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.

Appendectomy Does Not Increase the Risk of Future Emergence of Parkinson’s Disease: A Meta-analysis

2021 ◽  
pp. 000313482198903
Author(s):  
Mitsuru Ishizuka ◽  
Norisuke Shibuya ◽  
Kazutoshi Takagi ◽  
Hiroyuki Hachiya ◽  
Kazuma Tago ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Models ◽  
Significant Difference ◽  
The Cochrane Library ◽  
The Impact ◽  
The Relationship ◽  
Observation Period

Objective To explore the impact of appendectomy history on emergence of Parkinson’s disease (PD). Background Although there are several studies to investigate the relationship between appendectomy history and emergence of PD, the results are still controversial. Methods We performed a comprehensive electronic search of the literature (the Cochrane Library, PubMed, and the Web of Science) up to April 2020 to identify studies that had employed databases allowing comparison of emergence of PD between patients with and those without appendectomy history. To integrate the impact of appendectomy history on emergence of PD, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) for the selected studies, and heterogeneity was analyzed using I2 statistics. Results Four studies involving a total of 6 080 710 patients were included in this meta-analysis. Among 1 470 613 patients with appendectomy history, 1845 (.13%) had emergences of PD during the observation period, whereas among 4 610 097 patients without appendectomy history, 6743 (.15%) had emergences of PD during the observation period. These results revealed that patients with appendectomy history and without appendectomy had almost the same emergence of PD (RR, 1.02; 95% CI, .87-1.20; P = .83; I2 = 87%). Conclusion This meta-analysis has demonstrated that there was no significant difference in emergence of PD between patients with and those without appendectomy history.

scholarly journals The Role of Architecture and Design in the Management of Parkinson’s Disease: A Systematic Review

2020 ◽  
Vol 10 (4) ◽  
pp. 1301-1314
Author(s):  
Joana Beisl Ramos ◽  
Gonçalo S. Duarte ◽  
Raquel Bouça-Machado ◽  
Margherita Fabbri ◽  
Tiago A. Mestre ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Fear Of Falling ◽  
Experimental Studies ◽  
Postural Instability ◽  
Functional Mobility ◽  
Housing Type ◽  
Architecture And Design ◽  
The Impact

Background: Parkinson’s disease (PD) is a neurological condition characterized by the development of daily disabling symptoms. Although the architecture and design of a PD patient’s environment can hinder or facilitate full participation in daily activities, their putative role in the management of these patients has received little attention to date. Objective: We conducted a systematic review to evaluate the evidence of architectural and design features in the management of people with PD. Methods: An electronic database search of observational and experimental studies was conducted in MEDLINE and Embase from inception to May 2020, with two independent reviewers identifying the studies. Falls, fear of falling, postural instability, gait impairment/disability, and functional mobility were our outcomes of interest. Results: Thirty-six studies were included, among which nineteen were observational and seventeen were experimental studies (overall participants = 2,965). Pavement characteristics, notably unstable surfaces and level differences, were found to be a major cause of falling. Ground-based obstacles and confined/narrowed spaces were found to disturb gait, increase postural instability, and decrease functional mobility. Housing type did not appear to increase risk of falling, nor to significantly explain concerns about falling. Conclusion: Findings suggest a need to adjust architectural features of the surrounding space to ensure appropriate care and provide a safe environment to PD patients. More evidence about the impact of such modifications on PD outcomes is needed.

