ABSTRACT
Background: The main effects of Lee Silvermann Voice Treatment-BIG® therapy (LSVT-BIG) on gait function are improvements in gait speed and stride length. Considering the mechanism of this improvement, LSVT-BIG may affect joint angles of the lower extremities. Therefore, further investigation of the effect of LSVT-BIG on gait function, especially joint angles, is needed. Methods: Patients with Parkinson's disease (PD) who were eligible for LSVT-BIG were recruited. We measured the following items pre- and post-LSVT-BIG: MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Functional Independence Measure (FIM), timed up and go test (TUG), and gait parameters using RehaGait®. Gait parameters included gait speed, stride duration and length, the standard deviation of stride duration and length, cadence, the ratio of the stance/swing phase, and the flexion and extension angles of the hip, knee, and ankle joints. Range of motion (ROM) was calculated as the difference of values between the maximum flexion and extension angles of each joint. Results: Twenty-four participants completed the LSVT-BIG. Significant improvement was observed in the MDS-UPDRS (mean changes: Part I, -2.4 points; Part II, -3.5 points; Part III -8.9 points), TUG (-0.61 s), gait speed (+0.13 m/s), stride length (+0.12 m), flexion and extension angles and ROM of the hip joints (flexion, +2.0°; extension, +2.0; ROM, +4.0°). Enlargement in ROM of the hip joint was strongly correlated with increase in gait speed and stride length (r = 0.755, r = 0.804, respectively). Conclusions: LSVT-BIG enlarged flexion and extension angles and ROM of the hip joint significantly. Change of ROM of the hip joint was directly related to the increase in stride length and gait speed observed in patients with PD after LSVT-BIG.
ABSTRACT
The proton location and proton transfer (PT) dynamics of a hydrogen bond are under the influence of the static and dynamical properties of the solvent and counterions. In the present study, the N-H distances were determined for salts of 1,8-bis(dimethylamino)naphthalene, DMANH(+)X(-) (X(-) = BPh4(-), ClO4(-), and Cl(-)), in acetonitrile (AN) solution, and DMANH(+)Br(-) in water by observing the (15)N spin-lattice relaxation caused by the (15)N-(1)H magnetic dipolar coupling under assumption that the PT time was shorter than the NH reorientation time (â¼10(-11) s). The obtained N-H distances decreased in the following order: DMANH(+)BPh4(-) > DMANH(+)ClO4(-) > DMANH(+)Br(-)/H2O > DMANH(+)Cl(-), indicating that interactions with the environment affect the PT potentials. To understand the results at the molecular level, Car-Parrinello molecular dynamics simulations were performed for DMANH(+), DMANH(+) in water, and DMANH(+)-Cl(-) ion-pair in AN. The results of simulation suggest that (1) the N-H distance decreases in the presence of a solvent and counterion; (2) the PT time is probably â¼10(-12) s, which confirms the above assumption used for the NMR relaxation data analyses; and (3) fluctuation of the interactions with the solvent or counterion has a significant role in PT. Quantum nuclear effects on the hydrogen bond were also examined.
