Assistive Devices for Personal Mobility in Parkinson's Disease: A Systematic Review of the Literature.
Ontology highlight
ABSTRACT: Background
Gait abnormalities are a hallmark of Parkinson's disease and contribute to falling risk. As disease symptoms progress, assistive devices are often prescribed. However, there are no guidelines for choosing appropriate ambulatory devices for gait impairment.Objective
To review the scientific evidence on assistive devices for gait impairment in Parkinson's disease.Methods
We performed a systematic literature review for articles relating to parkinsonian gait impairment and assistive devices. We assessed the studies' methodological quality and risk of bias using the PEDro scale.Results
Seventeen articles were reviewed. Four articles (23.53%) showed that canes and standard and two-wheeled walkers without visual cues decreased gait speed and stride length, with no significant effects on freezing of gait or falls. Instead, improvements were observed with the use of visual [seven articles (41.18%)] and auditory cues [three articles (17.65%)], including decreased number of freezing episodes and increased stride length.Conclusions
Although assistive devices seem to improve confidence, there is still limited information about the efficacy of assistive devices on gait parameters and functional disability in Parkinson's disease. Further, longitudinal, multicenter, randomized, blinded, and controlled studies using assistive devices in a free-living context are required to provide the best scientific evidence.
SUBMITTER: Garcia-Bustillo A
PROVIDER: S-EPMC9631832 | biostudies-literature | 2022 Nov
REPOSITORIES: biostudies-literature
Publications
Assistive Devices for Personal Mobility in Parkinson's Disease: A Systematic Review of the Literature.
García-Bustillo Álvaro Á Valiñas-Sieiro Florita F Allende-Río Marta M González-Santos Josefa J Cubo Esther E
Movement disorders clinical practice 20221007 8
<h4>Background</h4>Gait abnormalities are a hallmark of Parkinson's disease and contribute to falling risk. As disease symptoms progress, assistive devices are often prescribed. However, there are no guidelines for choosing appropriate ambulatory devices for gait impairment.<h4>Objective</h4>To review the scientific evidence on assistive devices for gait impairment in Parkinson's disease.<h4>Methods</h4>We performed a systematic literature review for articles relating to parkinsonian gait impair ...[more]
Similar Datasets
Project description:BackgroundWith the advent of smart sensing technology, mobile and wearable devices can provide continuous and objective monitoring and assessment of motor function outcomes.ObjectiveWe aimed to describe the existing scientific literature on wearable and mobile technologies that are being used or tested for assessing motor functions in mobility-impaired and healthy adults and to evaluate the degree to which these devices provide clinically valid measures of motor function in these populations.MethodsA systematic literature review was conducted by searching Embase, MEDLINE, CENTRAL (January 1, 2015, to June 24, 2020), the United States and European Union clinical trial registries, and the United States Food and Drug Administration website using predefined study selection criteria. Study selection, data extraction, and quality assessment were performed by 2 independent reviewers.ResultsA total of 91 publications representing 87 unique studies were included. The most represented clinical conditions were Parkinson disease (n=51 studies), followed by stroke (n=5), Huntington disease (n=5), and multiple sclerosis (n=2). A total of 42 motion-detecting devices were identified, and the majority (n=27, 64%) were created for the purpose of health care-related data collection, although approximately 25% were personal electronic devices (eg, smartphones and watches) and 11% were entertainment consoles (eg, Microsoft Kinect or Xbox and Nintendo Wii). The primary motion outcomes were related to gait (n=30), gross motor movements (n=25), and fine motor movements (n=23). As a group, sensor-derived motion data showed a mean sensitivity of 0.83 (SD 7.27), a mean specificity of 0.84 (SD 15.40), a mean accuracy of 0.90 (SD 5.87) in discriminating between diseased individuals and healthy controls, and a mean Pearson r validity coefficient of 0.52 (SD 0.22) relative to clinical measures. We did not find significant differences in the degree of validity between in-laboratory and at-home sensor-based assessments nor between device class (ie, health care-related device, personal electronic devices, and entertainment consoles).ConclusionsSensor-derived motion data can be leveraged to classify and quantify disease status for a variety of neurological conditions. However, most of the recent research on digital clinical measures is derived from proof-of-concept studies with considerable variation in methodological approaches, and much of the reviewed literature has focused on clinical validation, with less than one-quarter of the studies performing analytical validation. Overall, future research is crucially needed to further consolidate that sensor-derived motion data may lead to the development of robust and transformative digital measurements intended to predict, diagnose, and quantify neurological disease state and its longitudinal change.
