Rethinking the neurological examination II: dynamic balance assessment.

The authors propose that the neurological exam needs reevaluation with respect to the dynamic balance test (walking). Validated tests such as: preferred and maximum gait speed, dynamic gait index, five-times-sit-to-stand test, timed up & go cognitive and manual, should be part of the neurological examination routine. In the neurological exam of older patients, these same bedside tests bring the plus of evaluation the risk of occasional falling.

[1]  G. Özkaya,et al.  Assessment of Gait and Balance in Parkinson's Disease , 2013 .

[2]  Richard W. Bohannon.  Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. , 1997, Age and ageing.

[3]  Donna J. Cech.  Chapter 12 – Posture and Balance , 2012 .

[4]  C. Chalk,et al.  The essential neurologic examination , 2009, Neurology.

[5]  L. Sudarsky.  Gait Disorders in the Elderly , 1990 .

[6]  N. Lane,et al.  Embryonic development of glial cells and their junctions in the locust central nervous system , 1985, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[7]  L. Sudarsky.  Geriatrics: gait disorders in the elderly. , 1990, The New England journal of medicine.

[8]  S. Studenski,et al.  Functional reach: a new clinical measure of balance. , 1990, Journal of gerontology.

[9]  Richard Wener,et al.  Mobile telephones, distracted attention, and pedestrian safety. , 2008, Accident; analysis and prevention.

[10]  D. Burn.  Ten steps to identify atypical parkinsonism , 2006, Journal of Neurology, Neurosurgery & Psychiatry.

[11]  C. Foster,et al.  Vestibular Rehabilitation , 1998, The SAGE Encyclopedia of Human Communication Sciences and Disorders.

[12]  B. Bloem,et al.  Images in clinical medicine. Cycling for freezing of gait. , 2010, The New England journal of medicine.

[13]  D. Lanska.  The Romberg sign and early instruments for measuring postural sway. , 2002, Seminars in neurology.

[14]  S. Cass,et al.  Clinical assessment of postural stability. , 1993, The American journal of otology.

[15]  B. Bloem,et al.  Why old people fall (and how to stop them) , 2007, Practical Neurology.

[16]  D J Lanska,et al.  Romberg’s sign , 2000, Neurology.

[17]  R W Bohannon,et al.  Decrease in timed balance test scores with aging. , 1984, Physical therapy.

[18]  H. Buschke,et al.  Walking while talking: effect of task prioritization in the elderly. , 2007, Archives of physical medicine and rehabilitation.

[19]  Michael C Schubert,et al.  Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. , 2009, Archives of internal medicine.

[20]  Michael C Schubert,et al.  Vestibulo-ocular physiology underlying vestibular hypofunction. , 2004, Physical therapy.

[21]  Alain Delarque,et al.  Evaluation of patients with gait abnormalities in physical and rehabilitation medicine settings. , 2008, Journal of rehabilitation medicine.

[22]  Olivier Beauchet,et al.  [Gait and dual-task: definition, interest, and perspectives in the elderly]. , 2006, Psychologie & neuropsychiatrie du vieillissement.

[23]  F. Horak,et al.  Assessing the Influence of Sensory Interaction on Balance , 1986 .

[24]  J. Jankovic,et al.  Prin & Prac of Movement Disorders , 2007 .

[25]  P. Maranhão-Filho,et al.  Can Clinical Tests Detect Early Signs of Monohemispheric Brain Tumors? , 2010, Journal of neurologic physical therapy : JNPT.

[26]  Joseph M. Furman,et al.  Computerized Dynamic Platform Posturography , 1997, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[27]  A. Shumway-cook,et al.  Predicting the probability for falls in community-dwelling older adults. , 1997, Physical therapy.

[28]  G. Marioni,et al.  Balance Function Assessment and Management , 2007 .

[29]  F. Owen Black,et al.  Clinical status of computerized dynamic posturography in neurotology , 2001 .

[30]  J. Pearce.  Marshall Hall and “Romberg’s sign” , 2005, Journal of Neurology Neurosurgery & Psychiatry.

[31]  F. O. Black,et al.  Adaptation to altered support and visual conditions during stance: patients with vestibular deficits , 1982, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[32]  L. Nyberg,et al.  “Stops walking when talking” as a predictor of falls in elderly people , 1997, The Lancet.

[33]  J. Bogousslavsky,et al.  Birth of modern psychiatry and the death of alienism: the legacy of Jean-Martin Charcot. , 2011, Frontiers of neurology and neuroscience.

[34]  H E Rockette,et al.  Normal subject postural sway during the Romberg test. , 1982, American journal of otolaryngology.

[35]  WF Abdo,et al.  The “bicycle sign” for atypical parkinsonism , 2011, The Lancet.

[36]  Gilles Berrut,et al.  Marche et double tâche : définition, intérêts et perspectives chez le sujet âgé , 2006 .

[37]  Jeffrey N. Browndyke,et al.  Validation of the Coin Rotation Test: A Simple, Inexpensive, and Convenient Screening Tool for Impaired Psychomotor Processing Speed , 2010, The neurologist.

[38]  Charles Hall,et al.  Validity of Divided Attention Tasks In Predicting Falls in Older Individuals: A Preliminary Study , 2002, Journal of the American Geriatrics Society.

[39]  B. Dubois,et al.  “Applause sign” helps to discriminate PSP from FTD and PD , 2005, Neurology.

[40]  F. Horak,et al.  Central programming of postural movements: adaptation to altered support-surface configurations. , 1986, Journal of neurophysiology.

[41]  V Honrubia,et al.  Clinical Neurophysiology of the Vestibular System , 1980, Neurology.

[42]  Ack,et al.  LOWER-EXTREMITY FUNCTION IN PERSONS OVER THE AGE OF 70 YEARS AS A PREDICTOR OF SUBSEQUENT DISABILITY , 2001 .

[43]  Mark S Redfern,et al.  Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the Five-Times-Sit-to-Stand Test. , 2005, Physical therapy.

[44]  R. Peterka.  Sensorimotor integration in human postural control. , 2002, Journal of neurophysiology.

[45]  S. Johnston,et al.  Should the Babinski sign be part of the routine neurologic examination? , 2005, Neurology.

[46]  Klaus Hauer,et al.  Dual-task performances can be improved in patients with dementia , 2010, Neurology.

[47]  S. Studenski,et al.  Functional reach: predictive validity in a sample of elderly male veterans. , 1992, Journal of gerontology.

[48]  Sid Gilman,et al.  Clinical neurophysiology of the vestibular system , 1981 .