Importance: Patients with Parkinson disease can use a wide variety of strategies to compensate for their gait impairments. Examples include walking while rhythmically bouncing a ball, crossing the legs when walking, or stepping over an inverted cane. An overview and classification of the many available compensation strategies may contribute to understanding their underlying mechanisms and developing focused rehabilitation techniques. Moreover, a comprehensive summary of compensation strategies may help patients by allowing them to select a strategy that best matches their needs and preferences and health care professionals by permitting them to incorporate these into their therapeutic arsenal. To create this overview, this narrative review discusses collected video recordings of patients who spontaneously informed clinicians about the use of self-invented tricks and aids to improve their mobility. Observations: Fifty-nine unique compensation strategies were identified from approximately several hundred videos. Here, these observed strategies are classified into 7 main categories for elaboration on their possible underlying mechanisms. The overarching working mechanisms involve an allocation of attention to gait, the introduction of goal directedness, and the use of motor programs that are less automatized than those used for normal walking. Conclusions and Relevance: Overall, these compensation strategies seem to appeal to processes that refer to earlier phases of the motor learning process rather than to a reliance on final consolidation. This review discusses the implications of the various compensation strategies for the management of gait impairment in Parkinson disease.
- MeSH
- lidé MeSH
- neurologické poruchy chůze etiologie rehabilitace MeSH
- Parkinsonova nemoc komplikace MeSH
- self-management * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
BACKGROUND: Disorders of posture, gait, and balance in Parkinson's disease (PD) are common and debilitating. This MDS-commissioned task force assessed clinimetric properties of existing rating scales, questionnaires, and timed tests that assess these features in PD. METHODS: A literature review was conducted. Identified instruments were evaluated systematically and classified as "recommended," "suggested," or "listed." Inclusion of rating scales was restricted to those that could be used readily in clinical research and practice. RESULTS: One rating scale was classified as "recommended" (UPDRS-derived Postural Instability and Gait Difficulty score) and 2 as "suggested" (Tinetti Balance Scale, Rating Scale for Gait Evaluation). Three scales requiring equipment (Berg Balance Scale, Mini-BESTest, Dynamic Gait Index) also fulfilled criteria for "recommended" and 2 for "suggested" (FOG score, Gait and Balance Scale). Four questionnaires were "recommended" (Freezing of Gait Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Survey of Activities, and Fear of Falling in the Elderly-Modified). Four tests were classified as "recommended" (6-minute and 10-m walk tests, Timed Up-and-Go, Functional Reach). CONCLUSION: We identified several questionnaires that adequately assess freezing of gait and balance confidence in PD and a number of useful clinical tests. However, most clinical rating scales for gait, balance, and posture perform suboptimally or have been evaluated insufficiently. No instrument comprehensively and separately evaluates all relevant PD-specific gait characteristics with good clinimetric properties, and none provides separate balance and gait scores with adequate content validity for PD. We therefore recommend the development of such a PD-specific, easily administered, comprehensive gait and balance scale that separately assesses all relevant constructs. © 2016 International Parkinson and Movement Disorder Society.
- MeSH
- diagnostické techniky a postupy normy MeSH
- lidé MeSH
- neurologické poruchy chůze diagnóza etiologie MeSH
- Parkinsonova nemoc komplikace diagnóza MeSH
- posturální rovnováha * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Research Support, N.I.H., Extramural MeSH
1. vydání 13 stran : formuláře, tabulky
Informační publikace pro nemocné s Parkinsonovou nemocí a pro pečující osoby o fyziatrické léčbě nemoci.
- MeSH
- Parkinsonova nemoc rehabilitace terapie MeSH
- Publikační typ
- populární práce MeSH
- Konspekt
- Fyzioterapie. Psychoterapie. Alternativní lékařství
- NLK Obory
- rehabilitační a fyzikální medicína
- neurologie
- NLK Publikační typ
- informační publikace
1. vydání 12 stran : formuláře, tabulky
Doporučený postup pro lékaře o fyziatrické léčbě Parkinsonovy nemoci. Kritéria pro indikaci fyzioterapie, jaké informace potřebuje fyzioterapeut od lékaře. Doporučení GRADE pro efektivní fyzioterapeutické intervence u osob s Parkinsonovou nemocí.
1. vydání 184 stran : ilustrace, tabulky
Evropské doporučené postupy pro fyzioterapeutickou léčbu Parkinsonovy nemoci.
- MeSH
- Parkinsonova nemoc rehabilitace terapie MeSH
- techniky fyzikální terapie normy MeSH
- Publikační typ
- příručky MeSH
- směrnice MeSH
