Introduction: Several factors have been identified to influence concussion. Migraine has been identified as a common symptom reported after concussion which has been related to a worse prognosis. ...Concussion is a common brain injury that affects physical and cognitive performance. While several studies indicated that adolescents are more likely to develop concussion, in the last decade concussion has been mainly explored in adults. Aim: To investigate the effect of migraine on functional performance and self-reported symptoms in children with concussion. Materials and Methods: This cross-sectional study involved 35 symptomatic children with concussion aged 9-17 years recruited within one year from their concussion injury at a tertiary care center in Pittsburgh, PA, Unites States of America. Participants’ symptoms and functional performance were assessed using the Postconcussion Symptoms Scale (PCSS) and the Functional Gait Assessment (FGA) respectively. Statistical Package for the Social Sciences (SPSS) Statistics for Windows (version 22; IBM Corp, Armonk, NY) was used for all statistical analysis. Results: Mann-Whitney U Test showed that concussed children with migraine had significantly worse symptoms of fatigue and visual problems (p <0.05). The mean age of participants were mean age of 14.03±2.47 years and 66% were females. Conclusion: Although concussed children with and without migraine didn’t show any differences on functional performance, worse fatigue and visual symptoms were found in concussed children with migraine.
Objective:
To evaluate construct validity and reproducibility of the Functional Gait Assessment (FGA) for measuring walking balance capacity in persons after stroke.
Design:
Cross-sectional study.
...Setting:
Inpatient and outpatient rehabilitation center.
Subjects:
Fifty-two persons post-stroke (median (25% and 75% percentiles)) time post-stroke 6 (5–10) weeks) with independent walking ability (mean gait speed 1.1 ± .4 m/s).
Methods:
Subjects completed a standardized FGA twice within one to eight days by the same investigator. Validity was evaluated by testing hypotheses on the association with two timed walking tests, Berg Balance Scale, and the mobility domain of the Stroke Impact Scale using correlation coefficients (r), and with Functional Ambulation Categories using the Kruskal–Wallis test. Reproducibility of FGA scores was assessed with intraclass correlation coefficient and standard error of measurement.
Results:
Subjects scored a median of 22 out of 30 points at the first FGA. Moderate to high significant correlations (r .61–.83) and significant differences in FGA median scores between the Functional Ambulation Categories were found. Eight hypotheses (80%) could be confirmed. Inter-rater, intra-rater, and test–retest reliability of the total scores were excellent. The standard error of measurement and minimal detectable change were 2 and 6 points, respectively. No relevant ceiling effect was observed.
Conclusion:
The FGA demonstrated good measurement properties in persons after stroke and yielded no ceiling effect in contrast to other capacity measures. In clinical practice, a measurement error of 6 points should be taken into account in interpreting changes in walking balance.
The Functional Gait Assessment (FGA) evaluates postural stability in gait and predicts fall risk in older adults. Individual tasks within the FGA consider aspects of mobility assumed to require ...strength and/or balance to complete. Identifying how quantitative measures of strength and balance relate to FGA performance would allow for more targeted interventions based on one’s pattern of performance on different tasks.
Is performance on the FGA (total score and individual task scores) related to measures of strength and balance in healthy older adults?
In a cross-sectional study, healthy older adults (N = 46) were evaluated with the FGA, measures of knee extensor strength, and balance (static stance and weight shifting) (N = 46). Correlational analyses were performed between FGA scores (total and individual) and measures of strength and balance.
Total FGA performance was positively correlated with knee extensor strength (maximum torque and rate of torque development). Individual FGA tasks of walking backwards (task 9) and stair climbing (task 10) had the highest correlations with strength measures. Total FGA performance was correlated with reduced postural sway in static balance tasks, but not with balance performance on the weight shifting tasks. The individual FGA task that challenged proprioceptive (task 7) inputs for balance was associated with static balance.
The total FGA score is related to domains of strength and static balance. The results indicate that the FGA can be influenced by reduced strength and balance. The pattern of performance on individual FGA tasks may indicate whether reduced postural stability in gait is related to deficits in strength or balance domains in this older population.
•Older adults (N = 46) performed strength, balance, and gait assessments.•Specific Functional Gait Assessment tasks were related to strength.•Tandem gait performance was related to static balance.•Functional Gait Assessment scores were not related to balance in weight shifts.•Pattern of performance on assessment may imply specific strength/balance deficit.
Gait is often impaired in people after stroke, restricting personal independence and affecting quality of life. During stroke rehabilitation, walking capacity is conventionally assessed by measuring ...walking distance and speed. Gait features, such as asymmetry and variability, are not routinely determined, but may provide more specific insights into the patient's walking capacity. Inertial measurement units offer a feasible and promising tool to determine these gait features.
We examined the test-retest reliability of inertial measurement units-based gait features measured in a two-minute walking assessment in people after stroke and while in clinical rehabilitation.
Thirty-one people after stroke performed two assessments with a test-retest interval of 24 h. Each assessment consisted of a two-minute walking test on a 14-m walking path. Participants were equipped with three inertial measurement units, placed at both feet and at the low back. In total, 166 gait features were calculated for each assessment, consisting of spatio-temporal (56), frequency (26), complexity (63), and asymmetry (14) features. The reliability was determined using the intraclass correlation coefficient. Additionally, the minimal detectable change and the relative minimal detectable change were computed.
Overall, 107 gait features had good-excellent reliability, consisting of 50 spatio-temporal, 8 frequency, 36 complexity, and 13 symmetry features. The relative minimal detectable change of these features ranged between 0.5 and 1.5 standard deviations.
