White Matter Hyperintensities, Exercise, and Improvement in Gait Speed: Does Type of Gait Rehabilitation Matter?
Objectives To examine whether white matter hyperintensities (WMHs) on brain magnetic resonance imaging (MRI) in tracts in older adults with mobility impairment are linked to outcomes of gait rehabilitation interventions. Design Twelve‐week randomized controlled single‐blind trial. Setting University...
Gespeichert in:
| Veröffentlicht in: | Journal of the American Geriatrics Society (JAGS) 2013-05, Vol.61 (5), p.686-693 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 693 |
|---|---|
| container_issue | 5 |
| container_start_page | 686 |
| container_title | Journal of the American Geriatrics Society (JAGS) |
| container_volume | 61 |
| creator | Nadkarni, Neelesh K. Studenski, Stephanie A. Perera, Subashan Rosano, Caterina Aizenstein, Howard J. Brach, Jennifer S. Van Swearingen, Jessie M. |
| description | Objectives
To examine whether white matter hyperintensities (WMHs) on brain magnetic resonance imaging (MRI) in tracts in older adults with mobility impairment are linked to outcomes of gait rehabilitation interventions.
Design
Twelve‐week randomized controlled single‐blind trial.
Setting
University‐based mobility research laboratory.
Participants
Ambulatory adults aged 65 and older with mobility impairment.
Intervention
A conventional gait intervention focusing on walking, endurance, balance, and strength (WEBS, n = 21) and a task‐oriented intervention focused on timing and coordination of gait (TC, n = 23).
Measurements
Self‐paced gait speed was measured over an instrumented walkway before and after the intervention, and WMH and brain volumes were quantified on preintervention brain MRI using an automated segmentation process. A white matter tract atlas was overlaid on the segmented images to measure tract WMH volumes, and WMH volumes were normalized to total brain volume. Aggregate WMH volumes in all white matter tracts and individual WMH volumes in specific longitudinal tracts (superior longitudinal fasciculus, inferior longitudinal fasciculus, and fronto‐occipital fasciculus) and the cingulum were measured.
Results
Gait speed gains in the TC group were of the same magnitude, independent of WMH volume measures in all except the cingulum, but in the WEBS group, gain in gait speed was smaller with greater overall tract WMH volumes (P |
| doi_str_mv | 10.1111/jgs.12211 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3874589</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1469295744</sourcerecordid><originalsourceid>FETCH-LOGICAL-c6431-8ff28f2ff7e8a3f0e4b6d2fd2df3e6713e56fd82e23021ab2ca97c5f290ff1a03</originalsourceid><addsrcrecordid>eNqNkltvEzEQhVcIREPhgT-ALCEkkLqtL-u1lwcQaktaCCA1RX20nN1x43Rv2E5p_j1ONw0XCal-8cN8c449c5LkOcH7JJ6DxaXfJ5QS8iAZEc5oyjPCHyYjjDFNZU6yneSJ9wuMCcVSPk52KOMFplyMkv5ibgOgLzoEcOhk1YOzbYDW22DB76HjG3Cl9bCHdFuh06Z33TU00AZkWzTWNqBpD1C9RUcdeHQe-1FnhsIZzPXM1jboYLt2Y_H-afLI6NrDs829m3z_eHx-eJJOvo1PDz9M0jLPGEmlMVQaaowAqZnBkM3yipqKVoZBLggDnptKUqAMU6JntNSFKLmhBTaGaMx2k3eDbr-cNVCV8clO16p3ttFupTpt1d-V1s7VZXetmBQZl0UUeL0RcN2PJfigGutLqGvdQrf0imR5QQsusuweKClYzgS5B8o4pTLuhkb05T_oolu6Ng4tCrJCEsFvqTcDVbrOewdm-0WC1TodKqZD3aYjsi_-nMmWvItDBF5tAO1LXRun27j839x6MhSvTQ8G7qetYfV_R_VpPL2zTocO6wPcbDu0u1K5YIKri69jNZXZRBzJz-qM_QK0X9-i</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1439817552</pqid></control><display><type>article</type><title>White Matter Hyperintensities, Exercise, and Improvement in Gait Speed: Does Type of Gait Rehabilitation Matter?</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Nadkarni, Neelesh K. ; Studenski, Stephanie A. ; Perera, Subashan ; Rosano, Caterina ; Aizenstein, Howard J. ; Brach, Jennifer S. ; Van Swearingen, Jessie M.</creator><creatorcontrib>Nadkarni, Neelesh K. ; Studenski, Stephanie A. ; Perera, Subashan ; Rosano, Caterina ; Aizenstein, Howard J. ; Brach, Jennifer S. ; Van Swearingen, Jessie M.</creatorcontrib><description>Objectives
To examine whether white matter hyperintensities (WMHs) on brain magnetic resonance imaging (MRI) in tracts in older adults with mobility impairment are linked to outcomes of gait rehabilitation interventions.
