ArticleGait & posture2023
Objective quantification of responses to the clinical pull-test in people with Parkinson's disease.
Article in Gait & posture, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed.
- Effects of anthropometry, age and sex on center of pressure displacement evoked by small trunk perturbations in balance tests.European journal of applied physiology · 2026Article
- Responsiveness of the mini-balance evaluation systems test, dynamic gait index, Berg balance scale, and performance-oriented mobility assessment in parkinson's disease.Scientific reports · 2025Article
- Festination-like steps during forward and backward gait while playing tennis.Journal of Parkinson's disease · 2024Article
- Extraction of the pull force from inertial sensors during the pull test for Parkinson's disease: A reliability study.Journal of movement disorders · 2024Article
- A non-expensive bidimensional kinematic balance assessment can detect early postural instability in people with Parkinson's disease.Frontiers in neurology · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundPostural instability can occur in the later-stages of Parkinson's disease (PD). The clinical pull-test is scored on a 0-4 scale on the Unified Parkinson's disease rating scale (UPDRS), with postural instability scored 2 or higher. This ordinal scale does not adequately track progression in early-PD or predict development of postural instability. RESEARCH QUESTION: To develop a test that quantifiably measured the backward stepping response on the pull-test in early-PD.
methodsParticipants (35 controls and 79 PD participants) were prospectively enrolled in this study. Participants stepped backwards with each shoulder pull at four strengths on an instrumented gait mat. Four spatiotemporal parameters (reaction-time, step-back-time, step-back-distance, step-back-velocity) were quantified using Protokinetics Movement Analysis Software. Spatiotemporal pull-test parameters were compared to standard PD measures using linear regression and correlation coefficients. Repeated measures analysis was used to determine group differences in pull-test parameters. In a subset of participants repeated testing was performed and Bland-Altman plots were used to determine reproducibility of the pull-test parameters.
resultStep-back-distance and step-back-velocity were inversely related to motor UPDRS and freezing of gait questionnaire scores. PD participants had shorter step-back-distance than controls adjusted for age and sex. Repeat assessments in 16 participants, on average 0.7 years apart, showed good agreement on most of the quantified parameters. SIGNIFICANCE: The backward stepping response in PD participants was quantifiable, reproducible, and related to disease severity and could be used to quantify progression towards postural instability in early-PD.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.