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 Vibrotactile Feedback Alters Dynamics Of Static Postural Control In Persons With Parkinson’s Disease But Not Older Adults At High Fall Risk

2018 ◽  
Vol 63 ◽  
pp. 202-207 ◽  
Author(s):  
Carleigh M. High ◽  
Hannah F. McHugh ◽  
Stephen C. Mills ◽  
Shinichi Amano ◽  
Jane E. Freund ◽  
...  
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Fall Risk ◽  
Vibrotactile Feedback

scholarly journals Cortical and Cerebellar Oscillatory Responses to Postural Instability in Parkinson's Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Taylor J. Bosch ◽  
Stefan Kammermeier ◽  
Christopher Groth ◽  
Matt Leedom ◽  
Elizabeth K. Hanson ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Spectral Power ◽  
Postural Instability ◽  
Oscillatory Activity ◽  
Control Task ◽  
Theta Power ◽  
Balance Task ◽  
Beta Power

Introduction: Posture and balance dysfunctions critically impair activities of daily living of patients with progressing Parkinson's disease (PD). However, the neural mechanisms underlying postural instability in PD are poorly understood, and specific therapies are lacking. Previous electrophysiological studies have shown distinct cortical oscillations with a significant contribution of the cerebellum during postural control tasks in healthy individuals.Methods: We investigated cortical and mid-cerebellar oscillatory activity via electroencephalography (EEG) during a postural control task in 10 PD patients with postural instability (PDPI+), 11 PD patients without postural instability (PDPI–), and 15 age-matched healthy control participants. Relative spectral power was analyzed in the theta (4–7 Hz) and beta (13–30 Hz) frequency bands.Results: Time-dependent postural measurements computed by accelerometer signals showed poor performance in PDPI+ participants. EEG results revealed that theta power was profoundly lower in mid-frontal and mid-cerebellar regions during the postural control task in PDPI+, compared to PDPI– and control participants. In addition, theta power was correlated with postural control performance in PD subjects. No significant changes in beta power were observed. Additionally, oscillatory changes during the postural control task differed from the resting state.Conclusion: This study underlines the involvement of mid-frontal and mid-cerebellar regions in postural stability during a balance task and emphasizes the important role of theta oscillations therein for postural control in PD.

scholarly journals The Impact of Parkinson’s Disease on Postural Control in Older People and How Sex can Mediate These Results: A Systematic Review

Geriatrics ◽  
2021 ◽  
Vol 6 (4) ◽  
pp. 105
Author(s):  
Mathieu Dallaire ◽  
Guillaume Gagnon ◽  
Émilie Fortin ◽  
Josée Nepton ◽  
Anne-France Severn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Older People ◽  
Postural Control ◽  
Elderly People ◽  
Postural Instability ◽  
Current Evidence ◽  
Men And Women ◽  
Significant Difference ◽  
The Impact

Introduction: Parkinson’s disease is most prevalent among elderly people, 65 years and over, and leads to an alteration in motor control associated with postural instability. Current evidence shows that postural control decreases with the aging process. In addition, postural control is more altered in healthy aged men than in women. Until today, few studies have evaluated the combined impact of Parkinson’s disease and sex on postural control. This review has allowed to evaluate the impact of Parkinson’s disease and sex on postural control measurements in elderly people. Methodology: Studies have been selected from two main databases: PubMed and EBSCO using the keywords “Parkinson”, “postural control OR balance” and “sex”. Articles related to the evaluation of postural control, including men and women with Parkinson’s aged over 65 years old, regardless of stage, were included (n = 179). Articles were excluded if not written in French or English or not presenting original content. Results: Ten (10) studies out of 179 that fulfilled inclusion and exclusion criteria were reported in the final analysis, which cumulates a total of 944 individuals with Parkinson’s (410 women). In general, results show greater postural instability among people with Parkinson’s compared to healthy subjects, and this according to different objective measurements using stabilographic parameters from force platforms. Only two studies out of ten evaluated postural control while briefly considering distinctions between sex, but without showing a significant difference between men and women with Parkinson’s. Parkinson’s severity, length of time of Parkinson’s disease and cognitive state of the person are the three variables with a negative impact on postural control. Conclusion: Older people with Parkinson’s disease have greater postural instability. Sex does not seem to influence the postural control of elderly people with Parkinson’s, although more studies are necessary.

