Postural instability and fall risk in Parkinson’s disease: impaired dual tasking, pacing, and bilateral coordination of gait during the “ON” medication state

2011 ◽  
Vol 210 (3-4) ◽  
pp. 529-538 ◽  
Author(s):  
Meir Plotnik ◽  
Nir Giladi ◽  
Yaacov Dagan ◽  
Jeffery M. Hausdorff
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Fall Risk ◽  
Postural Instability ◽  
Dual Tasking ◽  
Bilateral Coordination

scholarly journals The Effect of Pramipexole Therapy on Balance Disorder and Fall Risk in Parkinson’s Disease at Early Stage: Clinical and Posturographic Assessment

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Sibel Güler ◽  
Levent Sinan Bir ◽  
Beyza Akdag ◽  
Fusun Ardıc
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Drug Therapy ◽  
Fall Risk ◽  
Early Stage ◽  
Postural Instability ◽  
Assessment Tools ◽  
Control Subjects ◽  
Significant Difference ◽  
And Control

The aim of this study was to determine balance problems and severity and ratio of postural instability of newly diagnosed, early stage Parkinson’s patients who did not receive any antiparkinson treatment before, to evaluate fall risk clinically and posturographically and to examine the effects of pramipexole on these signs and symptoms. Detailed posturographic assessments which involved central vestibular, visual, peripheric vestibular somatosensory field tests were applied to both patient and control subjects and fall risk was determined. There was not statistically significant difference between patients and control subjects before and after drug therapy in the assesment of fall risk in posturography and there was not any improvement with drug usage in the patient group. However, in the analysis of subsystems separately, only the involvement in central vestibular field was more severe and could appear at all positions in Parkinson’s patients comparing with the control group, and pramipexole was partially effective in improving this disorder. Central vestibular field is the subsystem that should be examined with first priority. Posturography is relatively reliable in defining fall risk and postural instability ratio in Parkinson’s disease. But it should be considered that clinical assessment tools can be more sensitive in the evaluation of balance and postural disorders and in the follow-up of the response to drug therapy.

scholarly journals Perceived walking difficulties in Parkinson’s disease – predictors and changes over time

2020 ◽  
Author(s):  
Magnus Lindh-Rengifo ◽  
Stina B. Jonasson ◽  
Susann Ullén ◽  
Niklas Mattsson-Carlgren ◽  
Maria H. Nilsson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Predictive Factors ◽  
Intervention Studies ◽  
Postural Instability ◽  
Dual Tasking ◽  
Paired Samples ◽  
Changes Over Time ◽  
Over Time

Abstract Background People with Parkinson’s disease (PD) have described their walking difficulties as linked to activity avoidance, social isolation, reduced independence and quality of life. There is a knowledge gap regarding predictive factors of perceived walking difficulties in people with PD. Such knowledge could be useful when designing intervention studies. This study aimed to investigate how perceived walking difficulties evolve over a 3-year period in people with PD. A specific aim was to identify predictive factors of perceived walking difficulties. Methods 149 people with PD (mean age 67.9 years) completed the Walk-12G questionnaire (which assesses perceived walking difficulties) at both baseline and the 3-year follow-up. Paired samples t-test was used for comparing baseline and follow-up mean scores. Multivariable linear regression analyses were used to identify predictive factors of perceived walking difficulties. Results Perceived walking difficulties increased after 3 years: mean Walk-12G score 14.7 versus 18.6, p < 0.001. Concerns about falling was the strongest predictor (β = 0.467) of perceived walking difficulties, followed by problems maintaining balance while dual tasking (β = 0.265), pain (β = 0.137) and postural instability (β = 0.116). Problems maintaining balance while dual tasking was the strongest predictor (β = 0.180) of a change in perceived walking difficulties, followed postural instability (β = 0.098). Conclusions Perceived walking difficulties increase over time in people with PD. The predictive factors identified in this study (concerns about falling, problems maintaining balance while dual tasking, pain, postural instability) are modifiable. Future intervention studies that address these factors need to confirm their preventative effect on perceived walking difficulties.

