[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.

[Ground reaction forces during gait in people with unilateral transtibial amputation, a series of cases]

Unilateral Transtibial Amputees (UTA) usually present deficiencies in the mechanisms underlying their gait likely because of the absence of the resected segment, thus having an impact on the ability to actively adjust the lower limb prosthesis. Five participants with UTA were evaluated considering the ground reaction forces during gait by using an integrated BTS GAITLAB system. The first and the second vertical peak forces tended to be greater in the Healthy Lower Limb (HLL) than in the Lower Limb prosthesis (LLP). Both the deceleration and propulsion forces were lower in this limb prosthesis, in addition, a variability of the mediolateral force was observed. Maintaining active control of the center of gravity during gait from the HLL was probably due to mechanical restrictions to actively control the ankle and the limitations for force absorption and generation that allow controlling postural stability during gait from the LLP.

Gouty Involvement of Foot and Ankle: Beyond Flares

The foot and ankle are common locations of deposition of monosodium urate (MSU) crystals, as indicated by the clinical manifestations presented by patients with gout, which are not limited to the acute inflammation of the big toe. We present a narrative literature review aimed to update the gout involvement of foot and ankle and how it affects the quality of life. Cumulative reports indicate that gout, even at the non-tophaceous stage, could cause pain, gait impairment and limit the mobility at lower limbs. These patients may present difficulties in some activities of daily living such as choosing footwear, thus leading to an impaired quality of life. Gout is a curable disease by dissolving MSU crystals but remains unclear how this could modify some of these foot and ankle manifestations, especially when structural damage has already occurred. Furthermore, a collaboration between rheumatologists and podiatrists seems helpful to understand, relieve these symptoms and improve the quality of life in gouty patients.

Predictive factors of cognitive impairment in people over 60

OBJECTIVE

To determine the relationship of depressive symptoms, sleep hygiene, nutritional status and gait speed with cognitive impairment in people over 60 years.

METHOD

Cross-sectional, correlational design with a non-probability convenience sampling. The population was made up of people over 60 years of age belonging to recreational stays in an urban area of Tamaulipas, Mexico. Criterion measures included three neuropsychological tests (Stroop Test, Trail Making Test and Digit Span Subtest) the Geriatric Depression Scale, Pittsburgh Sleep Quality Index, Mini Nutritional Assessment and the Short Physical Performance Battery.

RESULTS

The final sample was of 108 participants. Regarding the influence of risk factors to predict cognitive impairment a significant model was observed (F=12.914, gl=4, P≥.001), showing a variance explained of 33.4%, where depressive symptoms (β=.205, P=.048), sleep (β=-.322, P=.001), nutritional status (β=-.336, P=.001) and gait speed (β=.244, P=.004) were associated with cognitive impairment.

CONCLUSIONS

High levels of depressive symptoms, prolonged sleep duration, a malnutrition status and a slow gait speed predict cognitive impairment of the people over 60 years, this provides knowledge for the implementation of interventions aimed at preventing the risk factors that predict cognitive decline in order to delay its appearance.

[Trunk kinematics during walking in stroke patients: A systematic review]

The trunk and pelvis are affected after stroke, predisposing individuals to falls and dependency. The aim of this review was to describe the lineal and angular kinematics of the trunk and pelvis in patients with post-stroke sequels during walking. We included studies published up to June 2018 using a 2-3 D motion capture system during walking. We searched the Cochrane, Medline, PEDRo, Lilacs, Scielo, EBSCO, ClinicalKey and Elsevier databases. Twelve articles were selected. Linear kinematics showed greater lateral displacement and acceleration in all axes. Angular kinematics in the swing phase of the paretic segment showed the pelvis in posterior rotation, with elevation and lower velocity and the trunk in anterior flexion, with lateral inclination and ipsilateral rotation. The studies showed wide variability, making it impossible to establish of a common effect. However, the results allow description of the movement of the trunk and pelvis.

[Development of the Spanish version of the Wisconsin Gait Scale. Reliability and consistency analysis of spatial and temporal parameters with gait assessment in stroke patients]

BACKGROUND AND OBJECTIVE

We aimed to perform a cross-cultural adaptation of the Wisconsin Gait Scale (WGS) to Spanish and ensure its reliability, validity and sensitivity.