Design
Twelve‐week randomized controlled single‐blind trial.
Setting
University‐based mobility research laboratory.
Participants
Ambulatory adults aged 65 and older with mobility impairment.
Intervention
A conventional gait intervention focusing on walking, endurance, balance, and strength (WEBS, n = 21) and a task‐oriented intervention focused on timing and coordination of gait (TC, n = 23).
Measurements
Self‐paced gait speed was measured over an instrumented walkway before and after the intervention, and WMH and brain volumes were quantified on preintervention brain MRI using an automated segmentation process. A white matter tract atlas was overlaid on the segmented images to measure tract WMH volumes, and WMH volumes were normalized to total brain volume. Aggregate WMH volumes in all white matter tracts and individual WMH volumes in specific longitudinal tracts (superior longitudinal fasciculus, inferior longitudinal fasciculus, and fronto‐occipital fasciculus) and the cingulum were measured.
Results
Gait speed gains in the TC group were of the same magnitude, independent of WMH volume measures in all except the cingulum, but in the WEBS group, gain in gait speed was smaller with greater overall tract WMH volumes (P < .001) and with greater WMH volume in the three longitudinal tracts (P < .001 to .02).
Conclusion
Gains in gait speed with two types of gait rehabilitation are associated with individual differences in WMHs. Task‐oriented therapy that targets timing and coordination of gait may particularly benefit older adults with WMHs in brain tracts that influence gait and cognition.</description><identifier>ISSN: 0002-8614</identifier><identifier>EISSN: 1532-5415</identifier><identifier>DOI: 10.1111/jgs.12211</identifier><identifier>PMID: 23590257</identifier><identifier>CODEN: JAGSAF</identifier><language>eng</language><publisher>Hoboken, NJ: Blackwell Publishing Ltd</publisher><subject>Aged ; Biological and medical sciences ; Brain ; Cerebral Cortex - pathology ; Cognition & reasoning ; Exercise - physiology ; Exercise Therapy - methods ; Female ; Follow-Up Studies ; gait ; Gait - physiology ; General aspects ; Humans ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Miscellaneous ; Mobility ; Mobility Limitation ; Nerve Fibers, Myelinated - pathology ; NMR ; Nuclear magnetic resonance ; Older people ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Rehabilitation ; Single-Blind Method ; subcortical vascular disease ; tracts ; Walking - physiology ; white matter hyperintensities</subject><ispartof>Journal of the American Geriatrics Society (JAGS), 2013-05, Vol.61 (5), p.686-693</ispartof><rights>2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society</rights><rights>2014 INIST-CNRS</rights><rights>2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.</rights><rights>2013 American Geriatrics Society and Wiley Periodicals, Inc</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6431-8ff28f2ff7e8a3f0e4b6d2fd2df3e6713e56fd82e23021ab2ca97c5f290ff1a03</citedby><cites>FETCH-LOGICAL-c6431-8ff28f2ff7e8a3f0e4b6d2fd2df3e6713e56fd82e23021ab2ca97c5f290ff1a03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgs.12211$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgs.12211$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27458202$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23590257$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nadkarni, Neelesh K.</creatorcontrib><creatorcontrib>Studenski, Stephanie A.</creatorcontrib><creatorcontrib>Perera, Subashan</creatorcontrib><creatorcontrib>Rosano, Caterina</creatorcontrib><creatorcontrib>Aizenstein, Howard J.</creatorcontrib><creatorcontrib>Brach, Jennifer S.</creatorcontrib><creatorcontrib>Van Swearingen, Jessie M.</creatorcontrib><title>White Matter Hyperintensities, Exercise, and Improvement in Gait Speed: Does Type of Gait Rehabilitation Matter?</title><title>Journal of the American Geriatrics Society (JAGS)</title><addtitle>J Am Geriatr Soc</addtitle><description>Objectives
To examine whether white matter hyperintensities (WMHs) on brain magnetic resonance imaging (MRI) in tracts in older adults with mobility impairment are linked to outcomes of gait rehabilitation interventions.
Design
Twelve‐week randomized controlled single‐blind trial.
Setting
University‐based mobility research laboratory.
Participants
Ambulatory adults aged 65 and older with mobility impairment.
Intervention
A conventional gait intervention focusing on walking, endurance, balance, and strength (WEBS, n = 21) and a task‐oriented intervention focused on timing and coordination of gait (TC, n = 23).