Gait can reliably be assessed in people after stroke in clinical stroke rehabilitation using three inertial measurement units.
Gait speed is often used to estimate the walking ability in daily life in people after stroke. While measuring gait with inertial measurement units (IMUs) during clinical assessment yields additional ...information, it remains unclear if this information can improve the estimation of the walking ability in daily life beyond gait speed.
We evaluated the additive value of IMU-based gait features over a simple gait-speed measurement in the estimation of walking ability in people after stroke.
Longitudinal data during clinical stroke rehabilitation were collected. The assessment consisted of two parts and was administered every three weeks. In the first part, participants walked for two minutes (2MWT) on a fourteen-meter path with three IMUs attached to low back and feet, from which multiple gait features, including gait speed, were calculated. The dimensionality of the corresponding gait features was reduced with a principal component analysis. In the second part, gait was measured for two consecutive days using one ankle-mounted IMU. Next, three measures of walking ability in daily life were calculated, including the number of steps per day, and the average and maximal gait speed. A gait-speed-only Linear Mixed Model was used to estimate the association between gait speed and each of the three measures of walking ability. Next, the principal components (PC), derived from the 2MWT, were added to the gait-speed-only model to evaluate if they were confounders or effect modifiers.
Eighty-one participants were measured during rehabilitation, resulting in 198 2MWTs and 135 corresponding walking-performance measurements. 106 Gait features were reduced to nine PCs with 85.1% explained variance. The linear mixed models demonstrated that gait speed was weakly associated with the average and maximum gait speed in daily life and moderately associated with the number of steps per day. The PCs did not considerably improve the outcomes in comparison to the gait speed only models.
Gait in people after stroke assessed in a clinical setting with IMUs differs from their walking ability in daily life. More research is needed to determine whether these discrepancies also occur in non-laboratory settings, and to identify additional non-gait factors that influence walking ability in daily life.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: Aging process represents the natural process, which cannot be obviated. It is caused by biological factor that goes naturally that influence the anatomical, biochemical and physiological ...changes. The natural changes contribute in falling on elderly. The objective of this study was to describe the falling prediction in elderly using Functional Gait Assessment.
Method: This study used descriptive study design. The population was 48 elderly, with sample of 43 elderly involved by means of purposive sampling, taken according to inclusion criteria. The variable was falling prediction. The data were collected using Functional Gait Assessment and then were analyzed.
Result: Forty-three elderly in Panti Werdha Wana Seraya (aged 60-103 years, with a mean of 77,48 ± 1,61) were included. The result showed that elderly had a high risk of falls. Functional Gait Assessment showed that 41 from 43 respondents scored
Background
A number of assessments exist that evaluate function in ambulatory adults. However, these assessments take for granted the cognitive abilities required for the participant to understand ...what is being asked of them in order to demonstrate their functional abilities. It has been shown that individuals with Down syndrome (DS) demonstrate lower functional levels when asked to perform additional tasks while walking. Therefore, measurements of function may not be reflective of actual function if the assessment requires additional tasks in those with DS. It is for these reasons the current investigation sought to evaluate four common functional assessments, two with modified Berg balance test (mBERG) and Functional Gait Assessment (FGA) and two without Timed Up and Go (TUG) and Established Populations for Epidemiologic Study in the Elderly (EPESE) complex tasks.
Methods
Adults with DS (n = 19) completed four functional assessments, which were later compared using bivariate Pearson correlation coefficients.
Results
There were large associations between simple assessments (TUG–EPESE: r = −0.525, P = 0.021) and complex assessments (FGA–mBERG: r = 0.612, P = 0.005), respectively. The TUG also inversely correlated with the FGA (r = −0.476, P = 0.039), and the EPESE had a large association with mBERG (r = 0.508, P = 0.027).
Conclusions
The mBERG may be the best test to replicate real‐world scenarios through its tasks, although it may also be confounded by the cognitive load required to perform the movements as asked. The TUG and EPESE may be more appropriate as mobility assessments because they require very little cognitive attention when completing the tasks. True assessments of mobility ought to err on the side of simple so to not confuse the outcomes with executive functionality.
Although the tap test for patients with suspected idiopathic normal pressure hydrocephalus (iNPH) is still often performed as part of the preoperative evaluation, it is true that some studies have ...reported the limitations of the tap test, claiming that it does not provide the additional information for appropriate patient selection for surgery. We aimed to determine whether a better method of pre- and post-tap test assessment could lead to appropriate patient selection for shunting.
We performed the tap test as part of the preoperative evaluation in all 40 patients who underwent lumboperitoneal shunt surgery for iNPH from April 2021 to September 2021. We retrospectively analyzed the patient data. We examined whether a comprehensive evaluation of the effect of the tap test using the Functional Gait Assessment (FGA) and Global Rating of Change (GRC) scales would identify a wider range of patients who would benefit from shunt surgery than the 3-m Timed Up and Go test (TUG) alone.
Assuming a prevalence of 1% for iNPH, the TUG had a sensitivity of 0.23, specificity of 0.71, positive likelihood ratio of 0.79, and negative likelihood ratio of 1.09. When improvement in either the FGA or the GRC was used as a criterion for the validity of the tap test, the sensitivity was 0.88, specificity was 0.17, positive likelihood ratio was 1.06, and negative likelihood ratio was 0.71.
Improvement in either the FGA or the GRC is a more sensitive criterion for the effectiveness of the tap test for the gait aspect than the TUG. Since the negative likelihood ratio is lower than that for the TUG alone, it is more appropriate to exclude patients with neither FGA nor GRC improvement from surgical indications than to exclude surgical indications based on a negative TUG.
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