Why have people with dementia problems with walking and balance?

Main Article Content

Jan van de Rakt, Physical Therapist NDT teacher IBITA Steve McCarthy-Grunwald2, MSc BSc RMN

Abstract

Introduction: The walking performance and the balance are elements that change by people with dementia even before the diagnosis -dementia – is established. The reason is still a mystery, still there are investigations that think on an increase of pathological neurological increasing tone -paratonia. Investigations of that tone-increase are done in the beginning of this disease but mostly in a sitting-relax- position. But then is often a slight or even no increase present, but to know the impact, the tone measurement should be measure when people are performed this activity.


Method: To invest the impact of movements by people with dementia, we have taken the Rikli and Jones - Senior Fitness Test- by 35 participant with the diagnosis dementia. Further we did tests as the B.B.S., Tinetti, Statiek test and the tone measurement -Mas-P when walking or immediately after in stand or when stand was no option in sit.


Results: All participants give a worse results on the elements, balance, speed and walking and scored almost equal with age equal persons without dementia on the other items. The other tests (B.B.S., Tinetti, Statiek test) were also lesser and all had a higher tone when this measurement was done immediately after the walking/balance performance and certainly when they are doing the performance.


Conclusion: The impact of the pathological neurological tone (paratonia) was evident in this investigation of 35 people with dementia. The tone was the most important factor that interfered with the speed, walking and balance performance. But this asked for further investigation what walking and balance do with the tone of people with dementia. Further is it a question of an treatment as fall prevention on the way given now, has an effect or maybe has an negative influence on the balance performance. To get a better treatment than must the tone decrease, to get the possibilities of selectivity and speed possible and that is only possible in an gravity decreasing environment as par example water. That should be THE therapy that can slowdown the disease and stimulated the balance performance much longer than when the situation has to deal with gravity and thus an increase tone.


Why have people with dementia problems with walking and balance?   


Authorship Credit: “Criteria authorship scientific article” has been used “Equal Contribution” (EC)

Keywords: dementia, dementia problems, dementia problems with walking, dementia problems with balance, dementia problems with walking and balance

Article Details

How to Cite
RAKT, Jan van de; MCCARTHY-GRUNWALD2, Steve. Why have people with dementia problems with walking and balance?. Medical Research Archives, [S.l.], v. 11, n. 7.1, july 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4077>. Date accessed: 15 may 2024. doi: https://doi.org/10.18103/mra.v11i7.1.4077.
Section
Research Articles

References

1. Ramakers I. Visser P. Aalten P. Boesten J. Metsemakers J. Jolles J. Verhey F. Symptoms of Preclinical Dementia in General Practice up to Five Years before Dementia Diagnosis Dementia and Geriatric Cognitive Disorders. 2007.

2. Investigation starting in the University of Rotterdam Erasmus. 2023. Gelderlander

3.Mirelman A, Maidan I, Bernad-Elazari H, Shustack S, Giladi N, Hausdorff JM. Effects of aging on prefrontal brain activation during challenging walking conditions. Brain Cogn. 2017 Jul;115:41-46. doi: 10.1016/j.bandc.2017.04.002. Epub 2017 Apr 21. PMID: 28433922.

4.Hausdorff J. Hillel I. Shustak S. Del Din S. Bekkers E. Pelosin E. Nieuwhof F. Rochester L. Mirelman A.(2017) Everday stepping quantity and quality among older adult fallers with and without mild cognitive impairment: Initial evidence for nem motor markers of cognitive deficits? The journal of Gerontology. 08 October Doi:https:/doi.org/10.1093/Gerona/glx187.

5. Van de Rakt J. McCarthy-Grunwald S. Physical treatment of individuals with dementia. Part 1 A. Ita. J. Sports Reh. Po.; 2020 ; 7 ; 2 ; 1546 -1581 ISSN 2385-1988 [online] IBSN 007-111-19 - 55 CGI J OAJI :0,101

6. Scherder E. (2017) Singing in the brain. Athenaeum –Polak$ Van Gennep .ISBN.978025307035

7. Zhang Y. Zhou X. Pijnappels M. Bruijn S. Differences in gait stability, trunk and foot accelerations between healthy young and older women bioRxiv 25. 2021.

