The transition between turning and sitting in patients with Parkinson's disease: A wearable device detects an unexpected sequence of events.
Aner Weiss, Talia Herman, Anat Mirelman and 6 others
PMID 30380506WHAT IT FOUND
Most participants with Parkinson’s disease overlapped turning and sitting during the Timed Up and Go.
Longer overlap was linked to worse balance and gait difficulty, not to cognition or medication state.
Key findings
01During OFF medication, 65.4% of participants used the overlapping strategy and 34.6% used the distinct strategy.
02Among participants who overlapped turning and sitting, a longer overlap was associated with worse postural instability and gait difficulty, and this association remained after accounting for disease duration.
03The strategy choice was mostly stable with medication, as 73% kept the same strategy between OFF and ON states.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was cross-sectional, so it cannot show that overlapping turning and sitting causes worse balance or gait difficulty. There was no matched healthy control group tested with the same methods, so differences from older adults without Parkinson's disease may be partly due to methods or cohort differences. Cognitive tests were performed in the ON medication state, while the main turning analysis was in the OFF state, so the cognitive comparison is not perfectly matched. Participants were not demented and had no major comorbidities likely to affect gait, so findings may not apply to all people with Parkinson's disease. The study did not test an intervention, so it cannot tell therapists whether changing the turning-to-sit sequence improves falls or freezing.
Declared interests
The authors declared no conflict of interest. The paper is listed as supported by NIH extramural and non-U.S. government research funding.
The easy way to misread this
Do not read the overlapping strategy as proof that a patient will fall or that a therapy can fix it. The paper reports an association in people with Parkinson's disease and does not test treatment, cause, or falls outcomes.