MATERIAL AND METHOD

A cross-sectional descriptive study was conducted in patients with stroke between September 2017 and March 2019. We developed the Spanish version through the translation-back-translation method, and reached a consensus on the problematic items. The Spanish version of the WGS was applied in 25 post-stroke patients, assessed in the Hospital Movement Analysis Unit. All patients were evaluated by 2 independent evaluators, subsequently performing the instrumented gait analysis using the Elite System (BTS), SMART System. Interobserver confirmation (intraclass correlation coefficient), internal consistency (Cronbach's alpha), and validation were verified by checking their relationship with spatial and temporal parameters and sensitivity to change (Pearson's correlation).

RESULTS

After the translation-back-translation, the committee found cultural equivalence in all but 2 items and reached a consensus on the final version. Interobserver reliability had an intraclass coefficient of 0.99 for the total score, and > 0.7 for each item; Cronbach's alpha was > 0.8; the validity between the WGS and the spatial and temporal parameters was significant (p < 0.05). Sensitivity to change was significant on comparison of the results of the scale at baseline and at 1 month (correlation coefficient 0.92).

CONCLUSION

The Spanish version of the WGS is a culturally equivalent instrument to the original version, providing an objective means to document observational analysis of gait in post-stroke patients by rehabilitation teams.

[Effect of physical rehabilitation in patients with hereditary spinocerebellar ataxia. A systematic review]

Evidence of the effectiveness of rehabilitation interventions in spinocerebellar ataxia is scarce and variable. OBJECTIVES: The aim of this systematic review was to gather the existing evidence on the effectiveness of these interventions. MATERIAL AND METHODS: To do this, we analysed all the clinical trials published to date and assessed their results in terms of improved balance, gait, and performance of daily activities after treatment. Significant improvements were found for posture (P<.008) and gait (P<.02), as well as a reduction in the scores for the SARAg&p subscale (gait and posture) and SCAFI 8MW index (gait speed) (P=.02). We also observed improvements in speech disorders (P=.02), depressive symptoms (P<.0001) and accidental falls (P<.005).

[Observational gait scale for persons with lower extremity amputation. Design and content validity]

INTRODUCTION

Gait pattern is altered in persons with lower extremity amputation. To assess gait pattern, it is important to use observational gait scales with a good content validity.

OBJECTIVES

To design an observational gait scale and to analyze its content validity.

MATERIAL AND METHODS

An expert committee was formed to obtain a version of the scale. The same committee was responsible for evaluating the scale. The content validity index (CVI) was calculated, both for each item and for the global scale.

RESULTS

The main kinematic and spatiotemporal alterations were selected to design the items. The scale consists of 2sections and 25 items, with a maximum score of 35 points. An overall CVI score of 0.90 was obtained, and an index of validity for most items with values higher than 0.78.

CONCLUSION

The Observational gait scale for persons with amputation of the lower extremity showed excellent content validity according to the CVI obtained. Future studies should evaluate its reliability and construct validity.

[Benefits of robotics in gait rehabilitation in cerebral palsy: A systematic review]

BACKGROUND AND AIM

Cerebral palsy is the most common motor disability in childhood, with an estimated incidence of two out of every 1,000 live births. The impairment mostly affects gait. The aim of rehabilitation programmes is to enhance independence in affected individuals, especially mobility. To do this, robot-assisted gait rehabilitation programmes have been developed. Therefore, this study aimed to identify the benefits of robotics in gait rehabilitation in cerebral palsy.

MATERIAL AND METHODS

We performed a literature search using the MeSH terms «cerebral palsy», «robotics» and «gait».

RESULTS

After applying the selection criteria, we obtained 10 research studies and three protocols analysing the benefits of robotics in cerebral palsy and demonstrating that their use provides major advantages.

[Gait speed and the appearance of neurocognitive disorders in older adults: Results of a Peruvian cohort]

INTRODUCTION

The prevention and management of neurocognitive disorders (NCD) among older adults can be improved by early identification of risk factors such as walking speed. The objective of the study is to assess the association between gait speed and NCD onset in a population of Peruvian older adults.

