Worsening Of Balance Research Articles

Is there any relationship between scoliosis, cervical pain and postural imbalance in Parkinson's disease? A cross-sectional pilot study.

Parkinson's disease (PD) is defined by progressive worsening of gait, posture, and balance, as well as disability in daily life activities, and improvement in chronic musculoskeletal pain, particularly neck pain associated with worsening of balance. The study's goal is to look into the relationship between scoliosis, balance, and cervical pain in Parkinson's disease patients. Cross-sectional, pilot study. The study included 16 Parkinson's patients. Neck cervical pain was measured using the pain visual analogue scale and the short form McGill pain questionnaire, while dynamic balance was assessed using static balance, Tinetti, Berg Balance, and the Short Physical Performance Battery scales (SPPB). Cobb angles are measured on a whole-spine standard X-ray to assess spinal scoliosis.An observational statistical analysis was performed with patients subdivided into two groups: non-scoliosis (NS) and true scoliosis (TS) based on whether they presented a Cobb's angle below or ≥10°. Neck pain was reported by 37% (n=3) of participants in the NS group versus 50% (n=4) in the TS group. Neck pain was more prevalent in patients with a disease duration of less than 48 months (n=6; 75.0% vs n=1; 12.5%; p-value < 0.05). Scoliosis, cervical pain, and postural imbalance are all significant but often overlooked Parkinson's disease complaints.

Public guarantees to SME lending: Do broader eligibility criteria pay off?

This study evaluates the causal effects of admission to the Italian credit guarantee program on SMEs’ profitability, financial health, investments, borrowing costs, and creditworthiness. It further investigates how access to the public guarantee scheme (PGS) affected the firms that became eligible only after the program's creditworthiness assessment criteria were eased following the credit rationing that especially hit SMEs after the sovereign debt crisis. Deterioration of financial conditions, rise in debt payback period, worsening of balance between current assets and current liabilities, increase in borrowing costs, and greater weight of interest expenses on sales were found in beneficiary firms. These negative effects were stronger for firms that were admitted to the PGS following the softening of the eligibility criteria. Therefore, having a less severe public guarantee scheme contradicts its counter-cyclical function as the enduring deterioration of the admitted firms’ financial conditions threatens their resilience to adverse market conditions.

Local dynamic stability during long-fatiguing walks in people with multiple sclerosis

BackgroundAltered balance/stability during walking is common in people with multiple sclerosis (PwMS). While dynamic gait stability has been related to falling and localized muscle fatigue, it has rarely been studied in MS. Specifically, the effects of walking-related fatigue on dynamic stability are unclear in PwMS. Research questions: 1) Are temporal changes in dynamic stability during long-walks different among PwMS and healthy controls (HC)? 2) Is there a relationship between stability and walking performance changes in PwMS? MethodsTwenty-five PwMS and ten HC participated in the six-minute walk test (6MWT) wearing six-wireless inertial sensors. Local dynamic stability (LDS) during gait was quantified by maximum-finite-time Lyapunov exponents (λS), where larger λS indicates less stable dynamics. Linear mixed models were fit to compare changes in LDS and walking performance over time among two groups. Additionally, the percent changes in λS and distance from minute 1 to 6 were recorded as Dynamic Stability Index (DSI6-1) and Distance-Walked Index (DWI6-1) respectively. Finally, Pearson correlation compared the association between DSI6-1 and DWI6-1. ResultsA significant group*time interaction was found for LDS. PwMS did not have different LDS than HC until minute-4 of walking, and differences persisted at minute-6. Further, PwMS walked significantly shorter distances and demonstrated a greater decline in walking performance (DWI6-1) during the 6MWT. Finally, DSI6-1 and DWI6-1 were significantly correlated in PwMS. Significance The dynamic stability differences among PwMS and HC were only apparent after 3-minutes of walking and ∼60% of PwMS became less stable over time, supporting the use of long walks in MS to capture stability changes during the motor task performance. A significant relationship between the decline in stability and poor walking performance over time during the 6MWT suggested a possible role of walking-related fatigue in the worsening of balance during long walks in PwMS.

TRACKING THE NATURAL HISTORY OF MOBILITY LOSS IN NEURODEGENERATIVE DISEASES

Purpose: The natural history of neurodegenerative diseases is a decline in mobility and worsening of balance. In most cases, this decline in function has been quantified by researchers using rating scales such as the UPDRS or the EDSS. However, these scales lack the sensitivity to specifically capture the progression of mobility loss and balance impairment. The use of more sensitive measures to generate natural history data is critical to clearly defining the benefits of rehabilitation interventions. The purpose of this presentation is to describe the implementation, benefit, and use of an on-line database tracking system by presenting the changes in clinical measures of balance, mobility, and balance confidence in persons with Parkinsonism over a one year period. Description: In order to allow data gathering and immediate data entry from two separate clinical research facilities, an on-line data base tracking system was created. Prior to initiation of this project, approval from the Health Sciences IRB was received. Participating therapists entered data through a data entry interface on a password protected website housed on a secure server. Data collected and recorded included disease specific information and performance on three specific clinical tests: the Berg Balance Scale (BBS), the Timed up and Go (TUG), and the Activities Specific Balance Confidence Scale (ABC). Data entered was encrypted and sent to populate a research database. As a pilot test of this tracking system, participants in on-going community based exercise program consented to participate. Data was collected at 3 month intervals over the course of 1 year for a total of 5 data points (0, 3, 6, 9, and 12 months). Summary of Use: As a group (n=14), persons with mild to moderate PD (Hoehn and Yahr 2–3)demonstrated no significant change in BBS, TUG, and ABC scores over the course of 1 year (P>.05, Friedman's ANOVA). The general patterns of change were mild increases in balance, mobility, and balance confidence upon the initiation of treatment (0–3 months), followed by a decline to the initial treatment levels at the one year follow-up. Of particular interest were the lack of changes observed in 2 tremor predominate persons with PD patients contrasted with the declines of 3 persons with akinetic rigid predominate PD. Importance to Members: The use of an on-line database tracking system can facilitate data gathering and entry from separate clinical facilities and result in greater efficiency (greater numbers of participants and less data loss) in tracking persons with neurodegenerative diseases. This type of tracking of natural history will contribute to a greater understanding of the prognosis of disease sub-types and to the acute and chronic effects of rehabilitation interventions.