems should provide pelvis mobility control. The aim of this review is to help researchers identify weaknesses and come up with solutions for new generations of gait rehabilitation devices. The data on current gait systems with pelvic mechanisms was collected from various databases on 26 August 2020. The selection criteria included all devices that had at least one pelvic degree of freedom actuated by a pelvis mechanism and excluded all devices with all pelvic degrees of freedom passive or restricted and all devices with pelvic support only for registering data and not for controlling pelvic motion. A number of 16 devices were identified. Different characteristics are compared, including: the type of system, the system mechanical components, the type of surface, the pelvic robot – human interface, the allowed human pelvis movements and the types of pelvic movements (actuated, free or blocked), the pelvis actuation, the operating modes and the center of mass trajectory. There is no perfect system; each one of them has both strong and weak points. Research directions are suggested for system improvements that might help future gait rehabilitation devices. [ABSTRACT FROM AUTHOR]