The Effects of Sensory Cues on the Gait Impairments in patients with Parkinson’s disease

Anitha, R (2018) The Effects of Sensory Cues on the Gait Impairments in patients with Parkinson’s disease. Masters thesis, Nandha College of Physiotherapy, Erode.


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INTRODUCTION: Parkinson’s disease is a neurological disorder caused by the progressive degeneration of dopamine producing cells in the substantia nigra pars compacta. Progressive degeneration of these cells results in the four cardinal symptoms of Parkinson’s disease, which include tremor, rigidity, postural instability and bradykinesia. Gait impairment is one of the most disabilitating cardinal signs of Parkinson’s disease. Parkinson’s disease can cause gait instability and patterning difficulty characterized by increased cadence, reduced stride length, freezing of gait and reduced velocity. AIM OF THE STUDY: The Aim of the study is to ascertain the effects of sensory cues on the gait impairment in patients with Parkinson’s disease. OBJECTIVES: 1. To have in depth knowledge in Parkinson’s patients. 2. To improve gait in Parkinson’s patients. 3. To find out the effectiveness of sensory cues on the gait impairment in patients with Parkinson’s disease. MATERIALS AND METHODOLOGY: MATERIALS: One chair with arm rest (standard chair with arm rest – 46cm seat height and 63-65cm arm rest height), One chair without arm rest. Stop watch or wrist watch with a second hand to time the performance. Measuring tape, 3 metre path free of obstruction, A Ruler, A Foot stool or step, BP Apparatus, Stethoscope, Patient assessment chart, Data analysis chart, Patient consent form. METHODOLOGY: All patients underwent a neuro examination and gait evaluation. The BBS and TUG test is conducted to confirm diagnose of balance and gait in Parkinson’s patients. POPULATION: Patients with age group of 45-65 years of Parkinson’s disease. CRITERIA FOR SAMPLE SELECTION: Simple random sampling. INCLUSION CRITERIA 1. Subjects with age group 45-65 years. 2. Subjects with freezing of gait/gait instability. 3. Both male and female subjects. 4. Duration of subjects should be between 3months and above. 5. MDS-UPDRS on PART III ≥45. 6. Stabilized drug therapy for at least 1month prior to study and during study. 7. Hearing and vision-able to identify the lines/blocks on floor, hear sounds. 8. Able to walk independently (with or without assistive device). EXCLUSION CRITERIA: 1. Severe co-morbidity (join problems, neuromuscular disorder affecting mobility), 2. Severe dyskinesias, 3. Positive history of neoplasms, cardio-vascular disease, respiratory disease, musculo-skeletal disease. 4. Uncorrected visual/auditory disturbances. SOURCE OF DATA: Outpatient Department, Nandha College of Physiotherapy, Erode, Government Headquarters Hospital, Erode, Bharath Neuro Hospital, Erode, Trust Hospital, Erode and Bharath Rehabilitation Centre, Erode. SAMPLE SIZES: Sample size is 30 subjects. Group A – 15 patients, Group B – 15 patients. STUDY DESIGN: Quasi Experimental Design, &Pre and Post Experimental Study Design. SAMPLING METHOD: Convenient Sampling Method. DURATION OF THE STUDY: 12 Months. RESULTS: The study sample comprised 30 patients, both male and female. The mean age of patients is 60 years. The median time interval between BBS and TUG assessment is applied before and after therapy was 6 weeks. Among 30 patients, 15 were treated with gait re-education training exercises without cues and 15 treated with gait re-education training exercises with cues. The pre and post test values were assessed by BBS, TUG in group A and group B. The mean difference value of BBS is 31 and 19, and TUG is 42 and 37 respectively. The Standard deviation of BBS is 2.42,1.62 and TUG is 1.30 and 1.14 respectively. The paired ‘t’ value of BBS is 48.69 and 43.75 and TUG is 126.61 and 122.70 respectively. The paired ‘t’ test value is more than table value 2.15 for 5% level of significance at 14 degrees of freedom. The calculated ‘t’ value by unpaired ‘t’test of BBS is 10.81, and TUG is 7.81 respectively. The calculated ‘t’values were more than the table value 2.05 for 5% level of significance at 28 degrees of freedom. CONCLUSION: Sensory cueing techniques are effective in improving gait and reducing the psychological impact of gait impairment in patients with Parkinson’s disease. The auditory and visual cue training both proved to be effective in improving gait parameters in Parkinson’s disease subjects. The cueing must be given to the patients for the improving gait. Type of cueing training given should depend on the patient’s condition and choice. Through the results, alternative hypothesis is accepted and also the study could be concluded that there is a significant effect on gait impairment in patients with Parkinson’s disease.

Item Type: Thesis (Masters)
Additional Information: Reg.No.271620062
Uncontrolled Keywords: Sensory Cues, Gait Impairments, Parkinson’s disease.
Subjects: PHYSIOTHERAPY > Physiotherapy in Neurology
Depositing User: Subramani R
Date Deposited: 10 Mar 2020 14:48
Last Modified: 10 Mar 2020 14:48

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