Measurements
Self‐paced gait speed was measured over an instrumented walkway before and after the intervention, and WMH and brain volumes were quantified on preintervention brain MRI using an automated segmentation process. A white matter tract atlas was overlaid on the segmented images to measure tract WMH volumes, and WMH volumes were normalized to total brain volume. Aggregate WMH volumes in all white matter tracts and individual WMH volumes in specific longitudinal tracts (superior longitudinal fasciculus, inferior longitudinal fasciculus, and fronto‐occipital fasciculus) and the cingulum were measured.
Results
Gait speed gains in the TC group were of the same magnitude, independent of WMH volume measures in all except the cingulum, but in the WEBS group, gain in gait speed was smaller with greater overall tract WMH volumes (P < .001) and with greater WMH volume in the three longitudinal tracts (P < .001 to .02).
Conclusion
Gains in gait speed with two types of gait rehabilitation are associated with individual differences in WMHs. Task‐oriented therapy that targets timing and coordination of gait may particularly benefit older adults with WMHs in brain tracts that influence gait and cognition.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Brain</subject><subject>Cerebral Cortex - pathology</subject><subject>Cognition & reasoning</subject><subject>Exercise - physiology</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>gait</subject><subject>Gait - physiology</subject><subject>General aspects</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Mobility</subject><subject>Mobility Limitation</subject><subject>Nerve Fibers, Myelinated - pathology</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Older people</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Rehabilitation</subject><subject>Single-Blind Method</subject><subject>subcortical vascular disease</subject><subject>tracts</subject><subject>Walking - physiology</subject><subject>white matter hyperintensities</subject><issn>0002-8614</issn><issn>1532-5415</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkltvEzEQhVcIREPhgT-ALCEkkLqtL-u1lwcQaktaCCA1RX20nN1x43Rv2E5p_j1ONw0XCal-8cN8c449c5LkOcH7JJ6DxaXfJ5QS8iAZEc5oyjPCHyYjjDFNZU6yneSJ9wuMCcVSPk52KOMFplyMkv5ibgOgLzoEcOhk1YOzbYDW22DB76HjG3Cl9bCHdFuh06Z33TU00AZkWzTWNqBpD1C9RUcdeHQe-1FnhsIZzPXM1jboYLt2Y_H-afLI6NrDs829m3z_eHx-eJJOvo1PDz9M0jLPGEmlMVQaaowAqZnBkM3yipqKVoZBLggDnptKUqAMU6JntNSFKLmhBTaGaMx2k3eDbr-cNVCV8clO16p3ttFupTpt1d-V1s7VZXetmBQZl0UUeL0RcN2PJfigGutLqGvdQrf0imR5QQsusuweKClYzgS5B8o4pTLuhkb05T_oolu6Ng4tCrJCEsFvqTcDVbrOewdm-0WC1TodKqZD3aYjsi_-nMmWvItDBF5tAO1LXRun27j839x6MhSvTQ8G7qetYfV_R_VpPL2zTocO6wPcbDu0u1K5YIKri69jNZXZRBzJz-qM_QK0X9-i</recordid><startdate>201305</startdate><enddate>201305</enddate><creator>Nadkarni, Neelesh K.</creator><creator>Studenski, Stephanie A.</creator><creator>Perera, Subashan</creator><creator>Rosano, Caterina</creator><creator>Aizenstein, Howard J.</creator><creator>Brach, Jennifer S.</creator><creator>Van Swearingen, Jessie M.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201305</creationdate><title>White Matter Hyperintensities, Exercise, and Improvement in Gait Speed: Does Type of Gait Rehabilitation Matter?</title><author>Nadkarni, Neelesh K. ; Studenski, Stephanie A. ; Perera, Subashan ; Rosano, Caterina ; Aizenstein, Howard J. ; Brach, Jennifer S. ; Van Swearingen, Jessie M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6431-8ff28f2ff7e8a3f0e4b6d2fd2df3e6713e56fd82e23021ab2ca97c5f290ff1a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Brain</topic><topic>Cerebral Cortex - pathology</topic><topic>Cognition & reasoning</topic><topic>Exercise - physiology</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>gait</topic><topic>Gait - physiology</topic><topic>General aspects</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Mobility</topic><topic>Mobility Limitation</topic><topic>Nerve Fibers, Myelinated - pathology</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Older people</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Rehabilitation</topic><topic>Single-Blind Method</topic><topic>subcortical vascular disease</topic><topic>tracts</topic><topic>Walking - physiology</topic><topic>white matter hyperintensities</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nadkarni, Neelesh K.</creatorcontrib><creatorcontrib>Studenski, Stephanie A.</creatorcontrib><creatorcontrib>Perera, Subashan</creatorcontrib><creatorcontrib>Rosano, Caterina</creatorcontrib><creatorcontrib>Aizenstein, Howard J.</creatorcontrib><creatorcontrib>Brach, Jennifer S.</creatorcontrib><creatorcontrib>Van Swearingen, Jessie M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nadkarni, Neelesh K.</au><au>Studenski, Stephanie A.</au><au>Perera, Subashan</au><au>Rosano, Caterina</au><au>Aizenstein, Howard J.</au><au>Brach, Jennifer S.</au><au>Van Swearingen, Jessie M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>White Matter Hyperintensities, Exercise, and Improvement in Gait Speed: Does Type of Gait Rehabilitation Matter?</atitle><jtitle>Journal of the American Geriatrics Society (JAGS)</jtitle><addtitle>J Am Geriatr Soc</addtitle><date>2013-05</date><risdate>2013</risdate><volume>61</volume><issue>5</issue><spage>686</spage><epage>693</epage><pages>686-693</pages><issn>0002-8614</issn><eissn>1532-5415</eissn><coden>JAGSAF</coden><abstract>Objectives
To examine whether white matter hyperintensities (WMHs) on brain magnetic resonance imaging (MRI) in tracts in older adults with mobility impairment are linked to outcomes of gait rehabilitation interventions.
