Monday, January 14, 2019

ARTICLE REVIEW


               
Docu A and Docu D. (2015) performance of obstacle stepping in patients with Parkinson’s disease. Science, Movement and Health, Vol. XV, Issue 2 Supplements, 2015
Summary
                      The aim of this study is to undertake an investigation of the performance and acquisition of complex bilateral obstacle stepping activity and compare it with the unilateral obstacle stepping among patients with Parkinson’s diseases and a healthy control subject group with a matching age.

          The performance deterioration from the bilateral and unilateral task was through comparing the reports from previous studies on patients managing to perform complex hand movements on bilateral aspects. The observations were that healthy subjects who would face the least obstacle, unlike the PD subjects. Another observation is that there was the clearance of foot clearances in both the healthy and PD subjects in task acquisition. However, there was a slow improvement and a much poorer performance among the PD subjects.
          Similar to other studies on the upper limb, the PD subjects were experiencing much difficulty in task performance especially the bilateral activities compared to the healthy subjects. Evidence from this study suggests that force control impairment in walking leads to episodes of freezing that has the difficulty of unloading the wing leg as well as even initiating the swing phase. In evaluating the loco, the motor task of the complex lower limb like the bilateral obstacle stepping indicates much stronger defects. This kind of task requires a high level of demand on the interaction between voluntary control of leg movements and the anticipatory postural adjustments.
              This study manages also to show that the defective coordination of the lower and upper limbs combined with the abnormal postural reactions can lead to extensive problems in the bilateral performance when compared to the unilateral stepping task obstacle. The researchers use the external loading for force control manipulates and investigates on freezing of gait influence. The method of research is the treadmill and obstacle stepping. The use of the gait tasks is to provoke the freezing episodes that quantity by use of a videotaped blinded clinical assessment. Other methods are trials, tests, observation, and literature review. The subject was given an informed consent informing them about the experiment before volunteering to participate. The healthy subjects with a matching age were 15 and another group of 15 patients with PD. The subjects’ inclusion criteria were patients diagnosed with idiopathic PD as per the Brain Bank criteria and Yahr and Hoehn stages I.5-3.
           There was also the inclusion of subjects who could walk using a treadmill with no assistance. The study evaluates the PD patient’s ability to perform and acquire a high –precision task on bilateral locomotor task. The researchers conclude that task performance improves through repletion in both healthy subjects and those with PD. This finding suggests that motor learning in both groups depends on the task under investigation. The researchers suggest that the basal ganglia Dysfunction is as a result of the difficulty of switching between various motor programs.
         This study is relevant to nursing because it presents findings to support the hypotheses that patients are suffering from moderate and mild PD also have impaired performance and acquisition of the locomotors task precision like the case of the Obstacle bilateral stepping. In the repetition of tasks, there will be a slower improvement and the performance level becomes poorer for PD subjects, unlike the healthy subjects. The PD subjects, however, managed to improve their performances in the course of the experiment. These results provide the suggestion that PD subjects have difficulties in their daily life as a result of locomotory difficulties.                        Therefore, nurses need to pay attention to the unique needs of patients with PD. This study also shows nurses that some training can improve the patient’s adaptive locomotor behavior. This study also shows the nurses that individuals with Parkinson’s have specific care requirements and needs. It is, therefore, essential for them to provide these patients with medication at the right time and at all times.
         Nurses should also have the awareness of the off and nature of this condition. It is because patients indicate that their own is when the symptoms are under control and when the drugs are working. Their off situations are when it is most difficult for them to move and the symptoms are out of control. In such an instance, patients can stop moving altogether, and it is up to the nurses to assists these patients and understands their needs. Nurses need to know that Parkinson impacts on patients differently from one hour to another or from a day to another. The condition also varies depending on individual patients. The amount of support and help also varies. Therefore, nurses should be good listeners to the patient’s needs as well as listening to their families on how the condition is affecting them.

References
Docu, A and Docu D (2015) Performance of obstacle stepping in patients with Parkinson s disease.  Science, Movement and Health, Vol. XV, ISSUE 2 Supplement. 15 (2, Supplement): 334-338

Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in cheap term papers if you need a similar paper you can place your order from top research paper writing companies.

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