| S-EPMC9723979 | biostudies-literature
Project description:PurposeA primary goal for aging policy is to optimize independence in later life. We estimate the cross-sectional association between physical and social challenge in the home environment and use of assistive devices (AD) for mobility in the home, controlling for lower extremity physical performance (short physical performance battery [SPPB]) and other factors.Design and methodsData are from the Women's Health and Aging Study I, a prospective study of the factors related to physical disability in a sample of moderately to severely disabled older women. We describe these associations in the baseline sample overall and also within subsets who do and do not have both a baseline and a 3-year follow-up observation.ResultsOn average, physical challenge in the home environment is inversely associated with level of AD use (p < .05) in the overall sample, independent of SPPB, living alone, and other factors. We do not find a significant (p < .05) association between social challenge and the level of AD use in the overall sample. Findings by follow-up responder status were similar (with minor variability).ImplicationsFuture cohorts who are better educated and more receptive to technology may confront challenges in the home environment that limit their ability to age in place. Our findings suggest that the physical challenges of the home are significantly related to AD use. Future analyses that explore the mechanisms of the home environment as a source of challenges to independent functioning could help in the design of future interventions for these cohorts as they age.
| S-EPMC4110451 | biostudies-literature
Project description:BackgroundInformation and communication technology (ICT) has transformed the health care field worldwide. One of the main drivers of this change is the electronic health record (EHR). However, there are still open issues and challenges because the EHR usually reflects the partial view of a health care provider without the ability for patients to control or interact with their data. Furthermore, with the growth of mobile and ubiquitous computing, the number of records regarding personal health is increasing exponentially. This movement has been characterized as the Internet of Things (IoT), including the widespread development of wearable computing technology and assorted types of health-related sensors. This leads to the need for an integrated method of storing health-related data, defined as the personal health record (PHR), which could be used by health care providers and patients. This approach could combine EHRs with data gathered from sensors or other wearable computing devices. This unified view of patients' health could be shared with providers, who may not only use previous health-related records but also expand them with data resulting from their interactions. Another PHR advantage is that patients can interact with their health data, making decisions that may positively affect their health.ObjectiveThis work aimed to explore the recent literature related to PHRs by defining the taxonomy and identifying challenges and open questions. In addition, this study specifically sought to identify data types, standards, profiles, goals, methods, functions, and architecture with regard to PHRs.MethodsThe method to achieve these objectives consists of using the systematic literature review approach, which is guided by research questions using the population, intervention, comparison, outcome, and context (PICOC) criteria.ResultsAs a result, we reviewed more than 5000 scientific studies published in the last 10 years, selected the most significant approaches, and thoroughly surveyed the health care field related to PHRs. We developed an updated taxonomy and identified challenges, open questions, and current data types, related standards, main profiles, input strategies, goals, functions, and architectures of the PHR.ConclusionsAll of these results contribute to the achievement of a significant degree of coverage regarding the technology related to PHRs.
| S-EPMC5251169 | biostudies-literature
Project description:BackgroundFunctional mobility (FM) is a person's ability to move to accomplish activities of daily living; it bridges the concepts of mobility and functional ability. There is frequently a loss of FM in Parkinson's disease (PD). Several instruments have been used to assess this concept in PD; however, there is no consensus on which are the most appropriate.ObjectiveWe aimed to identify and critically appraise which measurement instruments have been used to assess FM.MethodsA systematic review was conducted using the databases CENTRAL, MEDLINE, Embase, and PEDro from their inception to January 2019 to identify all observational and experimental studies conducted in PD or atypical parkinsonism that included an FM assessment. Two reviewers independently screened citations, extracted data, and assessed clinimetric properties.ResultsWe included 95 studies that assessed FM in PD. Fifty-five (57.9%) studies mentioned FM in the article, and 39 (41.1%) specified the measurement tools used to evaluate FM. FM was the primary outcome in 12 (12.6%) studies. The Timed Up and Go test was the most frequently used measurement tool. Only one study presented a definition of FM. Several overlapping terms were used, the most common being mobility.ConclusionSeveral studies reported the use of FM measurement tools in PD, though with frequent misconceptions, an inadequate context of use, or suboptimal assessment. We propose the establishment of the concept of FM applied to PD, followed by the adequate clinimetric validation of existing measurement tools to provide a comprehensive and reliable evaluation of FM in PD.