scholarly journals Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson’s Disease and Healthy Adults

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Cathy C. Harro ◽  
Amanda Kelch ◽  
Cora Hargis ◽  
Abigail DeWitt
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Fall Risk ◽  
Postural Instability ◽  
Healthy Adults ◽  
Force Platform ◽  
Disease Stage ◽  
Balance Performance ◽  
Platform System

Introduction. Postural instability is a known contributing factor to balance dysfunction and increased fall risk in those with Parkinson’s disease (PD). Computerized posturography employing a force platform system provides objective, quantitative assessments of postural control impairments. This study examines balance performance as measured by force platform (FP) tests in persons with PD compared to age-matched healthy adults. Secondarily, we examine if these FP measures provide diagnostic and clinically meaningful information about the underlying balance impairments in the PD population.Methods. Participants—42 individuals with PD (Hoehn and Yahr stage = 2.33 ± 0.77) and 55 age-matched healthy adults—were assessed on three standardized balance measures on a computerized force platform system. Between groups, comparisons of FP performance were analyzed using independentt-test. Within the group, comparisons for the PD cohort were analyzed using ANOVA for comparing disease stage and Mann–WhitneyUtest for PD subtypes.Results. The PD cohort demonstrated significantly greater postural instability on the sensory organization test (SOT) measures (P=0.013, CI-95% = 1.286 to 10.37) and slower movement velocity on the limits of stability (LOS) test (P=0.001, CI-95% = 0.597 to 1.595) than the healthy cohort, suggesting that these tests were sensitive to detect sensory integration and voluntary postural control deficits in the PD cohort. Within the PD group, the SOT differentiated between H&Y stages 1–3. The motor control test (MCT) detected changes in reactive postural control mainly in later disease stages. All three FP tests distinguished between PD subtypes, with thePosture Gait Instabilitysubtype demonstrating poorer balance performance thanTremor Dominantsubtype.Conclusion. These findings suggest FP measures provide clinically meaningful, diagnostic information in the examination of balance impairments in individuals with PD. FP measures may inform clinicians regarding intrinsic balance deficits and guide them in designing targeted balance interventions to reduce fall risk in persons with PD.

scholarly journals The Effect of Parkinson’s Disease on the Step Response to a Backwards Pull

2008 ◽  
Author(s):  
Molly A. McVey ◽  
Antonis P. Stylianou ◽  
Carl W. Luchies ◽  
Kelly E. Lyons ◽  
Rajesh Pahwa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Economic Impacts ◽  
Postural Instability ◽  
Step Response ◽  
Risk Of Falling ◽  
Effective Interventions ◽  
Increased Risk

Postural instability is one of the most disabling symptoms of Parkinson’s disease (PD) and often leads to falls. Falls can have severe physical, psychological, and economic impacts including fractures, fear of falling, and loss of independence [1]. Effective interventions to reduce fall risk exist [2, 3] and would be most effective if they could be implemented prior to a fall occurring. Unfortunately, the current methods to evaluate postural instability in PD are not sensitive enough to predict those who are at an increased risk of falling so it is difficult to identify the best time to begin fall interventions.

Rapid assessment of postural instability in Parkinson’s disease (RAPID): a pilot study

2011 ◽  
Vol 18 (2) ◽  
pp. 260-265 ◽  
Author(s):  
R. K. Y. Chong ◽  
J. Morgan ◽  
S. H. Mehta ◽  
I. Pawlikowska ◽  
P. Hall ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Rapid Assessment ◽  
Postural Instability

scholarly journals Postural instability in Parkinson?s disease ? 120 years after Charcot?s death

2014 ◽  
Vol 72 (8) ◽  
pp. 633-635 ◽  
Author(s):  
Hélio Afonso Ghizoni Teive ◽  
Renato Puppi Munhoz
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Instability

The authors present the original Charcot’s description of postural instability in Parkinson’s disease as well as the evolution of this sign after 120 years of Charcot’s death.

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