TY  - JOUR
PY  - 2015//
TI  - Concurrent arm swing-stepping (CASS) can reveal gait start hesitation in Parkinson's patients with low self-efficacy and fear of falling
JO  - Aging clinical and experimental research
A1  - Chomiak, Taylor
A1  - Pereira, Fernando V.
A1  - Clark, Terry W.
A1  - Cihal, Alexandra
A1  - Hu, Bin
SP  - 457
EP  - 463
VL  - 27
IS  - 4
N2  - Background Movement incoordination, freezing of gait, fear of falling, low self-efficacy, and multi-tasking can all contribute to falls in Parkinson's disease. How these multi-factorial risks interact in individual patients remain poorly understood. <br><br>METHODS Concurrent arm swing-stepping is a simple motor test in which subjects are first asked to swing their arms before being instructed to initiate the secondary task of leg stepping-in-place. We postulated that in patients with multiple fall risks, sensorimotor impairments in upper- and lower-limb movement control can render concurrent arm swing-stepping a demanding dual task, thereby triggering gait hesitation. A total of 31 subjects with Parkinson's disease were enrolled in the study. <br><br>RESULTS It was found that concurrent arm swing-stepping induced hesitation primarily in Parkinson's disease patients with low fall-related self-efficacy and a fear of falling. By contrast, concurrent arm swing-stepping led to limb incoordination in both patients and in healthy elderly controls. The calculated specificity and sensitivity of the concurrent arm swing-stepping test was 100 and 42 % for hesitation and 12 and 77 % for incoordination. <br><br>CONCLUSION These results suggest that the concurrent arm swing-stepping test can be used in conjunction with conventional psychometric assessments to facilitate multi-factorial assessment of potential fall risk.<p />  <p>Language: en</p>
LA  - en
SN  - 1594-0667
UR  - http://dx.doi.org/10.1007/s40520-014-0313-0
ID  - ref1
ER  -