MATERIAL AND METHODS

Cohort conducted in older adults who attended the geriatrics service of Naval Medical Center (Callao, Peru). During the baseline assessment, participants' gait speed was recorded. Subsequently, participants were followed-up annually for 5 years, with a mean of 21 months. NCD onset was defined as the occurrence of a score ≤24 points on the Mini Mental State Examination (screening test) during follow-up. The hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated using Cox regression.

RESULTS

The study included 657 participants, with a mean age of 73.4±9.2 (SD) years, of whom 47.0% were male, 47.8% had a gait speed <0.8 m/s, and 20.1% developed NCD during the follow up. It was found that older adults who had gait speed <0.8 m/s at baseline were more likely to develop NCD than those who had a gait speed ≥0.8 m/s (adjusted HR=1.41, 95% CI=1.34-1.47).

CONCLUSION

A longitudinal association was found between decreased gait speed and NCD onset, suggesting that gait speed could be useful to identify patients at risk of NCD onset.

A guide to treating gait impairment with prolonged-release fampridine (Fampyra®) in patients with multiple sclerosis

INTRODUCTION

Gait impairment, a frequent sign in multiple sclerosis (MS), places a major burden on patients since it results in progressive loss of personal and social autonomy, along with work productivity. This guide aims to provide recommendations on how to evaluate gait impairment and use prolonged-release fampridine (PR-fampridine) as treatment for MS patients with gait impairment in Spain.

DEVELOPMENT

PR-fampridine dosed at 10mg every 12hours is currently the only drug approved to treat gait impairment in adults with MS. Additionally, PR-fampridine has been shown in clinical practice to significantly improve quality of life (QoL) in patients who respond to treatment. Treatment response can be assessed with the Timed 25-Foot Walk (T25FW) or the 12-item MS Walking Scale (MSWS-12); tests should be completed before and after starting treatment. The minimum time recommended for evaluating treatment response is 2 weeks after treatment onset. Patients are considered responders and permitted to continue the treatment when they demonstrate a decrease in their T25FW time or an increase in MSWS-12 scores. A re-evaluation is recommended at least every 6 months. The SF-36 (Short Form-36) and the MSIS-29 (MS Impact Scale-29) tests are recommended for clinicians interested in performing a detailed QoL assessment. This drug is generally well-tolerated and has a good safety profile. It should be taken on an empty stomach and renal function must be monitored regularly.

CONCLUSIONS

These recommendations will help ensure safer and more efficient prescription practices and easier management of PR-fampridine as treatment for gait impairment in Spanish adults with MS.

[Effects of cognitive state on balance disturbances and gait disorders in institutionalised elderly]

BACKGROUND

Ageing has been linked to a high prevalence of cognitive impairment, which, in turn, has been related to balance disturbances and gait disorders. The aim of this study was to identify whether there are differences between subjects with and without cognitive impairment regarding the quality of gait and balance.

MATERIAL AND METHODS

An observational study was conducted on institutionalised people older than 65 years (n=82). Gait and balance was evaluated after the assessment of cognitive impairment using the Mini-Mental State Examination (MMSE). Single and dual tests were used including, the 6-minute walking, stride length, and gait speed. Timed Up and Go tests were also used to evaluate balance.

RESULTS

The participants were divided into three groups: 28 subjects in the group without cognitive impairment (MMSE≥27), 29 subjects with mild (27<MMSE≤21) and 26 subjects with moderate cognitive impairment (MMSE<21). Gait assessment showed significant between-groups differences in all the variables (P<.05). The variables assessing balance also showed significantly worse values in those groups with cognitive impairment.

CONCLUSION

The severity of cognitive impairment is related to impaired balance and gait, thus the clinical monitoring of these variables in population at risk is needed.

Variability and repeatability analysis of plantar pressure during gait in older people

INTRODUCTION

Repeatability and variability of the plantar pressure during walking are important components in the clinical assessment of the elderly. However, there is a lack of information on the uniformity of plantar pressure patterns in the elderly.

OBJECTIVE

To analyze the repeatability and variability in plantar pressure considering mean, peak and asymmetries during aged gait.

