Impairments of balance, stepping reactions and gait in people with cervical dystonia

Barr, C; Barnard, R; Edwards, L; Lennon, S; Bradnam, L

Impairments of balance, stepping reactions and gait in people with cervical dystonia

Barr, C Barnard, R Edwards, L Lennon, S Bradnam, L

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Publication Type:: Journal Article
Citation:: Gait and Posture, 2017, 55 pp. 55 - 61
Issue Date:: 2017-06-01

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Field	Value	Language
dc.contributor.author	Barr, C	en_US
dc.contributor.author	Barnard, R	en_US
dc.contributor.author	Edwards, L	en_US
dc.contributor.author	Lennon, S	en_US
dc.contributor.author	Bradnam, L https://orcid.org/0000-0002-3067-0326	en_US
dc.date.available	2017-04-02	en_US
dc.date.issued	2017-06-01	en_US
dc.identifier.citation	Gait and Posture, 2017, 55 pp. 55 - 61	en_US
dc.identifier.issn	0966-6362	en_US
dc.identifier.uri	http://hdl.handle.net/10453/124900
dc.description.abstract	© 2017 Elsevier B.V. Background Impaired balance is common in neurological disorders. Cervical dystonia is a neurological movement disorder affecting the neck. The effect of this aberrant head posture on physical function is unknown. Objectives To compare balance, mobility, gait and stepping reactions between ten people with cervical dystonia and ten control adults. Methods Spatiotemporal gait parameters and walking speed were assessed using a computerised walkway. Step length and time, time in double support and gait variability were calculated, then normalised to gait speed. Centre of pressure path length was assessed with eyes open and eyes closed to calculate a Romberg Quotient. Simple and choice reaction times were measured using customised apparatus while mobility was assessed by the timed up and go. Cervical spine range of motion was measured using a head mounted goniometer. Self-reported scales included Falls Self Efficacy Scale and Dystonia Discomfort Scale. Results There was a difference between groups for most outcome measures. The timed up-and-go and walking speed was slower (both P < 0.005) and the Romberg Quotient lower (P = 0.046) in cervical dystonia. People with cervical dystonia had lower falls self-efficacy (P = 0.0002). Reduced cervical range of motion was correlated with balance, stepping reaction time and mobility (all P < 0.05). Timed up and go was positively associated with stepping reaction time (P < 0.01). Dystonia discomfort did not impact function. Conclusions People with cervical dystonia displayed deficits in balance, gait and stepping reactions, and expressed higher fear of falling. Studies to further elucidate functional limitations and their impact on activity and participation in daily life are required.	en_US
dc.relation.ispartof	Gait and Posture	en_US
dc.relation.isbasedon	10.1016/j.gaitpost.2017.04.004	en_US
dc.subject.classification	Orthopedics	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Torticollis	en_US
dc.subject.mesh	Gait	en_US
dc.subject.mesh	Walking	en_US
dc.subject.mesh	Self Efficacy	en_US
dc.subject.mesh	Accidental Falls	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Physical Therapy Modalities	en_US
dc.subject.mesh	Postural Balance	en_US
dc.subject.mesh	Walking Speed	en_US
dc.title	Impairments of balance, stepping reactions and gait in people with cervical dystonia	en_US
dc.type	Journal Article
utslib.citation.volume	55	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1106 Human Movement and Sports Sciences	en_US
utslib.for	0913 Mechanical Engineering	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
utslib.copyright.status	closed_access
pubs.publication-status	Published	en_US
pubs.volume	55	en_US

Abstract:

© 2017 Elsevier B.V. Background Impaired balance is common in neurological disorders. Cervical dystonia is a neurological movement disorder affecting the neck. The effect of this aberrant head posture on physical function is unknown. Objectives To compare balance, mobility, gait and stepping reactions between ten people with cervical dystonia and ten control adults. Methods Spatiotemporal gait parameters and walking speed were assessed using a computerised walkway. Step length and time, time in double support and gait variability were calculated, then normalised to gait speed. Centre of pressure path length was assessed with eyes open and eyes closed to calculate a Romberg Quotient. Simple and choice reaction times were measured using customised apparatus while mobility was assessed by the timed up and go. Cervical spine range of motion was measured using a head mounted goniometer. Self-reported scales included Falls Self Efficacy Scale and Dystonia Discomfort Scale. Results There was a difference between groups for most outcome measures. The timed up-and-go and walking speed was slower (both P < 0.005) and the Romberg Quotient lower (P = 0.046) in cervical dystonia. People with cervical dystonia had lower falls self-efficacy (P = 0.0002). Reduced cervical range of motion was correlated with balance, stepping reaction time and mobility (all P < 0.05). Timed up and go was positively associated with stepping reaction time (P < 0.01). Dystonia discomfort did not impact function. Conclusions People with cervical dystonia displayed deficits in balance, gait and stepping reactions, and expressed higher fear of falling. Studies to further elucidate functional limitations and their impact on activity and participation in daily life are required.

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http://hdl.handle.net/10453/124900