Christian Schlenstedt

Christian Schlenstedt
Medical School Hamburg | MSH · Department of Medicine

Professor

About

44
Publications
6,354
Reads
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572
Citations
Additional affiliations
September 2021 - present
Medical School Hamburg
Position
  • Professor (Full)
January 2017 - August 2021
University Hospital Schleswig-Holstein, Christian-Albrechts-University
Position
  • Group Leader
June 2016 - December 2016
Oregon Health & Science University
Position
  • PostDoc Position

Publications

Publications (44)
Article
Background: Freezing of gait (FOG) in Parkinson’s disease (PD) is associated with gait asymmetry and switching difficulty. A split-belt treadmill may potentially address those deficits. Objective: To investigate the immediate and retention effects of one-session split-belt treadmill training (SBT) in contrast to regular tied-belt treadmill trainin...
Article
Full-text available
Background: Dual-tasking is challenging for people with Parkinson's disease and freezing of gait (PD+FOG) and can exacerbate freezing episodes and falls. Split-belt treadmill training (SBT) is a novel tool to train complex gait and may improve dual-task (DT) walking and turning. Objective: To investigate the single-session effects of SBT on DT walk...
Article
Introduction: A stooped posture is a main clinical feature of Parkinson's disease (PD). The assessment of posture is important to measure treatment effects. The aim of this study was to investigate the reliability of a standardized postural rating tool, to calculate minimal detectable change scores and to assess the role of gender and age. Method...
Article
Full-text available
Introduction: This study aims at investigating whether impaired anticipatory postural adjustments (APA) during gait initiation contribute to the occurrence of freezing of gait (FOG) or whether altered APAs compensate for FOG in Parkinson’s disease (PD). Methods: Gait initiation after 30 s quiet stance was analyzed without and with a cognitive dual...
Preprint
Background The development of optimal strategies to treat impaired mobility related to ageing and chronic disease requires better ways to detect and measure it. Digital health technology, including body worn sensors, has the potential to directly and accurately capture real-world mobility. Mobilise-D consists of 34 partners from 13 countries who ar...
Article
Background: Freezing of gait (FOG) is a complex symptom in Parkinson's disease (PD) that is both elusive to elicit and varied in its presentation. These complexities present a challenge to measuring FOG in a sensitive and reliable way, precluding therapeutic advancement. Objective: We investigated the reliability, validity, and responsiveness of...
Article
Full-text available
Background: Meta-analyses indicate positive effects of cognitive training (CT) in patients with Parkinson's disease (PD), however, most previous studies had small sample sizes and did not evaluate long-term follow-up. Therefore, a multicenter randomized controlled, single-blinded trial (Train-ParC study) was conducted to examine CT effects in PD pa...
Article
Full-text available
Background: Gait impairments are common in healthy older adults (HOA) and people with Parkinson's disease (PwPD), especially when adaptations to the environment are required. Traditional rehabilitation programs do not typically address these adaptive gait demands in contrast to repeated gait perturbation training (RGPT). RGPT is a novel reactive fo...
Article
Background The gait initiation (GI) process can be characterized by anticipatory postural adjustments (APAs) and first step characteristics. However, even within a constrained environment, it is unclear how many trails are necessary to obtain a reliable measurement of the GI process within one assessment. Research question How many gait initiation...
Article
Objective The response of freezing of gait (FOG) to deep brain stimulation of the subthalamic nucleus (STN-DBS) is controversial and depends on many poorly controlled factors. On the other hand, a clinical predictor for the individual patient is needed to counsel the patient regarding this symptom. Methods A cohort of 124 patients undergoing STN-D...
Article
Background: Parkinson's disease (PD) is the most frequent movement disorder. Patients access YouTube, one of the largest video databases in the World, to retrieve health-related information increasingly often. Objective: We aimed to identify high-quality publishers, so-called "channels" that can be recommended to patients. We hypothesized that t...
Article
Introduction Freezing of gait (FOG) in Parkinson’s disease (PD) is associated with an altered posture during quiet stance as well as an impaired preparation and execution of the gait initiation process. We aimed to investigate whether an altered initial posture impacts anticipatory postural adjustments (APAs) and first-step execution during gait in...