Design
Twelve‐week randomized controlled single‐blind trial.
Setting
University‐based mobility research laboratory.
Participants
Ambulatory adults aged 65 and older with mobility impairment.
Intervention
A conventional gait intervention focusing on walking, endurance, balance, and strength (WEBS, n = 21) and a task‐oriented intervention focused on timing and coordination of gait (TC, n = 23).
Measurements
Self‐paced gait speed was measured over an instrumented walkway before and after the intervention, and WMH and brain volumes were quantified on preintervention brain MRI using an automated segmentation process. A white matter tract atlas was overlaid on the segmented images to measure tract WMH volumes, and WMH volumes were normalized to total brain volume. Aggregate WMH volumes in all white matter tracts and individual WMH volumes in specific longitudinal tracts (superior longitudinal fasciculus, inferior longitudinal fasciculus, and fronto‐occipital fasciculus) and the cingulum were measured.
Results
Gait speed gains in the TC group were of the same magnitude, independent of WMH volume measures in all except the cingulum, but in the WEBS group, gain in gait speed was smaller with greater overall tract WMH volumes (P < .001) and with greater WMH volume in the three longitudinal tracts (P < .001 to .02).
Conclusion
Gains in gait speed with two types of gait rehabilitation are associated with individual differences in WMHs. Task‐oriented therapy that targets timing and coordination of gait may particularly benefit older adults with WMHs in brain tracts that influence gait and cognition.</abstract><cop>Hoboken, NJ</cop><pub>Blackwell Publishing Ltd</pub><pmid>23590257</pmid><doi>10.1111/jgs.12211</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-8614 |
| ispartof | Journal of the American Geriatrics Society (JAGS), 2013-05, Vol.61 (5), p.686-693 |
| issn | 0002-8614 1532-5415 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3874589 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Biological and medical sciences Brain Cerebral Cortex - pathology Cognition & reasoning Exercise - physiology Exercise Therapy - methods Female Follow-Up Studies gait Gait - physiology General aspects Humans Magnetic Resonance Imaging Male Medical sciences Miscellaneous Mobility Mobility Limitation Nerve Fibers, Myelinated - pathology NMR Nuclear magnetic resonance Older people Public health. Hygiene Public health. Hygiene-occupational medicine Rehabilitation Single-Blind Method subcortical vascular disease tracts Walking - physiology white matter hyperintensities |
| title | White Matter Hyperintensities, Exercise, and Improvement in Gait Speed: Does Type of Gait Rehabilitation Matter? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T18%3A23%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=White%20Matter%20Hyperintensities,%20Exercise,%20and%20Improvement%20in%20Gait%20Speed:%20Does%20Type%20of%20Gait%20Rehabilitation%20Matter?&rft.jtitle=Journal%20of%20the%20American%20Geriatrics%20Society%20(JAGS)&rft.au=Nadkarni,%20Neelesh%20K.&rft.date=2013-05&rft.volume=61&rft.issue=5&rft.spage=686&rft.epage=693&rft.pages=686-693&rft.issn=0002-8614&rft.eissn=1532-5415&rft.coden=JAGSAF&rft_id=info:doi/10.1111/jgs.12211&rft_dat=%3Cproquest_pubme%3E1469295744%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1439817552&rft_id=info:pmid/23590257&rfr_iscdi=true |