Question

Velayutham, S. G., Chandra, S. R., Bharath, S., & Shankar, R. G. (2017). Quantitative balance and gait measurement in patients with frontotemporal dementia and Alzheimer diseases: A pilot study. Indian Journal of Psychological Medicine, 39(2), 176-182. doi:10.4103/0253-7176.203132 What is the purpose of this research? What is the research question (or questions)? This may be implicit or explicit. Give a complete description of the research design of this study. Was the sample approach adequate for the research design that was selected and explain why. Describe the data collection procedure. How were the data analyzed after collection? Discuss the limitations found in the study. Discuss the authors' conclusions. Do you feel these conclusions are based on the data that they collected? How does this advance knowledge in the field?

Answer 1

Alzeimers disease and fronto temporal dementia are common neurodegenerative dementias..falls are common cause among elderly people..This study helpful in planning preventive strategies to prevent falls..
Frontotemporo dementia(FTD) increasing the morbidity among this patients..the changes are expected in the early phase and hence qualitative measurements will be of great help in understanding the pattern for serving as early accessible biomarker,it help serving for rehabilitattory tools early in the course of disease..Resaerch question between FTD and AL congnitive function impairment will be the same?
   Twenty-four male subjects age group 50-70 years of age,8 in each group with FTD diagnosed by revised consensus dementia,probable AD,diagnosed by AD association criteria,and healthy volunteers as controls..this patients are recruited from outpatient department of neurology anf geriatric clinic,controls from the community with informed consent after measuing age,gender,height,weight are recorded..
The balance was measured by biodex balance using dynamic posturography provides objective balnace measurements in two situations that is dynamic balance and limits ofstability..the circular platform became unstable and experience wobbling..feedback about their stand position from the display monitor and instructed to target at the innermost circle or epicenter of the grid..At last BOS recorded..
Dynamic balance-single task:
   Three trials each 20s duration BOS recorded without using handrail support..The test results overall balance index(OBI) anteroposterior index)API) and mediolateral index(MLI)..higher score indicates poor balance..
Limits of stability-single task:
    It is balance test with original BOS after the self-initiated sway in eight different direction1,forward2,backward3,right4,left5,forward right6,forward left7,backward right8,backward left was tested..Score was 100 with maximum time of 300s..higher score and shorter time indicate better balance..
dual task includes LOS task with congnitive task and repeated after a rest period for 2min from the single task..patient must use visual feedback to gait balance..
Gait assessment:
It was measured by walk for 2min in a sensor-based treadmill at a comfortable speed,stride and step length,coefficient variation of the steps(CV)..after 2min rest period again second time dual task where counted backward from 100 as a congnitive task on treadmill.The result contain total walking distance,average walking speed and step cycle,average step length,CV of the right and left leg..higher score indicate better gait stability,increased coefficient variation of steps indicate poor gait stability..
Results:
the shapiro-wilkins test used for measuing parameters,,Descriptive analysis was done for age,body mass index,education in years..single versus dual task was analysed with paired t-tast .one-way ANOVA was conducted to find out the difference..AD group had significant differnce in mediolateral(MLI) stability index only in single versus dual task..limits of stability has all 3 group significant differnces..gait analysis control group showed no significant worsening of gait,,Ambulation Index(AI) is a cumulative score was low for both dementias,dynamic balance had worsening of balance in OBI,API only..Limits of stability LOS score FTD group had no deficit in overall LOS score except few directions..it has deficit in forward,backward right direction AD had deficit in forward,backward,forward right and left affected in FTD and AD control groups..gait analysis distance walked speed,step cycle,CV right and left leg and AI affected in FTD and AD..
Conclusion:
this research was implicit..AD and FTD has cognitive functions balance impairment and affected in both groups..controls and had problems in dual task in all parameters even healthy aging..they had poor score..The study shows balance and gait problems in normal elderly and FTD and AD during dual task..It is shows in FTD and AD patient AI abnormality more in FTD than AD..Mediolateral balance affect AD than FTD..FTD have tendency to tilt forward AD to backward..This differentiate there two condition in the early stages..Postural stablity training with AD and gait training in patient with FTD help in delaying future development of falls in these patients...