| S-EPMC7011644 | biostudies-literature
Project description:BackgroundParkinson's disease (PD) management comprises of drug treatments, surgery, and physical activity/occupational therapies to relieve PD's symptoms. The aim of this study is twofold; first, to appraise recent economic evaluation studies on PD management in order to update the existing knowledge; and second, to facilitate decision making on PD management by assessing the cost-effectiveness of all types of PD interventions.MethodsA systematic search for studies published between 2010 and 2018 was conducted. The inclusion and exclusion of the articles were based on criteria relevant to population, intervention, comparison, outcomes, and study design (PICO). The reporting quality of the articles was assessed according to Consolidated Health Economic Evaluation Reporting Standards.ResultsTwenty-eight articles were included, 10 of which were evaluations of drug treatments, 10 deep brain stimulation (DBS), and eight physical/occupational therapies. Among early-stage treatments, Ti Ji dominated all physical activity interventions; however, its cost-effectiveness should be further explored in relation to its duration, intensity, and frequency. Multidisciplinary interventions of joint medical and nonmedical therapies provided slightly better health outcomes for the same costs. In advanced PD patients, adjunct drug treatments could become more cost-effective if introduced during early PD and, although DBS was more cost-effective than adjunct drug therapies, the results were time-bound.ConclusionsConditionally, certain PD interventions are cost-effective. However, PD progression differs in each patient; thus, the cost-effectiveness of individually tailored combinations of interventions that could provide more time in less severe disease states and improve patients' and caregivers' quality of life, should be further explored.
| S-EPMC6476603 | biostudies-literature
Project description:Exoskeletons, orthoses, exosuits, assisting robots and such devices referred to as wearable assistive devices are devices designed to augment or protect the human body by applying and transmitting force. Due to the problems concerning cost- and time-consuming user tests, in addition to the possibility to test different configurations of a device, the avoidance of a prototype and many more advantages, digital human models become more and more popular for evaluating the effects of wearable assistive devices on humans. The key indicator for the efficiency of assistance is the interface between device and human, consisting mainly of the soft biological tissue. However, the soft biological tissue is mostly missing in digital human models due to their rigid body dynamics. Therefore, this systematic review aims to identify interaction modelling approaches between wearable assistive devices and digital human models and especially to study how the soft biological tissue is considered in the simulation. The review revealed four interaction modelling approaches, which differ in their accuracy to recreate the occurring interactions in reality. Furthermore, within these approaches there are some incorporating the appearing relative motion between device and human body due to the soft biological tissue in the simulation. The influence of the soft biological tissue on the force transmission due to energy absorption on the other side is not considered in any publication yet. Therefore, the development of an approach to integrate the viscoelastic behaviour of soft biological tissue in the digital human models could improve the design of the wearable assistive devices and thus increase its efficiency and efficacy.
| S-EPMC9872199 | biostudies-literature
Project description:Researchers and clinicians refer to outcomes of genomic testing that extend beyond clinical utility as 'personal utility'. No systematic delineation of personal utility exists, making it challenging to appreciate its scope. Identifying empirical elements of personal utility reported in the literature offers an inventory that can be subsequently ranked for its relative value by those who have undergone genomic testing. A systematic review was conducted of the peer-reviewed literature reporting non-health-related outcomes of genomic testing from 1 January 2003 to 5 August 2016. Inclusion criteria specified English language, date of publication, and presence of empirical evidence. Identified outcomes were iteratively coded into unique domains. The search returned 551 abstracts from which 31 studies met the inclusion criteria. Study populations and type of genomic testing varied. Coding resulted in 15 distinct elements of personal utility, organized into three domains related to personal outcomes: affective, cognitive, and behavioral; and one domain related to social outcomes. The domains of personal utility may inform pre-test counseling by helping patients anticipate potential value of test results beyond clinical utility. Identified elements may also inform investigations into the prevalence and importance of personal utility to future test users.
