Publications by authors named "Jason K Longhurst"

3 Publications

  • Page 1 of 1

A vicious cycle of fear of falling avoidance behavior in Parkinson's disease: A path analysis.

Clin Park Relat Disord 2021 4;4:100089. Epub 2021 Feb 4.

University of Nevada, Las Vegas, United States.

Background: Postural instability (PI) in Parkinson's disease (PD) is associated with several negative downstream consequences.

Objective: The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance confidence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI.

Methods: A path analysis of cross-sectional data from 55 participants with PD was conducted. The four constructs in the model connected in succession were: 1. PI (principal components analysis (PCA) composite of the Unified Parkinson's Disease Rating Scale PI and Gait Difficulty score, Timed Up and Go test, and Berg Balance Scale); 2. balance confidence (Activities-Specific Balance Confidence Scale); 3. FOF avoidance behavior (PCA composite of the FOF Avoidance Behavior Questionnaire and average number of steps per day); and, 4. physical conditioning (2-Minute Step Test).

Results: The path model was an excellent fit to the data, χ2 (7) = 7.910, p = .341, CFI = 0.985, TLI = 0.968, RMSEA = 0.049 (90% CI: 0.000 to 0.179). The moderate to strong and uniformly significant parameter estimates were -0.519, -0.651, -0.653, and -0.570, respectively (ps < 0.01).

Conclusions: PI directly and inversely predicted balance confidence, which in turn directly and inversely predicted FOF avoidance behavior. Furthermore, FOF avoidance behavior directly and inversely predicted physical conditioning, which directly and inversely predicted PI, thereby closing the cycle. These findings highlight the downstream consequences of PI in PD and support the notion of a vicious cycle of FOF avoidance behavior.
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http://dx.doi.org/10.1016/j.prdoa.2021.100089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299987PMC
February 2021

Brain volumes and dual-task performance correlates among individuals with cognitive impairment: a retrospective analysis.

J Neural Transm (Vienna) 2020 07 29;127(7):1057-1071. Epub 2020 Apr 29.

Department of Physical Therapy, University of Nevada, 4505 Maryland Parkway, Box 453029, Las Vegas, NV, 702-895-1377, USA.

Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. To examine associations between brain volumes, dual-task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual-task performance, and measures of gait and balance. Greater cognitive and combined dual-task effects (DTE) are associated with smaller brain volumes. In contrast, motor DTE is not associated with distinct pattern of brain volumes. As brain volumes decrease, dual-task performance becomes more motor prioritized. Cognitive DTE is more strongly associated with decreased performance on measures of gait and balance than motor DTE. Decreased gait and balance performance are also associated with increased motor task prioritization. Cognitive DTE appears to be more strongly associated with decreased automaticity and gait and balance ability than motor DTE and should be utilized as a clinical and research outcome measure in this population. The increased motor task prioritization associated with decreased brain volume and function indicates a potential for accommodative strategies to maximize function in those with CI. Counterintuitive correlations between motor brain volumes and motor DTE in our study suggest a complicated interaction between brain pathology and function.
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http://dx.doi.org/10.1007/s00702-020-02199-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293667PMC
July 2020

Anterior cervical decompression and fusion on neck range of motion, pain, and function: a prospective analysis.

Spine J 2013 Nov 14;13(11):1650-8. Epub 2013 Sep 14.

Department of Physical Therapy, University of Nevada, Las Vegas, 4505 Maryland Parkway, Box 453029, Las Vegas, NV 89154, USA. Electronic address:

Background Context: Intractable cervical radiculopathy secondary to stenosis or herniated nucleus pulposus is commonly treated with an anterior cervical decompression and fusion (ACDF) procedure. However, there is little evidence in the literature that demonstrates the impact such surgery has on long-term range of motion (ROM) outcomes.

Purpose: The objective of this study was to compare cervical ROM and patient-reported outcomes in patients before and after a 1, 2, or 3 level ACDF.

Study Design: Prospective, nonexperimental.

Patient Sample: Forty-six patients.

Outcome Measures: The following were measured preoperatively and also at 3 and 6 months after ACDF: active ROM (full and painfree) in three planes (ie, sagittal, coronal, and horizontal), pain visual analog scale, Neck Disability Index, and headache frequency.

Methods: Patients undergoing an ACDF for cervical radiculopathy had their cervical ROM measured preoperatively and also at 3 and 6 months after the procedure. Neck Disability Index and pain visual analog scale values were also recorded at the same time.

Results: Both painfree and full active ROM did not change significantly from the preoperative measurement to the 3-month postoperative measurement (ps>.05); however, painfree and full active ROM did increase significantly in all three planes of motion from the preoperative measurement to the 6-month postoperative measurement regardless of the number of levels fused (ps≤.023). Visual analog scale, Neck Disability Index, and headache frequency all improved significantly over time (ps≤.017).

Conclusions: Our results suggest that patients who have had an ACDF for cervical radiculopathy will experience improved ROM 6 months postoperatively. In addition, patients can expect a decrease in pain, an improvement in neck function, and a decrease in headache frequency.
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http://dx.doi.org/10.1016/j.spinee.2013.06.020DOI Listing
November 2013
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