PubMed · 11347236
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N H Mayer, A Esquenazi, M A Keenan. 2001. Patterns of upper motoneuron dysfunction in the lower limb.. https://pubmed.ncbi.nlm.nih.gov/11347236/
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While medications have improved the function of patients with Parkinson's disease (PD), over time most patients experience progressive problems with gait and balance. There have been important recent advances in the development of mechanical assistive devices that have the potential of improving mobility, but there are possible risks and the optimal role for such devices in PD has not been carefully studied. We review the available literature and provide practical information about available mobility assistive devices for patients with PD.
Freezing of gait (FOG) is a disabling episodic gait disturbance that is common among patients with Parkinsonism. FOG typically lasts a few seconds and is associated with a unique sensation: the patient feels that his feet are glued to the ground, causing him to remain in place despite making a concerted effort to overcome the motor block and move forward. Traditionally, FOG has been viewed as a motor symptom of advanced Parkinson's disease. Here we describe evidence which demonstrates that mental conditions also likely play an important role in the pathogenesis of FOG. Stress, anxiety, depression and cognitively challenging situations are associated with FOG, and may set the stage for and increase the likelihood that FOG occurs. A conceptual model that explains how mental conditions may modulate FOG is developed.
The aim of this series of pilot case studies was to examine the feasibility of enhancing the walking of individuals with post-stroke hemiparesis through the imagery practice of gait activities at home. Four persons with chronic hemiparesis received imagery gait practice, 3 days a week for 6 weeks. The intervention addressed gait impairments of the affected lower limb and task-specific gait training. Pre-intervention, mid-term, post-intervention and follow-up evaluations were performed. At 6 weeks from the beginning of treatment, the participants increased walking speed, stride length, cadence and single-support time on the affected lower limb, while decreasing double-support time. The findings appear to justify the institution of a larger-scale study in order to better delineate the contribution of motor imagery practice to gait performance in individuals with post-stroke hemiparesis.