Article
Full-text available
Background Patients with upper limb action tremor frequently exhibit additional neurological signs of uncertain significance. Clinicians vary in their interpretation, and interrater agreement on the final diagnosis is poor. Objectives A new clinical tool for assessing the presence or absence of clinical signs that are important in axis‐1 classific...
Article
Full-text available
Freezing of gait (FOG) in Parkinson’s disease (PD) is a highly disabling symptom which impacts quality of life. The New FOG Questionnaire (NFOG-Q) is the most commonly used tool worldwide to characterize FOG severity in PD. This study aims to provide a German translation of the NFOG-Q and to assess its validity in people with PD. The questionnaire...
Article
Full-text available
Background: Meta-analyses have demonstrated cognitive training (CT) benefits in Parkinson's disease (PD) patients. However, the patients' cognitive status has only rarely been based on established criteria. Also, prediction analyses of CT success have only sparsely been conducted. Objective: To determine CT effects in PD patients with mild cogni...
Article
Background Freezing of gait (FOG) in Parkinson's disease (PD) is provoked by specific situations. The sensitivity of these situations to detect FOG and the relative FOG response to l-dopa and subthalamic nucleus deep brain stimulation (STN-DBS) is unknown. Methods Two blinded reviewers analyzed the video recordings of a standardized patient assess...
Article
Background Gait initiation and turning are common triggers for Freezing of Gait (FOG) in people with Parkinson’s disease (PD). Recently, it has been shown that closed-loop tactile feedback (CLTF) can be effective to improve turning performance in people with FOG. Research Question Does CLTF change the preparation and execution of the first step du...
Article
Full-text available
Introduction Advances in wearable sensor technology now enable frequent, objective monitoring of real-world walking. Walking-related digital mobility outcomes (DMOs), such as real-world walking speed, have the potential to be more sensitive to mobility changes than traditional clinical assessments. However, it is not yet clear which DMOs are most s...
Article
Full-text available
Introduction: Postural abnormalities are common in Parkinson's disease (PD) and increasing with disease progression. While many studies focus on balance and gait, postural alignment is only infrequently studied. Purpose: The aim of the present study was to examine the immediate and long-term effects of medication and deep brain stimulation (DBS) in...
Article
Objective: Two strategies are known for turning while walking: step turns (the direction change is performed with 3 steps or more) and spin turns (turning on one/both feet simultaneously). It is unknown which strategy patients with Parkinson’s disease (PD) choose and if L-dopa and STN-DBS are influencing this strategy. Methods: Video-recordings of...
Article
Background: A precise understanding of the neuronal circuits involved in the control of anticipatory postural adjustments (APAs) for gait initiation is missing. Neurostimulation in Parkinson's disease (PD) provides a method of modulating APAs to gain insight into the underlying circuitry. Objective: Our objective was to investigate if APA kinema...
Article
Gang- und Gleichgewichtsstörungen schränken das Leben älterer Patienten erheblich ein. Um ihre Eigenständigkeit und Lebensqualität zu verbessern, müssen die Betroffenen in der Regel selbst aktiv mitarbeiten und die Grunderkrankung angegangen werden.
Article
Background: Walking on a split-belt treadmill (SBT) can help to modulate an asymmetric gait, particularly for people with neurological conditions, such as Parkinson's disease (PD), where asymmetry plays a role due to the laterality of the disease. Research question: This systematic review critically evaluates the literature on SBT in PD. First,...
Article
Full-text available
Background and Aim: Individuals with Parkinson's disease (PD) and Freezing of Gait (FOG) have impaired postural control, which relate to the severity of FOG. The aim of this study was to analyze whether a moderate frequency resistance (RT) and balance training (BT), respectively, are effective to diminish FOG. Methods: This post-hoc sub-analysis of...
Article
Normalization methods are used to minimize the influence of external disturbances in the analysis of myo-electrical signals. Whether these methods actually minimize the error or only relocate it has not been evaluated so far. This verification is only possible in comparison to constant discharge conditions. The aims of this study were (I) to compar...
Article
Full-text available
