Effects of Bilateral Posteroventral Pallidotomy on Gait of Subjects With Parkinson Disease.Effects of Bilateral Posteroventra Pallidotomy on Gait of Subjects With Parkinson Disease Parkinson Disease Definition Parkinson disease (PD) is a progressive movement disorder marked by tremors, rigidity, slow movements (bradykinesia), and posture instability. Siegel KL, Metman LV (Rehabilitation Medicine Department, Warren Grant Magnuson Clinical Center; Experimental Therapeutics Branch, National Institute of Neurological Disorders and Stroke The National Institute of Neurological Disorders and Stroke is a part of the U.S. National Institutes of Health. The NINDS conducts and supports research on brain and nervous system disorders. Created by the U.S. , National Institutes of Health, Bethesda, Md), Arch Neurol. 2000;57:198-204. The purpose of this study was to quantify gait pattern changes following bilateral posteroventral pallidotomy in patients with Parkinson disease. The 11 subjects in the study (8 men, 3 women; average age=59.5 [+ or -] 9.8 years) were selected consecutively from those patients with Parkinson disease who were scheduled for bilateral pallidotomies at another institution. The average disease duration was 18.2 years (SD=7.6 years). All subjects had a clear response to levodopa levodopa: see l-dopa. levodopa or L-dopa Organic compound (L-3,4-dihydroxyphenylalanine) from which the body makes dopamine, a neurotransmitter deficient in persons with parkinsonism. and experienced motor fluctuations and dyskinesia dyskinesia /dys·ki·ne·sia/ (-ki-ne´zhah) distortion or impairment of voluntary movement, as in tic or spasm.dyskinet´ic biliary dyskinesia . Subjects were examined at the authors' institution 1 month before and 1 month after the pallidotomy. Anti-parkinson medication was withheld for 8 hours before testing. The examination consisted of a detailed neurological examination and gait analysis of 3 trials in which the subject walked along a 10-m walkway at a self-selected speed. Computer software determined 3-dimensional target trajectories, temporal and spatial gait measurements, and joint excursions. Group means for all gait measurements before and after the procedure were compared statistically using paired t tests and ANOVAs with repeated factors, which included operative status, standing angle, peak angle, and total joint excursion as well as side affected, where applicable. To predict postoperative results from preoperative pre·op·er·a·tive adj. Preceding a surgical operation. preoperative preceding an operation. preoperative care the preparation of a patient before operation. data, the authors used a forward, stepwise stepwise incremental; additional information is added at each step. stepwise multiple regression used when a large number of possible explanatory variables are available and there is difficulty interpreting the partial regression multiple regression analysis. The pallidotomy significantly increased average walking speed from 0.214 statures/second to 0.440 statures/ second. An increase in average stride length was almost exclusively responsible for this increase in speed. According to the multiple regression analysis, changes in the foot-floor angle and knee and hip excursion in gait explained 96% of the changes in stride length. The authors concluded that a bilateral posteroventral pallidotomy was associated with a 2-fold increase in walking speed and would likely provide a functional benefit. Carolyn Vaillancourt, PT, NCS (Network Call Signaling) CableLabs version of MGCP. See MGCP/MEGACO. NCS - Network Computing System: Apollo's RPC system used by DEC and Hewlett-Packard.The protocol has been adopted by OSF. Healthsouth Braintree Rehabilitation Center Braintree, Mass |
|
||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion