[Muscle activation times facing to a perturbation in patients with early-stage Parkinson's disease]

OBJECTIVES

Parkinson's disease (PD) generates a high incidence of falls, however, there is little evidence of instabilities in the initial stages. This investigation sought to compare the muscle activation times in patients with initial PD against a postural disturbance vs. a control group.

MATERIALS AND METHODS

The electromyographic activity (EMG) of 10 patients with PD in early stages (61.3 ±3.8 years) and a control group of 10 adults (62.2 ±3.0 year) was evaluated. The participants were subjected to a surface disturbance, which generated a stabilization response. The test was performed under 2conditions: eyes open (OA) v/s eyes closed (OC). Trunk (spinal erector) and lower extremity (soleus, tibialis anterior, femoral biceps, femoral rectus, adductor magnus, gluteus medius) muscle activation time was analyzed using surface EMG.

RESULTS

The PD group showed faster response times compared to the control group in the soleus muscle in OC (P=.04). This same muscle showed differences when comparing OA vs. OC only in the PD group (P=.04), showing a shorter response time in the OC condition. When comparing the spinal erector muscle, the PD group showed slower response times in the OA (P=.02) and OC (P=.04) conditions compared to the control group.

CONCLUSIONS

Muscle activation times show that people with PD respond slower in the trunk muscles, while activation times decrease at the distal level. In the early stages, the slower responses at the trunk level could explain the onset of instability postural in these patients.

Presbycusis and balance disorders in the elderly. Bibliographical review of ethiopathogenic aspects, consequences on quality of life and positive effects of its treatment

At this time, we still do not have adequate knowledge and awareness of the consequences of hearing loss in the elderly on quality of life. Similarly, there is also insufficient information on the relationship of presbycusis and balance disorders with other comorbidities. Such knowledge can contribute to improve both prevention and treatment of these pathologies, to reduce their impact on other areas such as cognition or autonomy, as well as to have more accurate information on the economic impact they generate in society and in the health system. Therefore, with this review article we aim to update the information on the type of hearing loss and balance disorders in people over 55 years of age, and their associated factors; to analyze the impact on the quality of life of these people and the one which can be generated at a personal and population level (both sociological and economic) if an early intervention in these patients is pursued.

[Short-term effect of neuromuscular bandaging on balance and gait in Parkinson's disease: Pilot study]

INTRODUCTION

Parkinson's disease is a progressive and irreversible neurodegenerative process characterized by tremor at rest, bradykinesia, stiffness, disorders in postural control, balance and gait. Kinesiology tape has a somatosensory stimulating effect, with benefits in postural control.

METHOD

A pilot study with a Physiotherapy Intervention Group and an Experimental Group (kinesiology tape was added) in gastrocnemius and lumbar spinal erectors. Outcome assessments were Berg scale, Tinetti scale (walking subscale), 10m test, TUG test, PDQ-39 and gastrocnemius electromyographic record. Three measurements were made: T0 (baseline), T1 (two days post-intervention) and T2 (one week post-intervention); PDQ-39 was administered at T0 and one month after the intervention.

RESULTS

Thirteen participants (stage III Hoehn and Yahr) were selected after applying the inclusion criteria (nine women and four men). N=7 Experimental Group and N=6 Physiotherapy Group. The intra-group contrast showed significant improvements in favor of the Experimental Group in Berg scale (T1 and T2), 10m test (T2) and in lower mean gastrocnemius muscle activity (T1). The inter-group contrast only evidenced differences in electromyographic recording of the muscle contraction of the right lower limb, after the application of kinesiology tape, in T1.

CONCLUSIONS

The application of kinesiology tape in the lumbar spinal erectors and gastrocnemius bilaterally could improve gait and balance, in subjects with Parkinson's disease in Hoehn and Yahr stage III, but its effect is not superior to conventional physiotherapy treatment.

[Effects of a physical exercise programme on the risk of falls, balance, and walking speed in older people with intellectual disabilities]

INTRODUCTION

People with intellectual disabilities (ID) have balance disturbances and risk of falls, which are aggravated with ageing. This study aimed to provide information on the effects of an exercise programme on fall risk, balance, and walking speed in a group of older people with ID.

MATERIALS AND METHODS

Eight people with mild to moderate ID (mean age: 56.37±7.08 years) participated in a 12-week programme based on a weekly session that included exercises aimed at strengthening stabilising muscles, stimulating proprioception, and enhancing reflexes in unstable situations. The effects of the programme on the risk of falling and on balance and walking speed were assessed using the Tinetti scale and the Timed Up and Go test, respectively.

RESULTS

The programme was feasible and no adverse effects were registered. At the end of the programme, the risk of falls remained unchanged, while balance and gait speed improved significantly.

CONCLUSIONS

A three-month weekly programme based on muscle strengthening and proprioceptive re-education exercises was feasible and had a positive impact on balance and walking speed in a group of older people with ID. These results lay the foundation for future randomised clinical trials aiming to confirm the effects of such programmes on the risk of falls in this population.

Effect of task-oriented training on balance and motor function of ambulant children with cerebral palsy

INTRODUCTION AND OBJECTIVES

The study evaluated the effect of task-oriented training (TOT) on the motor function (MF) and balance of ambulant children with cerebral palsy (CP).