8. Mirelman A. Hillel I. Rochester L. Del Din S. Bloem B. Avanzino L. Nieuwboer A. Maidan I. Herman T. Thaler A. Gurevich T. Kestenbaum M. Orr-Urtreger A. Brys M. Cederbaum J. Giladi N. Hausdorff J. Tossing and Turning in Bed: Nocturnal Movements in Parkinson’s Disease. Movement Disorders 2020.

9. loeter MK, Danielian LE, Kim YK. Effects of motor skill learning on reciprocal inhibition. Restor Neurol Neurosci. 2013;31(1):53-62. doi: 10.3233/RNN-120247. PMID: 23142814; PMCID: PMC4279717.

10. FallahTafti F. Watson K. Blaskewicz Boron J. Myers S. Schmid K. Yentes J. Strength of plantar- dorsiflexors mediates step regularity during a high cognitive load situation in a cross- sectional cohort of older and younger adults. Journal of Geriatric physical therapy.2019.

11. Kraft P, Gadeholt O, Wieser M (2009) Lying obliquely-a clinical sign of cognitive impairment: cross sectional observational study BMJ. 16: 339-b5273.

12. Franchignoni D (1997) Trunk Control Test as an early predictor of stroke rehabilitation outcome. Stroke 28:1382- 1385.

13. Van de Rakt J, Grunwald SMC (2020) Dementia, How We Can Created the Best Quality of Life for Them. OSP J Health Car Med 1. HCM-1-113

14. Berg WP, Alessio HM, Mills EM, et al. (1997) Circumstances and consequences of falls in independent community dwelling older adults. Age Ageing 26: 261-268.

15. Curcio F, Basile C, Liguori I, Della-Morte D, Gargiulo G, Galizia G, Testa G, Langellotto A, Cacciatore F, Bonaduce D, Abete P. Tinetti mobility test is related to muscle mass and strength in non-institutionalized elderly people. Age (Dordr). 2016 Dec;38(5-6):525-533. doi: 10.1007/s11357-016-9935-9. Epub 2016 Aug 26. PMID: 27566307; PMCID: PMC5266213.

16. Van de Rakt J. (2018) Statiek. Nieuwsbrief . NHV

17. Muskens M. Waarnemend behandelen vanuit een sensomotorisch perspectief De visie van Gerard Worm op het menselijk bewegen. 2022. Uitgevers 2010. ISBN 9789490951719

18. Worm G (2011) Cursus waarnemen en behandelen. Papendal.

19. Rikli R, Jones C (2002) Senior Fitness Test. Active aging 1-30.

20. Kang L (2017) Timed up and Go test can predict recurrent falls; a longitudinal study of the community-dwelling elderly in China. Clin Interv Aging. 12: 2009-2016.

21. Robinovitch S, Feldman F, Yang Y, et al. (2012) Video capture of the circumstances of falls elderly people residing in long -term care: an observational study. Lancet.

22. Van Schooten K (2014) Predicting falls. Amount and quality of daily-life gait as risk factors. Thesis 30-78

23. Waardenburg H. en anderen (1999) Is paratonie betrouwbaar te meten? Ned.Tijdsch.v.Fysio. nummer 2.

24. Hobbelen JS (2010) Paratonia enlightened. Definition, diagnosis, course, risk factors, and treatment. Proefschrift. Enschede, Gildeprintdrukkerijen.

25. Van Deun B. Van Den Noortgate N. Saucedo C. Van Bladel A. Cambier D. A Paratonia in Flemish nursing homes: Current state of practice. m J Alzheimers Dis Other Demen. 2018

26. Van Deun B. Hobbelen H. Cagnie B. Van Eetvelde B. Van Den Noortgate N. Cambier D. Reproducible measurements of muscle characteristics using the MyotonPRO device: Comparison between individuals with and without paratonia J Geriatr Phys Ther. 2018

27. Van Deun B. Van Den Noortgate N. Van Bladel A. Palmans T. Cambier D. The impact of paratonia on fine and gross motor function in older adults with mild and moderate dementia. Alzheimer Dis Assoc Disord. 2018 Oct 26.

28. Van Deun B. Van Den Noortgate N. Van Bladel A. De Weerdt K. Cambier D. Managing paratonia in persons with dementia: Short-term effects of supporting cushions and harmonic techniques. Submitted for publication to Journal of the American Medical Directors Association 2018.

29. Drenth H. Zuidema S. Bautmans I. Marinellie L. Kleiner G. and Hobbelen H. Paratonia in Dementia: A Systematic Review. Journal of Alzheimer’s Disease 2020.