scholarly journals Motor and Non-motor Symptoms Associated With Exercise Behavior in Parkinson's Disease Patients: Factors Differ Between Patients With and Without Postural Instability

2021 ◽  
Vol 12 ◽  
Author(s):  
Joomee Song ◽  
Jinyoung Youn ◽  
Young Eun Huh ◽  
Jun Kyu Mun ◽  
Jong Hyeon Ahn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Instability ◽  
Exercise Behavior ◽  
Motor Symptom ◽  
Disease Stage ◽  
Motor Symptoms ◽  
Non Motor Symptoms ◽  
Positive Determinant ◽  
Updrs Part

Background: Exercise is an important treatment for Parkinson's disease (PD). Therefore, recognizing determinants of exercise behavior for PD based on disease stage is essential. We sought to find whether the determinants differ based on presence of postural instability (PI), which is indicative of disease stage in PD.Methods: We enrolled patients at Samsung Medical Center from September 2019 to November 2020, who had the ability to perform exercise [modified Hoehn and Yahr (HY) stage ≤ 3]. All the motor and non-motor symptoms were investigated. The exercise of the PD patients was evaluated using the Physical Activity Scale of the Elderly (PASE)-leisure score. We classified patients into PD without PI (HY stage 1 – 2) and PD with PI (HY stage 2.5 – 3) groups. Multivariate linear regression was performed using backward elimination in each group to determine factors associated with PASE-leisure score.Results: A total of 233 patients were enrolled. In the PD without PI group (n = 177), the positive determinant of exercise was Activities-Specific Balance Confidence (ABC) score (β = 0.142, p = 0.032), and the negative determinants were fatigue score (β = −0.228, p = 0.018), female (β = −6.900, p = 0.016) and currently employed status (β = −6.072, p = 0.046). In the PD with PI group (n = 56), the positive determinant was non-motor symptom scale (NMSS) score (β = 0.221, p = 0.017) and disease duration (β = 1.001, p = 0.036), while the negative determinants were UPDRS part 3 score (β = −0.974, p < 0.001), UPDRS part 4 score (β = −2.192, p = 0.002), and age (β = −1.052, p < 0.001).Conclusion: Different motor and non-motor symptoms were associated with the exercise in PD patients with and without PI. When encouraging PD patients to exercise, personalized and different strategies should be applied based on the presence of PI.

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 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.

scholarly journals Assessment of postural instability in Parkinson’s disease patients

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohamed Aziz Mohamed Talaat ◽  
Amr Elfatatry ◽  
Nibras Mohamed Ibrahim Mohamed Noor ◽  
Mirhan Eldeeb
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Postural Instability ◽  
Control Group ◽  
Study Group ◽  
Clinical Tool ◽  
Body Movements ◽  
Dynamic Posturography ◽  
Balance Impairment

Abstract Background Parkinson’s disease (PD) is a degenerative, progressive, neurological condition that influences the control of a person’s body movements. Computerized dynamic posturography (CDP) is a clinical tool intended to evaluate the integration of visual, vestibular, and somatosensory inputs to maintain postural gait. Posturography can be used to measure postural instability in PD patients. So, the aim of this study was to evaluate the postural control and elaborate on the pathophysiology of the balance impairment in PD patients in the “on” state. Results All antero-posterior (AP) and medio-lateral (ML) sensory balance scores, except vestibular ones, were significantly lower in the study group compared to the control group. AP and ML sway were generally higher in the study group at all frequencies, with AP being mostly greater compared to ML sway in PD subjects. Global sensory scores were shown to deteriorate with increased durations of the disease and treatment. Conclusions PD patients have higher postural instability in comparison to controls with AP sway being higher compared to ML.

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