scholarly journals Margins of Postural Stability in Parkinson’s Disease: An Application of Control Theory

2021 ◽  
Author(s):  
Zahra Rahmati ◽  
Saeed Behzadipour ◽  
Ghorban Taghizadeh
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Control Theory ◽  
Training Program ◽  
Postural Stability ◽  
Balance Training ◽  
Postural Instability ◽  
Model Parameters ◽  
Margin Of Stability ◽  
Stability Theorems

Abstract Background: Postural instability is a restrictive feature in Parkinson’s disease (PD), usually assessed by clinical or laboratory tests. However, the exact quantification of postural stability, using stability theorems that take into account the human dynamics, is still lacking. We investigated the feasibility of control theory, Nyquist stability criterion (Gain Margin – GM –, and Phase Margin – PM –), in discriminating postural instability in PD; as well as the effects of a balance-training program. Methods: Center-of-pressure (COP) data of 40 PD patients before and after a 4-week balance-training program, and 20 healthy control subjects (HCs) (Study1); as well as COP data of 20 other PD patients at four time points during a 6-week balance-training program (Study2), collected in two earlier studies, were used. COP was recorded in four tasks, two on rigid surface and two on foam, eyes-open and closed. A postural control model (an inverted-pendulum with PID controller and time delay) was fitted to the COP data, to subject-specifically identify the model parameters; thereby calculating |GM| and PM for each subject in each task.Results: Patients had smaller margin of stability (|GM|, PM) compared to HCs. Particularly, patients, unlike HCs, showed drastic drop in PM on foam. Clinical outcomes and margin of stability improved in patients after balance training. |GM| improved early at week 4, followed by a plateau in the rest of the training. In contrast, PM improved late (week 6), in a relatively continuous-progression form. Conclusions: Using fundamental stability theorems is a promising technique for standardized quantification of postural stability in various tasks.

scholarly journals Virtual Reality Telerehabilitation for Postural Instability in Parkinson’s Disease: A Multicenter, Single-Blind, Randomized, Controlled Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Marialuisa Gandolfi ◽  
Christian Geroin ◽  
Eleonora Dimitrova ◽  
Paolo Boldrini ◽  
Andreas Waldner ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Virtual Reality ◽  
Postural Stability ◽  
Controlled Trial ◽  
Balance Training ◽  
Berg Balance Scale ◽  
Postural Instability ◽  
Cost Comparison ◽  
Group Differences

Introduction. Telerehabilitation enables patients to access remote rehabilitation services for patient-physiotherapist videoconferencing in their own homes. Home-based virtual reality (VR) balance training has been shown to reduce postural instability in patients with Parkinson’s disease (PD). The primary aim was to compare improvements in postural stability after remotely supervised in-home VR balance training and in-clinic sensory integration balance training (SIBT). Methods. In this multicenter study, 76 PD patients (modified Hoehn and Yahr stages 2.5–3) were randomly assigned to receive either in-home VR telerehabilitation (n=38) or in-clinic SIBT (n=38) in 21 sessions of 50 minutes each, 3 days/week for 7 consecutive weeks. VR telerehabilitation consisted of graded exergames using the Nintendo Wii Fit system; SIBT included exercises to improve postural stability. Patients were evaluated before treatment, after treatment, and at 1-month follow-up. Results. Analysis revealed significant between-group differences in improvement on the Berg Balance Scale for the VR telerehabilitation group (p=0.04) and significant Time × Group interactions in the Dynamic Gait Index (p=0.04) for the in-clinic group. Both groups showed differences in all outcome measures over time, except for fall frequency. Cost comparison yielded between-group differences in treatment and equipment costs. Conclusions. VR is a feasible alternative to in-clinic SIBT for reducing postural instability in PD patients having a caregiver.

scholarly journals Postural control learning dynamics in Parkinson’s disease: early ‎improvement with plateau in stability, and continuous progression in ‎flexibility and mobility

2020 ◽  
Author(s):  
Zahra Rahmati ◽  
Saeed Behzadipour ◽  
Alfred C. Schouten ◽  
Ghorban Taghizadeh ◽  
Keikhosrow Firoozbakhsh
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Training Program ◽  
Center Of Pressure ◽  
Balance Training ◽  
Patient Specific ◽  
Learning Dynamics ◽  
Early Improvement ◽  
Model Based

