Parkinson's Case Study - Nick Pre-Treatment Assessment
Original Editor - Tarina van der Stockt
Top Contributors - Tarina van der Stockt, Kim Jackson and Lauren Lopez
TUG[edit | edit source]
To work out if dual tasking is of help or increases risk of falls, work out the 10% range either side of baseline i.e. for Nick’s baseline of 14.56 seconds, the range is 13.10 to 16.02 seconds. Adding the motor and cognitive task to baseline pretreatment was not outside the 10% baseline range, so does not increase the risk of falling with this test, but his combined transfer, walking pattern and turns take longer to complete than is deemed ‘safe’.
The TUG may not be a tool of choice to look at gait, but for example, using a tool such as the <a href="https://physio-pedia.com/Tinetti_Test">Tinneti gait scale</a> https://physio-pedia.com/Tinetti_Test, you would record no hesitancy of gait initiation during the baseline walk, but hesitation when a second task is added, step length and height of feet are fine until he turns; symmetry affected but path and continuity of gait pattern fine, as is foot distance, but trunk is stiffer – this would give a score between 7 – 9/ 12 depending on the addition of a second task – again, demonstrating there are components that put Nick at moderate risk of a fall in the future.
Tragus to wall test[edit | edit source]
Nick never fully extends either knees or hips during his walk (forwards or backwards) despite the good step size. Although his walk is purposeful, the stress through the anterior knee joint constantly flexed during joint loading when in stance could be a reason for his pain. As I wanted to see whether the flexion was correctable, we performed a Tragus to wall test to understand the influence of forward pull on upright stance, and therefore gait.
*This page forms part of the Parkinson's Disease Outcome Measures Case Study Course