| S-EPMC5477355 | biostudies-literature
Project description:BackgroundNeurodegenerative diseases are mainly a consequence of degenerated proteins in neurons. Parkinson's disease (PD) is one of the most common neurodegenerative disorders and is characterized by Lewy body deposition. Autophagy is known as one of the cell maintenance mechanisms. Autophagy targets are damaged or degenerated macromolecules and organelles for lysosomal degradation. The role of disrupted autophagy in PD was established earlier. In this regard, the current study aimed to evaluate the frequency and status of the autophagy gene polymorphisms in PD by a systematic review approach.Materials and methodsIn the current study, electronic databases including Scopus, PubMed, and Science Direct were used for the search. The search was performed by using Parkinson's disease, autophagy, autophagy-related gene, ATG, Single-nucleotide polymorphisms, variant, Sequence variants, and with a date limitation of 2010 to 2023. All original research papers in the English language that evaluate the ATG polymorphisms in PD were included in the study.ResultsThe conducted search leads to 2626 primary studies screened based on the inclusion criteria. After the screening stage, 8 studies were included. ATG7 rs1375206 and ATG5 rs510432, rs573775 and rs17587319 were associated with PD. However, some other polymorphisms in ATGs that were not associated with PD were listed.ConclusionIn conclusion, regardless of the critical role of autophagy in PD pathogenesis, it seems that ATG16 and ATG7 polymorphisms are not associated with PD; however, ATG7 rs1375206 needs more evaluation for a clearer conclusion in future studies. ATG5 and ATG12 polymorphisms seem to be more important in PD. More comprehensive studies about all ATG5, 7, 12, and 16 seem to be urgently required for a conclusive judgment about their role in PD or even other neurodegenerative disorders.
| S-EPMC11910361 | biostudies-literature
Project description:Since the discovery of levodopa (L-dopa) in 1967, the range of medications available to treat Parkinson's disease has increased significantly and guidance on the use, efficacy, and safety of these medications has evolved. To assess levels of adherence to national prescribing guidelines and awareness of changes in the efficacy and safety data published in the profiles of medications for the treatment of PD, we have reviewed studies on patterns and determinants of prescribing PD medications conducted in the last 50 years (since the discovery of L-dopa). A systematic literature review was conducted using EMBASE (1967 to March, 2018), Ovid MEDLINE(R) ALL (1967 to March 16, 2018), PsycINFO (1967 to the 2nd week of March, 2018), and PubMed to identify all studies measuring prescribing patterns of PD medication between 1967 and 2017. Study design, source of data, country, year of study, number of patients and/or prescriptions, unit of analysis, prescribing determinants, and percentage utilisation of PD medications were extracted where possible. 44 studies examining prescribing patterns and/or prescribing determinants across 17 countries were identified. Unsurprisingly, L-dopa was the most commonly prescribed medication in all studies, accounting for 46.50% to 100% of all prescriptions for PD. In several studies, the prescribing rate of ergot-derived dopamine agonists (DAs) decreased over time in concordance with guidance. In contrast, the prescribing rates of non-ergot DAs increased over the last ten years in most of the included studies. In examining prescribing factors, two major categories were exemplified, patients' factors and prescribers' factors, with patients' age being the most common factor that affected the prescription in most studies. In conclusion, L-dopa is now the most commonly prescribed medication for cases of PD but there is large variation in the prescribing rates of catechol-O-methyltransferase (COMT) inhibitors, monoamine oxidase B (MAO-B) inhibitors, amantadine, and anticholinergics between countries. New studies examining the effects of recent clinical trials and measuring the prescribing rates of newly approved medications are warranted.
| S-EPMC6875178 | biostudies-literature
Project description:This systematic literature review encompassed the results of previous research on personal reputation and found opportunities in state of the literature to guide future research in communication, management, and other disciplines in the social sciences. A content analysis was conducted of 91 manuscripts from 1984 to November 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The findings suggest that the amount of literature on personal reputation has increased since 2006; however, it is still in a developing stage. Due to its scarcity, it is advisable to conduct more qualitative and probability studies. For this review, several of the most cited articles are probably pioneering manuscripts that contributed to building the personal reputation construct. This review establishes a total of six categories for guiding future research opportunities on personal reputation. To facilitate the classification of the different future research opportunities, some types of areas suggested by Gomez-Trujillo et al. were considered. The discussion of future research opportunities includes categories like Causes and Effects, Inventories and Scales, Online and Digital Context, Organizational and Group Environments, Leaders and Top Management Executives, and Theory-building. On the other hand, this study could be considered the first step towards future research on how personal reputation influences audiences' opinions and perceptions in different research fields. It also opens the possibility of conducting more specific systematic literature reviews on this topic. Finally, this manuscript offers an overview of the present and the future of construct of personal reputation in the social sciences.
| S-EPMC10172892 | biostudies-literature