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 depression on survival of Parkinson's disease patients: a five-year study

2013 ◽  
Vol 62 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Cláudia Débora Silberman ◽  
Cláudia Soares Rodrigues ◽  
Eliasz Engelhardt ◽  
Jerson Laks
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cox Regression ◽  
Rank Test ◽  
First Year ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Impact ◽  
Mean Time

OBJECTIVE: The aim of this study is to evaluate the survival rate in a cohort of Parkinson's disease patients with and without depression. METHODS: A total of 53 Parkinson's disease subjects were followed up from 2003-2008 and 21 were diagnosed as depressed. Mean time of follow up was 3.8 (SD 95% = 1.5) years for all the sample and there was no significant difference in mean time of follow up between depressed and nondepressed Parkinson's disease patients. Survival curves rates were fitted using the Kaplan-Meier method. In order to compare survival probabilities according to the selected covariables the Log-Rank test was used. Multivariate analysis with Cox regression was performed aiming at estimating the effect of predictive covariables on the survival. RESULTS: The cumulative global survival of this sample was 83% with nine deaths at the end of the study - five in the depressed and four in the nondepressed group, and 55.6% died in the first year of observation, and none died at the fourth and fifth year of follow up. CONCLUSION: Our finding point toward incremental death risk in depressed Parkinson's disease patients.

scholarly journals Positive impact of short-term gait rehabilitation in Parkinson patients: a combined approach based on statistics and machine learning

2021 ◽  
Vol 18 (5) ◽  
pp. 6995-7009
Author(s):  
Leandro Donisi ◽  
◽  
Giuseppe Cesarelli ◽  
Pietro Balbi ◽  
Vincenzo Provitera ◽  
...  
Keyword(s):  
Machine Learning ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gait Analysis ◽  
Neurodegenerative Disorder ◽  
Positive Impact ◽  
Short Term ◽  
Significant Difference ◽  
Motion Parameters ◽  
The Impact

<abstract> <p>Parkinson's disease is the second most common neurodegenerative disorder in the world. Assumed that gait dysfunctions represent a major motor symptom for the pathology, gait analysis can provide clinicians quantitative information about the rehabilitation outcome of patients. In this scenario, wearable inertial systems for gait analysis can be a valid tool to assess the functional recovery of patients in an automatic and quantitative way, helping clinicians in decision making. Aim of the study is to evaluate the impact of the short-term rehabilitation on gait and balance of patients with Parkinson's disease. A cohort of 12 patients with Idiopathic Parkinson's disease performed a gait analysis session instrumented by a wearable inertial system for gait analysis: Opal System, by APDM Inc., with spatial and temporal parameters being analyzed through a statistic and machine learning approach. Six out of fourteen motion parameters exhibited a statistically significant difference between the measurements at admission and at discharge of the patients, while the machine learning analysis confirmed the separability of the two phases in terms of Accuracy and Area under the Receiving Operating Characteristic Curve. The rehabilitation treatment especially improved the motion parameters related to the gait. The study shows the positive impact on the gait of a short-term rehabilitation in patients with Parkinson's disease and the feasibility of the wearable inertial devices, that are increasingly spreading in clinical practice, to quantitatively assess the gait improvement.</p> </abstract>

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.

scholarly journals Assessment of Functional Activities in Individuals with Parkinson’s Disease Using a Simple and Reliable Smartphone-Based Procedure

2020 ◽  
Vol 17 (11) ◽  
pp. 4123
Author(s):  
Pilar Serra-Añó ◽  
José Francisco Pedrero-Sánchez ◽  
Marta Inglés ◽  
Marta Aguilar-Rodríguez ◽  
Ismael Vargas-Villanueva ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Reaction Time ◽  
Postural Control ◽  
Neurodegenerative Disorder ◽  
Measurement Unit ◽  
Functional Activities ◽  
Sit To Stand ◽  
Study Participants ◽  
The Impact