Abstract Background: Balance training improves postural control in Parkinson’s disease (PD). However, a systematic approach for the development of individualized, optimal training programs is still lacking, as the learning dynamics of the postural control in PD, over a training program are poorly understood. Objectives: We investigated the learning dynamics of the postural control in PD, during a balance-training program, in terms of the clinical, posturographic, and novel model-based measures. Methods: Twenty patients with PD participated in a balance-training program, 3 days a week, for 6 weeks. Clinical tests assessed functional balance and mobility pre-training, mid-training, and post-training. Center-of-pressure (COP) was recorded at four time-points during the training (pre-, week 2, week 4, and post-training). COP was used to calculate the sway measures and to identify the parameters of a patient-specific postural control model, at each time-point. The posturographic and model-based measures constituted the two sets of stability- and flexibility-related measures. Results: Mobility- and flexibility-related measures showed a continuous improvement during the balance-training program. In particular, mobility improved at mid-training and continued to improve to the end of the training, whereas flexibility-related measures reached significance only at the end. The progression in the balance- and stability-related measures was characterized by early improvements over the first three to four weeks of training, and reached a plateau for the rest of the training. Conclusions: The progression in balance and postural stability is achieved earlier and susceptible to plateau out, while mobility and flexibility continues to improve during the balance training.

Feasibility of Adapting a Classroom Balance Training Program to a Video Game Platform for People with Parkinson's Disease

2013 ◽  
Vol 19 (4) ◽  
pp. 298-304 ◽  
Author(s):  
Glenna A. Dowling ◽  
Robert Hone ◽  
Charles Brown ◽  
Judy Mastick ◽  
Marsha Melnick
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Training Program ◽  
Video Game ◽  
Balance Training ◽  
Game Platform

scholarly journals BODY COMPOSITION AND POSTURAL INSTABILITY IN PEOPLE WITH IDIOPATHIC PARKINSON’S DISEASE

2016 ◽  
pp. 1-6
Author(s):  
A.S. Diab ◽  
L.A. Hale ◽  
M.A. Skinner ◽  
G. Hammond-Tooke ◽  
A.L. Ward ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Body Composition ◽  
Postural Stability ◽  
Postural Instability ◽  
Composite Score ◽  
Step Test ◽  
Timed Up And Go ◽  
Composite Scores ◽  
Age And Sex

Objectives: Idopathic Parkinson’s disease (PD) is the second most common neurodegenerative disorder. Our objective was to investigate the relationship between body composition and postural instability in people with PD, and age- and sex-matched controls. Design: Cross-sectional study among PD sufferers and age- and sex-matched controls. Setting: University of Otago’s Balance Clinic, School of Physiotherapy. Participants: Forty-seven people with PD and 58 age- and sex-matched controls. Measurements: Postural stability was assessed with the Sensory Organization Test, Motor Control Test, Timed Up and Go Test, and Step Test. Body composition was measured by dual energy x-ray absorptiometry (DXA). Movement Disorders Society-Unified Parkinson’s Disease Rating Scale was applied to assess PD severity. Results: Mean group differences between PD and controls for the equilibrium composite score, Timed Up and Go Tests, and Step Test were statistically significant (p<0.05); strategy and latency composite scores and body composition variables were not (p>0.05). Three PD participants were sarcopenic; 15 PD and 24 controls were obese. In PD participants, total body lean mass and age predicted latency composite scores. Disease, age, and leg fat mass predicted the Timed Up and Go Test results (p<0.05). Sex and disease predicted the equilibrium composite score (p<0.01). Conclusion: The prevalence of obesity was high and sarcopenia low in the PD group, which is a novel finding. Not surprisingly, participants with PD had reduced postural stability compared to controls. Disease status, age and sex were influential factors in the weak relationships found between postural stability and body composition. These findings may have clinical relevance for the treatment of the physical symptoms of those suffering from PD.

scholarly journals Postural control learning dynamics in Parkinson’s disease: early ‎improvement with plateau in stability, and continuous progression in ‎flexibility and mobility

2020 ◽  
Author(s):  
Zahra Rahmati ◽  
Saeed Behzadipour ◽  
Alfred C. Schouten ◽  
Ghorban Taghizadeh ◽  
Keikhosrow Firoozbakhsh
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Training Program ◽  
Center Of Pressure ◽  
Balance Training ◽  
Patient Specific ◽  
Learning Dynamics ◽  
Early Improvement ◽  
Model Based

Abstract Background: Balance training improves postural control in Parkinson’s disease (PD). However, a systematic approach for the development of individualized, optimal training programs is still lacking, as the learning dynamics of the postural control in PD, over a training program are poorly understood.Methods: We explored the learning dynamics of the postural control in PD, during a balance-training program, in terms of the clinical, posturographic, and model-based measures. Twenty patients with PD participated in a balance-training program, 3 days a week, for 6 weeks. Clinical tests assessed functional balance and mobility pre-training, mid-training, and post-training. Center-of-pressure (COP) was recorded at four time-points during the training (pre-, week 2, week 4, and post-training). COP was used to calculate the sway measures and to identify the parameters of a patient-specific postural control model, at each time-point (stability and flexibility degree). The posturographic and model-based measures constituted the two sets of stability- and flexibility-related measures.Results: Mobility- and flexibility-related measures showed a continuous improvement during the balance-training program. In particular, mobility improved at mid-training and continued to improve to the end of the training, whereas flexibility-related measures reached significance only at the end. The progression in the balance- and stability-related measures was characterized by early improvements over the first three to four weeks of training, and reached a plateau for the rest of the training. Conclusions: The progression in balance and postural stability is achieved earlier and susceptible to plateau out, while mobility and flexibility continues to improve during balance training.