30. Bohannon R.W., Smith M.B (1987) Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys.Ther 67: 206-207

31. Tardieu G., Rondont O., Mensch J., Dalloz J., Monfraix C., et al. (1997) Responses electromyograhpiques a l’etirement musculaire chez l’homme normal. Revue Neurologie 60-61.

32. Bernstein L. The coordination and regulation of movements Pergamon Press New York 1967.

33. Erickson KI, Voss MW, Prakash RS, Basak C, Szabo A, Chaddock L, Kim JS, Heo S, Alves H, White SM, Wojcicki TR, Mailey E, Vieira VJ, Martin SA, Pence BD, Woods JA, McAuley E, Kramer AF. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A. 2011 Feb 15;108(7):3017-22. doi: 10.1073/pnas.1015950108. Epub 2011 Jan 31. PMID: 21282661; PMCID: PMC3041121.

34. Groot C, Hooghiemstra AM, Raijmakers PG, van Berckel BN, Scheltens P, Scherder EJ, van der Flier WM, Ossenkoppele R. The effect of physical activity on cognitive function in patients with dementia: A meta-analysis of randomized control trials. Ageing Res Rev. 2016 Jan;25:13-23. doi: 10.1016/j.arr.2015.11.005. Epub 2015 Nov 28. PMID: 26607411.

35. Bossers WJ, van der Woude LH, Boersma F, Hortobágyi T, Scherder EJ, van Heuvelen MJ. A 9-Week Aerobic and Strength Training Program Improves Cognitive and Motor Function in Patients with Dementia: A Randomized, Controlled Trial. Am J Geriatr Psychiatry. 2015 Nov;23(11):1106-16. doi: 10.1016/j.jagp.2014.12.191. Epub 2015 Jan 3. PMID: 25648055.

36. Norton K, Norton L, Sadgrove D. Position statement on physical activity and exercise intensity terminology. J Sci Med Sport.2010;13(5):496–502.

37. Van de Rakt J (2013) Balanstraining bij ouderen. Physios 3: 12-24.

38. van de Rakt J and McCarthy-Grunwald S, 2022. Tone- Increase is an Answer after a Brain Damage: But How High Is Good?, Medical Research Archives, [online] 10(10). https://doi.org/10.18103/mra. v10i10.313

39. Van de Rakt J, Mc Carthy Grunwald S (2022) Physical treatment (Hydrotherapy) by individuals with and without dementia. Aquatic exercising. Part 1 Ita J Sports Reh Po 3: 1989-2017

40. Van de Rakt J, Lambeck J (2004) Therapeutisch zwemmen met" verpleeghuis" patiënten? N.V.F.G.

41. Lambeck J.( 2001) Hydrotherapie . Uigave N.P.I. ISBN; 9076986096.

42. Hamed S and others. The effects of Halliwick aquatic exercises on gross motor function of children aged from 3 to 5 years with spastic cerebral palsy. Pedagogy of Physical culture and Sports 2023 doi:10.15561/26649837.2023.0103

43. Sato M, Miyake J, Hashimoto Y, (2010) Tactile Perception of a Water Surface: Contributions of Surface Tension and Skin Hair.

44. Tripp W. Effekte der bewegungstherapie im wasser auf die funktionelle mobilat bei schal anfall patienten, eine kontrollierte ,randomisierte studie. Thesis. Uni. Frankfurt am Main, 2011

45. Fedor A (2015) The Effects of A Brief, Water-Based Exercise Intervention on Cognitive Function in Older Adults. Arch Clin Neuropsychol 30: 139-47.

46. Camper U. Wasserspezifische bewegingstherapie und training ; Gustav Fisher verlag. 1995

47. Bosch F (2010) Krachttraining en coördinatie. Uitgevers 2010.

48. Henz D, Schollhorn W (2016) Differential training Facilitates Early consolidation in Motor learning. Front Behav Neurosci 10:199.

49. Voncken en anderen, BrabantZorg (2014) Pilot: Bewegen met water. Team Bewegingsagogie en Psychomotorische therapie. NHV nieuwsbrief 4.

50. Als een vis in het water, zwemmen met dementerenden. Diesfeldt H. Februari 2015 DENKbeeld

51. Van de Rakt J. The diagonal-muscles pattern of the trunk.: Basic of all Movements. Scholars press.2021. ISBN 978-613-8-96056-0