Parkinson’s disease (PD) is a progressive neurodegenerative disorder leading to functional impairment. In order to monitor the progression of the disease and to implement individualized therapeutic approaches, functional assessments are paramount. The aim of this study was to determine the impact of PD on balance, gait, turn-to-sit and sit-to-stand by means of a single short-duration reliable test using a single inertial measurement unit embedded in a smartphone device. Study participants included 29 individuals with mild-to moderate PD (PG) and 31 age-matched healthy counterparts (CG). Functional assessment with FallSkip® included postural control (i.e., Medial-Lateral (ML) and Anterior-Posterior (AP) displacements), gait (Vertical (V) and Medial-Lateral (ML) ranges), turn-to-sit (time) and sit-to-stand (power) tests, total time and gait reaction time. Our results disclosed a reliable procedure (intra-class correlation coefficient (ICC) = 0.58–0.92). PG displayed significantly larger ML and AP displacements during the postural test, a decrease in ML range while walking and a longer time needed to perform the turn-to-sit task than CG (p < 0.05). No differences between groups were found for V range, sit-to-stand test, total time and reaction time (p > 0.05). In conclusion, people with mild-to-moderate PD exhibit impaired postural control, altered gait strategy and slower turn-to-sit performance than age-matched healthy people.

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 Dual-Task Interference: The Effects of Verbal Cognitive Tasks on Upright Postural Stability in Parkinson's Disease

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
J. D. Holmes ◽  
M. E. Jenkins ◽  
A. M. Johnson ◽  
S. G. Adams ◽  
S. J. Spaulding
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Dual Task ◽  
Postural Stability ◽  
Cognitive Tasks ◽  
Task Interference ◽  
Biomechanical Parameters ◽  
The Impact ◽  
Dual Task Interference

Although dual-task interference has previously been demonstrated to have a significant effect on postural control among individuals with Parkinson's disease, the impact of speech complexity on postural control has not been demonstrated using quantitative biomechanical measures. The postural stability of twelve participants with idiopathic Parkinson's disease and twelve healthy age-matched controls was evaluated under three conditions: (1) without a secondary task, (2) performing a rote repetition task and (3) generating a monologue. Results suggested a significant effect of cognitive load on biomechanical parameters of postural stability. Although both groups increased their postural excursion, individuals with Parkinson's disease demonstrated significantly reduced excursion as compared with that of healthy age-matched controls. This suggests that participants with Parkinson's disease may be overconstraining their postural adjustments in order to focus attention on the cognitive tasks without losing their balance. Ironically, this overconstraint may place the participant at greater risk for a fall.

scholarly journals Quantitative Analysis of Postural Instability in Patients with Parkinson’s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yang Yu ◽  
Siquan Liang ◽  
Yue Wang ◽  
Yanan Zhao ◽  
Jiaojiao Zhao ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Stage Iv ◽  
Postural Instability ◽  
Stage Ii ◽  
Stage Iii ◽  
Clinical Trial Registry ◽  
Yahr Stage ◽  
Significant Difference ◽  
Postural Abnormalities

Introduction. Postural instability is commonly observed in Parkinson’s disease, leading to an increasing risk of falling and worsening as the disease progresses. We found that limit of stability can be applied to reflect the dynamic evolution of postural instability in patients with Parkinson's disease. Methods. Forty-three patients (9 of Hoehn and Yahr stage I, 12 of stage II, 14 of stage III, and 8 of stage IV) met the criteria for the diagnosis of idiopathic Parkinson’s disease and could stand independently for at least 10 minutes. Twelve healthy controls with no sign of parkinsonism were also recruited. Postural instability was assessed by posturography in different directions (forward, backward, right, left, forward-right, forward-left, backward-right, and backward-left). This study trial was registered with the Chinese Clinical Trial Registry (no. ChiCTR1900022715). Results. All participants were able to complete the limit of stability tasks without any complications. Patients in stages II to IV exhibited smaller end point excursion and slower time to complete than controls, suggesting an impaired limit of stability. The patients in stage II exhibited a remarkable decline in most directions compared to controls, except for right and left, and forward and backward decline occurred the earliest. For patients in stage III, right was the only direction with no significant difference from controls. In stage IV patients, the limit of stability declined significantly in all directions ( p < 0.05 ). Conclusions. The postural abnormalities of Parkinson’s disease can occur at early stages, and the pattern of decline is more severe in the forward-backward direction. This trial is registered with ChiCTR1900022715.

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