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Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements, that indicates dysfunction of parts of the nervous system that coordinate movement, such as the cerebellum. These nervous system dysfunctions occur in several different patterns, with different results and different possible causes. Ataxia can be limited to one side of the body, which is referred to as hemiataxia. Friedreich's ataxia has gait abnormality as the most commonly presented symptom. Dystaxia is a mild degree of ataxia.
Charcot–Marie–Tooth disease (CMT) is a hereditary motor and sensory neuropathy of the peripheral nervous system characterized by progressive loss of muscle tissue and touch sensation across various parts of the body. This disease is the most commonly inherited neurological disorder, affecting about one in 2,500 people. It is named after those who classically described it: the Frenchman Jean-Martin Charcot (1825–1893), his pupil Pierre Marie (1853–1940), and the Briton Howard Henry Tooth (1856–1925).
Anhedonia is a diverse array of deficits in hedonic function, including reduced motivation or ability to experience pleasure. While earlier definitions emphasized the inability to experience pleasure, anhedonia is currently used by researchers to refer to reduced motivation, reduced anticipatory pleasure (wanting), reduced consummatory pleasure (liking), and deficits in reinforcement learning. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), anhedonia is a component of depressive disorders, substance-related disorders, psychotic disorders, and personality disorders, where it is defined by either a reduced ability to experience pleasure, or a diminished interest in engaging in pleasurable activities. While the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) does not explicitly mention anhedonia, the depressive symptom analogous to anhedonia as described in the DSM-5 is a loss of interest or pleasure.
Gait abnormality is a deviation from normal walking (gait). Watching a patient walk is the most important part of the neurological examination. Normal gait requires that many systems, including strength, sensation and coordination, function in an integrated fashion. Many common problems in the nervous system and musculoskeletal system will show up in the way a person walks.
Fall prevention includes any action taken to help reduce the number of accidental falls suffered by susceptible individuals, such as the elderly (idiopathic) and people with neurological or orthopedic indications.
Frailty is a common geriatric syndrome that embodies an elevated risk of catastrophic declines in health and function among older adults. Frailty is a condition associated with ageing, and it has been recognized for centuries. It is a marker of a more widespread syndrome of frailty, with associated weakness, slowing, decreased energy, lower activity, and, when severe, unintended weight loss. As a frequent clinical syndrome in the elderly, various health risks are linked to health deterioration and frailty in older age, such as falls, disability, hospitalization, and mortality. Generally, frailty refers to older adults who lose independence. It also links to the experiences of losing dignity due to social and emotional isolation risk. Frailty has been identified as a risk factor for the development of dementia.
Balance in biomechanics, is an ability to maintain the line of gravity of a body within the base of support with minimal postural sway. Sway is the horizontal movement of the centre of gravity even when a person is standing still. A certain amount of sway is essential and inevitable due to small perturbations within the body or from external triggers. An increase in sway is not necessarily an indicator of dysfunctional balance so much as it is an indicator of decreased sensorimotor control.
Transcription cofactor HES-6 is a protein that in humans is encoded by the HES6 gene.
Falls in older adults are a significant cause of morbidity and mortality and are a major class of preventable injuries. Falling is one of the most common accidents that cause a loss in the quality of life for older adults, and is usually precipitated by a loss of balance and weakness in the legs. The cause of falling in old age is often multifactorial and may require a multidisciplinary approach both to treat any injuries sustained and to prevent future falls. Falls include dropping from a standing position or from exposed positions such as those on ladders or stepladders. The severity of injury is generally related to the height of the fall. The state of the ground surface onto which the victim falls is also important, harder surfaces causing more severe injury. Falls can be prevented by ensuring that carpets are tacked down, that objects like electric cords are not in one's path, that hearing and vision are optimized, dizziness is minimized, alcohol intake is moderated and that shoes have low heels or rubber soles.
Falling is the action of a person or animal losing stability and ending up in a lower position, often on the ground. It is the second-leading cause of accidental death worldwide and a major cause of personal injury, especially for the elderly. Falls in older adults are a major class of preventable injuries. Construction workers, electricians, miners, and painters are occupations with high rates of fall injuries.
Parkinsonian gait is the type of gait exhibited by patients with Parkinson's disease (PD). It is often described by people with Parkinson's as feeling like being stuck in place, when initiating a step or turning, and can increase the risk of falling. This disorder is caused by a deficiency of dopamine in the basal ganglia circuit leading to motor deficits. Gait is one of the most affected motor characteristics of this disorder although symptoms of Parkinson's disease are varied.
Geriatric trauma refers to a traumatic injury that occurs to an elderly person. People around the world are living longer than ever. In developed and underdeveloped countries, the pace of population aging is increasing. By 2050, the world's population aged 60 years and older is expected to total 2 billion, up from 900 million in 2015. While this trend presents opportunities for productivity and additional experiences, it also comes with its own set of challenges for health systems. More so than ever, elderly populations are presenting to the Emergency Department following traumatic injury. In addition, given advances in the management of chronic illnesses, more elderly adults are living active lifestyles and are at risk of traumatic injury. In the United States, this population accounts for 14% of all traumatic injuries, of which a majority are just mainly from falls.