METHODS

Plantar pressure was monitored in four different days for ten elderly subjects (5 female), with mean±standard-deviation age of 73±6 years, walking barefoot at preferred speed. Data were compared between steps for each day and between different days.

RESULTS

Mean and peak plantar pressure values were similar between the different days of evaluation. Asymmetry indexes were similar between the different days evaluated.

CONCLUSION

Plantar pressure presented a consistent pattern in the elderly. However, the asymmetry indexes observed suggest that the elderly are exposed to repetitive asymmetric loading during locomotion. Such result requires further investigation, especially concerning the role of these asymmetries for development of articular injuries.

Characterization of Bacteriocin like inhibitory substance produced by a new Strain Brevibacillus borstelensis AG1 Isolated from 'Marcha'

In the present study, a bacterium isolated from Marcha- a herbal cake used as traditional starter culture to ferment local wine in North East India, was evaluated for bacteriocin like inhibitory substance production and was tested against six food borne/spoilage causing pathogens viz. Listeria monocytogenes MTCC 839, Bacillus subtilis MTCC 121, Clostridium perfringens MTCC 450, Staphylococcus aureus, Lactobacillus plantarum and Leuconostoc mesenteroides MTCC 107 by using bit/disc method followed by well diffusion method. The bacterial isolate was identified as Brevibacillus borstelensis on the basis of phenotypic, biochemical and molecular characteristics using 16Sr RNA gene technique. Bacteriocin like inhibitory substance produced by Brevibacillus borstelensis AG1 was purified by gel exclusion chromatography. The molecular mass of the Brevibacillus borstelensis AG1 was found to be 12 kDa. Purified bacteriocin like inhibitory substance of Brevibacillus borstelensis was further characterized by studying the effect of temperature, pH, proteolytic enzyme and stability. Bacteriocin like inhibitory substance was found to be thermostable upto 100 °C, active at neutral pH, sensitive to trypsin, and partially stable till third week of storage thus showing a bright prospective to be used as a potential food biopreservative.

[Gait characteristics of women with fibromyalgia: a premature aging pattern]

BACKGROUND

Fibromyalgia is a condition which involves chronic pain. Middle-aged individuals with fibromyalgia seem to exhibit changes in gait pattern, which may prematurely expose them to a gait pattern which resembles that found in the elderly population.

OBJECTIVE

To determine the 3D spatial (linear and angular) gait parameters of middle-aged women with fibromyalgia and compare to elderly women without this condition.

METHODS

25 women (10 in the fibromyalgia group and 15 in the elderly group) volunteered to participate in the study. Kinematics was performed using an optoelectronic system, and linear and angular kinematic variables were determined.

RESULTS

There was no difference in walking speed, stride length, cadence, hip, knee and ankle joints range of motion between groups, except the pelvic rotation, in which the fibromyalgia group showed greater rotation (P<0.05) compared to the elderly group. Also, there was a negative correlation with pelvic rotation and gluteus pain (r = -0.69; P<0.05), and between pelvic obliquity and greater trochanter pain (r = -0.69; P<0.05) in the fibromyalgia group.

CONCLUSION

Middle-aged women with fibromyalgia showed gait pattern resemblances to elderly, women, which is characterized by reduced lower limb ROM, stride length and walking speed.

Characterization and biocompatibility of glucan: a safe food additive from probiotic Lactobacillus plantarum DM5

BACKGROUND

Exopolysaccharide produced by lactic acid bacteria are the subject of an increasing number of studies for their potential applications in the food industry as stabilizing, bio-thickening and immunostimulating agents. In this regard, the authors isolated an exopolysaccharide producing probiotic lactic acid bacterium from fermented beverage Marcha of north eastern Himalayas.

RESULTS

The isolate Lactobacillus plantarum DM5 showed extracellular glucansucrase activity of 0.48 U mg⁻¹ by synthesizing natural exopolysaccharide glucan (1.87 mg mL⁻¹) from sucrose. Zymogram analysis of purified enzyme confirms the presence of glucosyltransferase of approximately 148 kDa with optimal activity of 18.7 U mg⁻¹ at 30 °C and pH 5.4. The exopolysaccharide was purified by gel permeation chromatography and had an average molecular weight of 1.11 × 10⁶ Da. Acid hydrolysis and structural characterization of exopolysaccharide revealed that it was composed of d-glucose residues, containing 86.5% of α-(1→6) and 13.5% of α-(1→3) linkages. Rheological study exhibited a shear thinning effect of glucan appropriate for food additives. A cytotoxicity test of glucan on human embryonic kidney 293 (HEK 293) and human cervical cancer (HeLa) cell lines revealed its nontoxic biocompatible nature.