Background: Deficits in gait and balance are common among neurological inpatients. Currently, assessment of these patients is mainly subjective. New assessment options using wearables may provide complementary and more objective information. Methods: In this prospective cross-sectional feasibility study performed over a four-month period, all pa...
Article
Full-text available
Introduction: Impaired sit-to-stand and stand-to-sit movements (postural transitions, PTs) in patients with Parkinson's disease (PD) and older adults (OA) are associated with risk of falling and reduced quality of life. Inertial measurement units (IMUs, also called “wearables”) are powerful tools to monitor PT kinematics. The purpose of this study...
Article
Background: Mobility is important and often affected in older adults. Mobility is related to cognitive function, which is associated with age-related decline. Computer-based cognitive training (CCT) is increasingly used to treat such cognitive deficits. Whether CCT also has an effect on mobility is not yet clear. Objective: The aim of this syste...
Article
Postural instability is one of the most disabling and risky symptoms of advanced Parkinson's disease (PD). The purpose of this study was to investigate whether and how this is mediated by a centrally impaired spatial orientation. Therefore, we performed a spatial orientation study in 21 PD patients (mean age: 68 years, SD: 8.5, 9 women) in a medica...
Article
Objective: To characterize anticipatory postural adjustments (APA) across a variety of step initiation tasks in people with Parkinson's disease (PD) and healthy control (HC). Design: Cross-sectional study. Step initiation was analyzed during a) self-initiated gait, b) perceptual cued gait, and c) compensatory forward stepping after platform pert...
Article
To investigate the impact of unilateral balance training on postural control of the trained and contralateral limb in healthy elderly. Fifty-one healthy old adults were randomly assigned into training group (TG) and control group (CG). Participants of the TG performed unilateral balance training (dominant (DOM) leg) over 4 weeks (4×/week). Centre o...
Article
The aim of this meta-analysis was to summarize the short- and long-term effects of bilateral deep brain stimulation of the subthalamic nucleus (STN-DBS) on gait and freezing of gait (FOG) in Parkinson's disease and to detect predictors of post-stimulation outcome. A comprehensive review of the literature was conducted up to October 2015 using Medli...
Article
Gait and balance disturbances are age-related and lead to injuries, reduced mobility and loss of independence. This overview discusses established and new clinical features and pathophysiological aspects of common age-related neurological gait and balance disorders. © Georg Thieme Verlag KG Stuttgart · New York.
Article
Background: The pathophysiology behind gait impairments seen in Parkinson's disease (PD), in particular freezing of gait (FOG), is not fully understood. Here we study the interplay between several gait features related to FOG during different split-belt treadmill (SBTM) conditions. Methods: We investigated the spatiotemporal properties, the phen...
Article
Introduction: The relationship between freezing of gait (FOG) and postural instability in Parkinson's disease (PD) is unclear. We analyzed the impact of FOG on postural control. Methods: 31 PD patients with FOG (PD+FOG), 27 PD patients without FOG (PD-FOG) and 22 healthy control (HC) were assessed in the ON state. Postural control was measured w...
Article
Full-text available
Background: Reduced muscle strength is an independent risk factor for falls and related to postural instability in individuals with Parkinson's disease. The ability of resistance training to improve postural control still remains unclear. Objective: To compare resistance training with balance training to improve postural control in people with P...
Article
Background: The correct identification of patients with Parkinson's disease (PD) at risk of falling is important to early initiate appropriate treatment. Objective: This study compares the Fullerton Advanced Balance (FAB) scale with the Mini Balance Evaluation Systems Test (Mini-BESTest) and Berg Balance Scale (BBS) to identify individuals with...
Thesis
Die vorliegende Arbeit gliedert sich in drei Teile. Zunächst geht es um die Erfassung der posturalen Instabilität bei Patienten mit Morbus Parkinson. Es wurde ein klinischer Gleichgewichtstest (Fullerton Advanced Balance (FAB) Scale) zur Erhebung der posturalen Kontrolle validiert und mit der Berg Balance Scale und dem Mini-Balance Evaluation Syste...
Article
Objectives: To validate the Fullerton Advanced Balance (FAB) Scale for patients with idiopathic Parkinson disease (PD); and to compare the FAB Scale with the Mini-Balance Evaluation Systems Test (Mini-BESTest) and Berg Balance Scale (BBS). Design: Observational study to assess concurrent validity, test-retest, and interrater reliability of the F...