MATERIALS AND METHODS

A total of 46 children were randomised into TOT group (n=23) and Control Group (CG [n=23]), but 39 children complete the study. Balance and MF were assessed at baseline, 6th and 12th weeks and 6 weeks post-intervention. Data were analysed with repeated measures ANOVA, Friedman's, Mann-Whitney U, Student's-t and post hoc tests at α≤0.05.

RESULTS

The two groups were comparable in all baseline scores (P>0.05). At the 6th week, significant between-group difference was observed in MF only [TOT=81.9 (18.5); CG=72.8 (19.4)] (P<0.05). There were significant between-group differences in MF [TOT=88.8 (9.4); CG=75.5 (18.5); P<0.05] and balance (TOT=9.4±4.5; CG=13.6±6.9; P<0.05) at the 12th week (P<0.05) and 6 weeks post-intervention (P<0.05).

CONCLUSION

TOT improved the balance and MF of ambulant children with CP.

[Assessment of postural control and balance in persons with temporomandibular disorders: A systematic review]

The stomatognathic system is the anatomo-functional unit of the cranio-cervico-facial region. Some dysfunctions affect its motor control. The aim of this study was to analyse the clinical usefulness of the various scales and instruments used in the assessment of postural control in people with temporomandibular disorders. A systematic review was carried out by 2independent reviewers in the PubMed, Medline, Ebsco, Science Direct and PEDro databases, selecting observational studies published between January 2006 and March 2017. The risk of bias and methodological quality was analysed following Cochrane indications and the Downs and Black quality scale. Ten studies were included, of which 9used computerised platforms, one added photogrammetry and one used electromyography. Seven studies were classified as moderate quality and 3as low quality. Posturography was the most widely used assessment instrument. Methodological differences did not allow determination of their clinical implications or the relationship between balance and the presence of temporomandibular disorders.

Effects of a resistance training program on balance and fatigue perception in patients with Parkinson's disease: A randomized controlled trial

INTRODUCTION AND OBJECTIVE

Fatigue and balance impairment leads to a loss of independence and are important to adequately manage. The objective of this study was to examine the effects of a resistance training program on dynamic balance and fatigue in patients with Parkinson's disease (PD).

PATIENTS AND METHODS

Randomized controlled trial. Forty-six patients with PD were randomly allocated to an intervention group receiving a 8-week resistance training program focused on lower limbs or to a control group. Balance was assessed using the Mini-BESTest and fatigue was assessed by the Piper Fatigue Scale.

RESULTS

Patients in the intervention group improved significantly (p<0.05) on dynamic balance (reactive postural control and total values) and perceived fatigue.

CONCLUSIONS

An 8-week resistance training program was found to be effective at improving dynamic balance and fatigue in patients with PD.

[Evaluation of coordination and balance in preterm children]

INTRODUCTION

Recent studies show that many preterm children without apparent neurological sequelae present some difficulties in different areas, such as coordination or balance during their school years. The Movement Assessment Battery for Children-2 (MABC-2) has demonstrated to be a useful tool to validate the coordination, while the stabilometric platform was the reference standard test for validating the balance.

PATIENTS AND METHOD

Case-control study carried out on preterm children from 7 to 10 years old and healthy term infant controls of the same ages. The same age band of MABC-2 was applied and the static balance by the stabilometric platform was analysed.

RESULTS

A total of 89 subjects were included, 30 preterm children≤1,500g birthweight, 29 preterm children>1,500g birthweight, and 30 controls. Preterm children obtained the lowest scores on an overall basis in hand dexterity and balance tests in MABC-2, regardless of their birthweight. Lower gestational age was associated with poorer outcomes in hand dexterity and total scores in MABC-2. Balance results were similar using the stabilometric platform, regardless of prematurity.

CONCLUSIONS

A little more than 10% preterm and term children could have coordination disorders or be at risk of developing them using the MABC-2. Despite the visual-motor coordination being similar, preterm children could face greater difficulties in hand dexterity while, in the absence of neurological comorbidity, preterm and term children balance could be comparable.

Effect of ankle-foot orthosis on postural control after stroke: a systematic review

INTRODUCTION

Stroke is currently the main cause of permanent disability in adults. The impairments are a combination of sensory, motor, cognitive and emotional changes that result in restrictions on the ability to perform basic activities of daily living (BADL). Postural control is affected and causes problems with static and dynamic balance, thus increasing the risk of falls and secondary injuries. The purpose of this review was to compile the literature to date, and assess the impact of ankle-foot orthosis (AFO) on postural control and gait in individuals who have suffered a stroke.

DEVELOPMENT

The review included randomised and controlled trials that examined the effects of AFO in stroke patients between 18 and 80 years old, with acute or chronic evolution. No search limits on the date of the studies were included, and the search lasted until April 2011. The following databases were used: Pubmed, Trip Database, Cochrane library, Embase, ISI Web Knowledge, CINHAL and PEDro. Intervention succeeded in improving some gait parameters, such as speed and cadence. However it is not clear if there was improvement in the symmetry, postural sway or balance.

CONCLUSIONS

Because of the limitations of this systematic review, due to the clinical diversity of the studies and the methodological limitations, 0these results should be considered with caution.