CONCLUSION

This is the first report on the structure and biocompatibility of homopolysaccharide α-D-glucan (dextran) from probiotic Lactobacillus plantarum strain and its unique physical and rheological properties that facilitate its application in the food industry as viscosifying and gelling agent.

Anti-listerial Bactericidal Activity of Lactobacillus plantarum DM5 Isolated from Fermented Beverage Marcha

The strain Lactobacillus plantarum DM5 was isolated from fermented beverage Marcha of Sikkim and explored for its antagonistic activity against food-borne pathogens. The cell-free supernatant of L. plantarum DM5 showed antibacterial activity of 6,400 AU/mL in MRS medium (pH 6.0) against the indicator strain Staphylococcus aureus. MRS medium supplemented with 15 g/L of maltose at 37 °C under static condition yielded highest antimicrobial activity (6,400 AU/mL) with 3 % increase in specific activity when compared to 20 g/L glucose. The antimicrobial compound was heat stable (60 min at 100 °C) and was active over a wide pH range. It showed bactericidal effect on S. aureus and Listeria monocytogenes by causing 96 and 98 % of cell lysis, respectively. The cell morphology of the treated S. aureus and L. monocytogenes was completely deformed as revealed by scanning electron microscopy, suggesting the high potential of L. plantarum DM5 as natural preservatives in food industry. The antimicrobial compound was purified by 80 % ammonium sulphate precipitation and showed antimicrobial activity of 12,800 AU/mL with 19-fold purification and a molecular mass of 15.2 kDa, indicating the proteinaceous nature of the compound.

Balzac and human gait analysis

INTRODUCTION

People have been interested in movement analysis in general, and gait analysis in particular, since ancient times. Aristotle, Hippocrates, Galen, Leonardo da Vinci and Honoré de Balzac all used observation to analyse the gait of human beings. The purpose of this study is to compare Honoré de Balzac's writings with a scientific analysis of human gait.

SOURCES

Honoré de Balzac's Theory of walking and other works by that author referring to gait.

DEVELOPMENT

Honoré de Balzac had an interest in gait analysis, as demonstrated by his descriptions of characters which often include references to their way of walking. He also wrote a treatise entitled Theory of walking (Théorie de la demarche) in which he employed his keen observation skills to define gait using a literary style. He stated that the walking process is divided into phases and listed the factors that influence gait, such as personality, mood, height, weight, profession and social class, and also provided a description of the correct way of walking.

CONCLUSIONS

Balzac considered gait analysis to be very important and this is reflected in both his character descriptions and Theory of walking, his analytical observation of gait. In our own technology-dominated times, this serves as a reminder of the importance of observation.

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.

Lactic acid bacteria in Hamei and Marcha of North East India

Hamei and Marcha are mixed dough inocula used as starters for preparation of various indigenous alcoholic beverages in Manipur and Sikkim in India, respectively. These starters are traditionally prepared from rice with wild herbs and spices. Samples of Hamei and Marcha, collected from Manipur and Sikkim, respectively, were analysed for lactic acid bacterial composition. The population of lactic acid bacteria (LAB) was 6.9 and 7.1 Log cfu/g in Hamei and Marcha, respectively. On the basis of phenotypic and genotypic characters, LAB strains isolated from Hamei and Marcha were identified as Pediococcus pentosaceus, Lactobacillus plantarum and Lactobacillus brevis. Technological properties of LAB such as antimicrobial properties, effect on acidification, ability to produce biogenic amines and ethanol, degree of hydrophobicity and enzymatic activities were also performed. Pediococcus pentosaceus HS: B1, isolated from Hamei, was found to produce bacteriocin. None of the strains produced biogenic amines. LAB strains showed a strong acidifying ability and they also produced a wide spectrum of enzymes.