scholarly journals Postural instability in subjects with parkinson’s disease undergoing different sensory pitfalls

2017 ◽  
Vol 18 (4) ◽  
Author(s):  
Thaís Cardoso Da Silva ◽  
Lilian Assunção Felippe ◽  
Rodrigo Luiz Carregaro ◽  
Gustavo Christofoletti
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Visual Information ◽  
Postural Stability ◽  
Body Position ◽  
Postural Instability ◽  
Sensory Stimuli ◽  
Eyes Closed ◽  
The Impact ◽  
Anterior Posterior

AbstractPurpose. Previous research has reported postural instability in subjects with Parkinson’s disease (PD). However, there are still doubts about the effect of sensory stimuli on one’s balance. In this study, we further investigated the stabilometric measures of individuals with PD, analysing the impact of different sensory stimuli on the outcomes. Methods. The total of 26 participants (13 with PD and 13 matched control peers) were submitted to 8 sensorimotor dynamics differing in relation to support base (30 cm vs. 10 cm, feet in parallel vs. feet in semi-tandem position), contact surface (foam vs. no foam), and visual conditions (eyes open vs. eyes closed). The measures used to assess one’s balance were body position in space, area of support base, and velocity of postural control. The variables involved the anterior-posterior and the mediolateral axes. Participants with PD were evaluated during the off medication state. Mann-Whitney U test and Friedman’s test were applied to carry out inter- and intra-group comparisons. Significance was set at 5%. Results. Cross-sectional analyses illustrated that tasks with sensory pitfalls impacted postural stability to a larger extent in PD subjects. The differences were found in anterior-posterior body position, area of support base, anterior-posterior velocity, and mediolateral velocity. Complementary analyses confirmed considerable instability on balance when support bases were small and visual information was absent (p < 0.05). Conclusions. The current results confirm worse postural stability response in subjects with PD and highlight that the interference of the sensory pitfalls is notable when individuals are off medication.

Effect of Balance Training on Postural Instability in Patients With Idiopathic Parkinson’s Disease

2010 ◽  
Vol 24 (9) ◽  
pp. 826-834 ◽  
Author(s):  
Nicola Smania ◽  
Elisabetta Corato ◽  
Michele Tinazzi ◽  
Clementina Stanzani ◽  
Antonio Fiaschi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Balance Training ◽  
Postural Instability ◽  
Idiopathic Parkinson’S Disease ◽  
Idiopathic Parkinson's Disease

scholarly journals Relationship between Gait Parameters and Postural Stability in Early and Late Parkinson's Disease and Visual Feedback-Based Balance Training Effects

2017 ◽  
Vol 5 (2) ◽  
pp. 207-214 ◽  
Author(s):  
Mohieldin M. Ahmed ◽  
Douaa M. Mosalem ◽  
Aziz K. Alfeeli ◽  
Ayyoub B. Baqer ◽  
Doaa Youssry Soliman
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gait Analysis ◽  
Postural Stability ◽  
Walking Speed ◽  
Balance Training ◽  
Assessment Tools ◽  
Dynamic Posturography ◽  
Gait Parameters ◽  
Group B

BACKGROUND: Gait disorders or postural instability has been done before. However, lack of reviews has addressed the relation between gait and postural stability in Parkinson's disease (PD).AIM: The aim was to evaluate the relation between gait parameters and postural stability in early and late stages of PD.MATERIALS AND METHODS: The forty-one idiopathic PD patients were divided into two groups into a group (A) considered as early PD and group (B) considered as late ambulant PD. They were evaluated for postural stability by computerised dynamic posturography (CDP) device and gait analysis using an 8 m-camera Vicon 612 data capturing system set.RESULTS: There was a statistically significant improvement of composite equilibrium score, the composite latency of motor response, walking speed and cadence after treatment as compared to before training (p < 0.05) in early PD. However, in the late PD, there was a non-significant change of previous parameters after treatment as compared to before training (p > 0.05).There was a significant correlation between UPDRS motor part score, walking speed and composite equilibrium score after training in early PD (p > 0.05).CONCLUSIONS: Both gait analysis and CDP are important quantitative assessment tools of gait and posture instability.

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