Normal aging movement control in humans is about the changes in the muscles, motor neurons, nerves, sensory functions, gait, fatigue, visual and manual responses, in men and women as they get older but who do not have neurological, muscular or neuromuscular disorder. With aging, neuromuscular movements are impaired, though with training or practice, some aspects may be prevented.
The fear of falling (FOF), also referred to as basophobia, is a natural fear and is typical of most humans and mammals, in varying degrees of extremity. It differs from acrophobia, although the two fears are closely related. The fear of falling encompasses the anxieties accompanying the sensation and the possibly dangerous effects of falling, as opposed to the heights themselves. Those who have little fear of falling may be said to have a head for heights. Basophobia is sometimes associated with astasia-abasia, the fear of walking/standing erect.
The Berg Balance Scale is a widely used clinical test of a person's static and dynamic balance abilities, named after Katherine Berg, one of the developers. For functional balance tests, the BBS is generally considered to be the gold standard.
The Timed Up and Go test (TUG) is a simple test used to assess a person's mobility and requires both static and dynamic balance.
The Morse Fall Scale (MFS) is a rapid and simple method of assessing a patient’s likelihood of falling. A large majority of nurses (82.9%) rate the scale as “quick and easy to use,” and 54% estimated that it took less than 3 minutes to rate a patient. "The scale consists of six items reflecting risk factors of falling such as: (i) history of falling, (ii) secondary diagnosis, (iii) ambulatory aids, (iv) intravenous therapy, (v) type of gait and (vi) mental status", and it has been shown to have predictive validity and interrater reliability. The MFS is used widely in acute care settings, both in the hospital and long-term care inpatient settings. The manual for using the MFS is: Preventing Patient Falls.
Gait deviations are nominally referred to as any variation of standard human gait, typically manifesting as a coping mechanism in response to an anatomical impairment. Lower-limb amputees are unable to maintain the characteristic walking patterns of an able-bodied individual due to the removal of some portion of the impaired leg. Without the anatomical structure and neuromechanical control of the removed leg segment, amputees must use alternative compensatory strategies to walk efficiently. Prosthetic limbs provide support to the user and more advanced models attempt to mimic the function of the missing anatomy, including biomechanically controlled ankle and knee joints. However, amputees still display quantifiable differences in many measures of ambulation when compared to able-bodied individuals. Several common observations are whole-body movements, slower and wider steps, shorter strides, and increased sway.
The Parallel Walk Test is a quick and simple quantitative measuring tool for balance during walking and could be a useful tool in clinical settings for assessing balance before and after treatments and to discriminate high fall risk potential.
Locomotive syndrome is a medical condition of decreased mobility due to disorders of the locomotor system. The locomotor system comprises bones, joints, muscles and nerves. It is a concept put forward by three professional medical societies in Japan: the Japanese Society for Musculoskeletal Medicine, the Japanese Orthopaedic Association, and the Japanese Clinical Orthopaedic Association. Locomotive syndrome is generally found in the ageing population as locomotor functions deteriorate with age. Symptoms of locomotive syndrome include limitations in joint mobility, pain, balance disorder, malalignment and gait abnormality. Locomotive syndrome is commonly caused by chronic locomotive organ diseases. Diagnosis and assessment of locomotive syndrome is done using several tests such as the stand-up and two-step tests. The risk of having locomotive syndrome can be decreased via adequate nutrition, attainment of an exercise habit and being active.
References
- ↑ Wolfson L, Whipple R, Amerman P, Tobin JN (January 1990). "Gait assessment in the elderly: a gait abnormality rating scale and its relation to falls". J Gerontol. 45 (1): M12–9. doi: 10.1093/geronj/45.1.m12 . PMID 2295773.
- ↑ VanSwearingen JM, Paschal KA, Bonino P, Chen TW (November 1998). "Assessing recurrent fall risk of community-dwelling, frail older veterans using specific tests of mobility and the physical performance test of function". J. Gerontol. A Biol. Sci. Med. Sci. 53 (6): M457–64. doi: 10.1093/gerona/53a.6.m457 . PMID 9823750.
- ↑ Russell TG, Jull GA, Wootton R (2003). "The diagnostic reliability of Internet-based observational kinematic gait analysis". J Telemed Telecare. 9. Suppl 2 (Supplement 2): S48–51. doi:10.1258/135763303322596255. PMID 14728760. S2CID 6910676.
- ↑ VanSwearingen JM, Paschal KA, Bonino P, Yang JF (September 1996). "The modified Gait Abnormality Rating Scale for recognizing the risk of recurrent falls in community-dwelling elderly adults". Phys Ther. 76 (9): 994–1002. doi: 10.1093/ptj/76.9.994 . PMID 8790277.
- ↑ "GAIT ASSESSMENT RATING SCALE". Archived from the original on 13 February 2012.
- ↑ "Abnormal Gait".