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2023 JUN 24 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in Neurodegenerative Diseases and Conditions - Parkinson's Disease. [...]

Background. Body-worn, inertial sensors can provide many objective measures of balance and gait. However, the objective measures that best reflect patient perception of mobility disability and clinician assessment of Parkinson disease (PD) are unknown. Objective. The purposes of this study were: (1) to determine which objective measures of balance and gait are most related to patient perception of mobility disability and disease severity in people with PD and (2) to examine the effect of levodopa therapy on these correlates. Design. This was an experimental correlation study. Methods. One hundred four people with idiopathic PD performed 3 trials of the Instrumented Stand and Walk Test (ISAW) in the 'on' and 'off' medication states. The ISAW consists of quiet standing (30 seconds), gait initiation, straight walking (7 m), and turning (180°), yielding 34 objective measures of mobility from body-worn inertial sensors. Patient perception of mobility disability was assessed with the Activities-specific Balance Confidence (ABC) scale and the mobility subscale of the Parkinson's Disease Questionnaire (PDQ-39). Disease severity was assessed with the Unified Parkinson's Disease Rating Scale, part III (motor UPDRS). Spearman correlations were used to relate objective measures of mobility to patient perception and disease severity. Results. Turning speed, gait speed, and stride length were most highly correlated to severity of disease and patient perception of mobility disability. The objective measures of mobility in the off-medication state were more indicative of patient perception of mobility disability and balance confidence compared with on-medication state measures. Limitations. Causation is an inherent problem of correlation studies. Conclusion. Physical therapists should evaluate mobility in people with PD in the off-medication state because the off-medication state is more related to disease severity and patient perception of mobility disability than the on-medication state mobility. Assessment and treatment of mobility in people with PD should target specific measures (ie, turning, gait speed, and stride length) because these measures best reflect patients' quality of life and balance confidence., Gait and balance impairments are common manifestations of idiopathic Parkinson disease (PD). These motor symptoms are debilitating, leading to decline in balance confidence (1) and self-perceived motor function. (2) Reduced [...]

Background. The Instrumented Stand and Walk (ISAW) test, which includes 30 seconds of stance, step initiation, gait, and turning, results in many objective balance and gait metrics from body-worn inertial sensors. However, it is not clear which metrics provide independent information about mobility. Objective. It was hypothesized that balance and gait represent several independent domains of mobility and that not all domains would be abnormal in individuals with Parkinson disease (PD) or would change with levodopa therapy. Design. This was a cross-sectional study. Methods, a factor analysis approach was used to identify independent measures of mobility extracted from the ISAW in 100 participants with PD and 21 control participants. First, a covariance analysis showed that postural sway measures were independent of gait measures. Then, the factor analysis revealed 6 independent factors (mobility domains: sway area, sway frequency, arm swing asymmetry, trunk motion during gait, gait speed, and cadence) that accounted for 87% of the variance of performance across participants. Results. Sway area, gait speed, and trunk motion differed between the PD group in the off-levodopa state and the control group, but sway frequency (but not sway area) differed between the PD group in the off-levodopa state and the control group. Four of the 6 factors changed significantly with levodopa (off to on): sway area, sway frequency, trunk motion during gait, and cadence. When participants were on levodopa, the sway area increased compared with off levodopa, becoming more abnormal, whereas the other 3 significant metrics moved toward, but did not reach, the healthy control values. Limitations. Exploratory factor analysis was limited to the PD population. Conclusions. The different sensitivity various balance and gait domains to PD and to levodopa also support neural control of at least 6 independent mobility domains, each of which warrants clinical assessment for impairments in mobility., Functional mobility requires the ability to: (1) maintain stable equilibrium during stance, (2) make appropriate anticipatory postural adjustments (APAs) prior to step initiation, (3) generate speed and temporal coordination of [...]

BALTIMORE :: In children ages 7 to 12 with residual amblyopia, use of one medication--levodopa--did not lead to a meaningful improvement in visual acuity compared with placebo, said Michael X. [...]

Parkinson?s disease, which has no known treatment to slow the disease?s progression, afflicts approximately 78,000 Australians.Levodopa therapy, which improves motor disability, loses effectiveness after three to five years of use. Surgical therapy where a wire is implanted into the brain for stimulation is ideal for those patients with dopa-induced dyskinesia or severe motor fluctuations, but is not recommended for those who do not respond to levodopa.