Longitudinal study of physical functioning in adults with chronic neurological conditions
There is limited information in the literature comparing gait speed among individuals who are in the chronic stages of Parkinson’s disease (PD), stroke and traumatic brain injury (TBI). The primary aim of this study was to examine the physical functioning of individuals with these chronic neurological conditions over a 12-month period assessed at baseline (time 1) and six month intervals (time 2, 3). This observational research study used descriptive statistics and to describe the physical functioning of individuals with PD, stroke and TBI and was part of a longitudinal study being conducted over five years to describe communication, dietary and physical activity behaviors of adults with neurological diagnoses. Seven community dwelling adults (n=7) between the ages of 34 and 71 years completed the evaluations. The tests used to examine physical function included gait speed, repeated chair stands, short physical performance battery (SPPB), timed up and go (TUG), and the Physical Activity and Disability Scale (PADS). The results were analyzed for the cohort and divided into two groups for comparison: PD and acquired brain injury (ABI). ABI included people with the TBI and stroke diagnoses. Changes in gait speed were determined using analysis of covariance. A Pearson’s product moment correlation coefficient was used to determine association between gait speed and physical function assessments. Statistical significance was set at p < 0.05. Analysis of covariance (ANCOVA) results showed a statistically significant decrease (i.e. improvement) in gait speed (p < 0.03) for the ABI group over 12 months. Although not statistically significant, there was also a decrease in gait speed (p < 0.10) for the PD group. The ANCOVA results also showed a statistically significant increase (i.e. decline) in the TUG test time of 3.33 seconds (p = 0.054) for the ABI group and increases in time for the PD group and cohort. Baseline gait speed for all participants correlated with the total SPPB score r = -0.97, p = 0.001) and the TUG test (r = 0.97, p = 0.001). Time 3 gait speed for all participants also correlated with the PADS score (r = -0.79, p = 0.06) in addition to the SPPB score (r = -0.87, p < 0.01) and TUG test (r = 0.96, p < 0.01). There was a statistically significant decrease in gait speed of adults with ABI measured three times in 12 months. Secondary findings include the significant decline in mobility in adults with ABI measured over 12 months. The significant relationship between gait speed and the physical function, mobility and physical activity scores was also a secondary finding. Future studies should consider interventions aimed at improving physical activity and fall and balance self-efficacy to explore the impact on gait speed in chronic neurological conditions. Future longitudinal research should also be conducted with a larger sample size and broader range of chronic neurological conditions to allow generalization of the study findings.
Marcia Kimberley Lyons,
"Longitudinal study of physical functioning in adults with chronic neurological conditions"
Dissertations and Master's Theses (Campus Access).