![]() PubMed: 20082966.Ĭastriotta RJ, Atanasov S, Wilde MC, Masel BE, Lai JM et al. Parkinsonism Relat Disord 15 (Suppl 3): S101-S104. Penner IK, Schlager R (2006) Fatigue - better understanding, better therapy? Schweizer Archiv für Neurologie und Psychiatrie 157: 46-53.Īrnulf I, Leu-Semenescu S (2009) Sleepiness in Parkinson's disease. (2012) Fatigue and sleep disturbance following traumatic brain injury-their nature, causes, and potential treatments. Ponsford JL, Ziino C, Parcell DL, Shekleton JA, Roper M et al. Modafinil is not yet sufficient to be recommended for these medical conditions until solid data are available. The majority of the studies had small sample sizes. Adverse events were similar between modafinil and placebo groups except that more patients were found with insomnia and nausea in modafinil group.Įxisting trials of modafinil for fatigue and EDS associated with PD, MS, TBI and PPS provided inconsistent results. Modafinil seemed to have no therapeutic effect on depression. No difference was seen between modafinil and placebo treatments in patients with PPS. Treatment results demonstrated a clear beneficial effect of modafinil on EDS in patients with PD (MD -2.45 95% CI -4.00 -0.91 p=0.002 I(2)=14%), but not with MS and TBI. Our results suggested a therapeutic effect of modafinil on fatigue in TBI (MD -0.82 95% CI -1.54 -0.11 p=0.02, I(2)=0%), while a beneficial effect of modafinil on fatigue was not confirmed in the pooled studies of PD or MS. Ten randomized controlled trials were identified including 4 studies of Parkinson's disease (PD), 3 of multiple sclerosis (MS), 2 of traumatic brain injury (TBI) and 1 of post-polio syndrome (PPS). Secondary outcomes included depression and adverse effects. Primary outcomes included fatigue and EDS. This meta-analysis was aimed to assess drug safety and effects of modafinil on fatigue and EDS associated with neurological disorders.Ī comprehensive literature review was conducted in order to identify published studies assessing the effects of modafinil on fatigue and EDS associated with neurological disorders. Existing trials of modafinil for fatigue and EDS associated with neurological disorders provided inconsistent results. The increase of leg swing velocity seems the main and unique adaptation mechanism that is utilized in the preferred walking gait in obese women.Modafinil is a novel wake-promoting agent approved by the FDA ameliorating excessive daytime sleepiness (EDS) in three disorders: narcolepsy, shift work sleep disorder and obstructive sleep apnea. While the swing time negatively correlated with the body mass index (BMI), the normalized stance and the double support exhibited strong positive correlation (r=0.46) with the BMI. As a consequence, the remaining normalized (i.e., expressed as percentage of gait cycle time) phases of stride: the stance and the double support were relatively longer. The temporal stride characteristics and the stance-to-swing ratio were, however, substantially modified in obese individuals due to attenuation of the swing time. Their stance time was not affected by body weight and it remained at the mean level of 746 +/- 90 ms for all groups. Data analysis showed that subjects from every experimental groups walked with a very similar speed (1.08 +/- 0.2 m/s) and cadence (106 +/- 10 steps/min). The acquired gait measures were used then to compute: a mean velocity of walking, double support times and a mean velocity of a foot during swing phase. Subjects' stance and swing times as well as the stride lengths were recorded by means of contact copper-film electrodes attached to a sole of subject' footwear. Among the subjects there were: 44 with class I obesity, 27 with class II obesity, and 29 with class III. To this end the basic spatial and temporal stride measures were assessed in 100 obese and 36 lean women (age range between 18 and 67 years) walking with their self-selected pace on a 10-meter long and 1 meter wide instrumented pathway. The objective of the present studies was to determine an impact of excess body weight on basic spatiotemporal gait measures and to test the hypothesis that leg swing phase may account for a load-related adaptation of the stride characteristics. ![]() The implications of a long-lasting mechanical load on the locomotor activity are poorly understood.
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