scholarly journals Association between Cardiac Autonomic Control and Postural Control in Patients with Parkinson’s Disease

Author(s):  
Yoan Espinoza-Valdés ◽  
Rocio Córdova-Arellano ◽  
Maiter Espinoza-Espinoza ◽  
Diego Méndez-Alfaro ◽  
Juan Pablo Bustamante-Aguirre ◽  
...  

Parkinson’s disease (PD) is a neurodegenerative disorder that affects postural and cardiac autonomic control. However, since it is unknown whether these changes are associated, the objective of this study was to determine whether such a relationship exists. Twenty-three patients with PD participated. The RR intervals were recorded in different positions and heart rate variability (HRV) was analyzed. Postural sway was analyzed based on the center of pressure. No significant differences on HRV indices were induced by postural change. A correlation was found between these indices and postural control, high frequency (HF), and anterior-posterior (AP) root mean square (RMS-AP) (r = 0.422, p = 0.045), low frequency (LF)/HF, and AP mean velocity (r = 0.478, p = 0.021). A correlation was found between HRV induced by postural change and postural control, Δ LF/HF and RMS-AP (r = 0.448, p = 0.032), Δ LF/HF and ellipse area (r = 0.505, p = 0.014), Δ LF/HF and AP mean velocity (r = −0.531; p = 0.009), and Δ LF and AP mean velocity (r = −0.424, p = 0.044). There is an association between the autonomic and postural systems, such that PD patients with blunted cardiac autonomic function in both the supine and orthostatic positions have worse postural control.

2020 ◽  
Vol 20 (09) ◽  
pp. 2040013
Author(s):  
DO-YOUNG KWON ◽  
YOON-HYEOK CHOI ◽  
YU-RI KWON ◽  
GWANG-MOON EOM ◽  
JI-WON KIM

Differentiating scans without evidence of dopaminergic deficits (SWEDDs) from Parkinson’s disease (PD) is very important to avoid costly and inappropriate interventions. The postural balance strategy patients with SWEDDs are not clear. This study investigates the difference in static postural balance between patients with SWEDDs and PD. Twenty-two patients (11 SWEDDs and 11 PD groups) and 11 control groups were instructed to quietly stand on a custom-made force platform. The outcome measures were, mean distance, 95% confidence ellipse area, mean velocity, mean frequency, peak frequency and peak power derived from the center of pressure (COP) data in overall, medio-lateral (ML) and anterio-posterior (AP) directions. As statistical analysis, ANOVA and post hoc tests were conducted for comparison of patients with SWEDDs and PD. SWEDDs patients presented a smaller postural sway size and a more frequent postural sway mainly in the ML direction ([Formula: see text]). On the contrary, there were no significant differences in mean velocity and peak power. Also, no significant differences existed between SWEDDs and normal subjects ([Formula: see text]). The results reflect that a few COP-based outcome variables might be useful to distinguish SWEDDs patients from PD patients. This study suggests that a static postural balance test can be used for clinical screening and identification of potential SWEDDs.


2020 ◽  
Author(s):  
Zahra Rahmati ◽  
Saeed Behzadipour ◽  
Alfred C. Schouten ◽  
Ghorban Taghizadeh ◽  
Keikhosrow Firoozbakhsh

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.


2020 ◽  
Author(s):  
Zahra Rahmati ◽  
Saeed Behzadipour ◽  
Alfred C. Schouten ◽  
Ghorban Taghizadeh ◽  
Keikhosrow Firoozbakhsh

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.


Author(s):  
Alexandre Rodrigues Severo ◽  
Mateus Corrêa Silveira ◽  
Carlos Bolli Mota ◽  
Eduardo Costa Rhoden ◽  
Nadiesca Taisa Filippin

Introduction: Parkinson’s disease (PD) causes impairments in postural control and mobility that affect the individual’s independence. Manual therapy has been used in the treatment of these disorders and can change mobility and postural control. Objective: To assess the immediate effects of an approach in high cervical and occipitomastoid on postural control and mobility of individuals with PD. Method: Three individuals with PD, females, aged 52 to 73 years, participated in this case series. Participants were assessed immediately before and after therapeutic intervention through releases of suboccipital muscles and occipitomastoid sutures. Trunk mobility, functional mobility and postural control (center of pressure parameters - COP) were evaluated. Results: All participants demonstrated improvements in trunk mobility. Participants 1 and 2 slightly improved functional mobility. Participants 1 and 2 showed a decrease in the medial-lateral displacement of the COP. All participants showed increases in at least one direction to the limits of stability. Conclusions: The results showed that the intervention appears more effective on trunk mobility. Variables related to postural control changed with no consistent pattern. Further studies could investigate the association of other manual therapy techniques and their effects on mobility and postural control in individuals with PD.


Author(s):  
Dorota Borzucka ◽  
Krzysztof Kręcisz ◽  
Zbigniew Rektor ◽  
Michał Kuczyński

Abstract Background The aim of this study was to compare the postural control of the Poland national women’s volleyball team players with a control group of non-training young women. It was hypothesized that volleyball players use a specific balance control strategy due to the high motor requirements of their team sport. Methods Static postural sway variables were measured in 31 athletes and 31 non-training women. Participants were standing on a force plate with eyes open, and their center of pressure signals were recorded for the 20s with the sampling rate of 20 Hz in the medial-lateral (ML) and anterior-posterior (AP) planes. Results In both AP and ML planes, athletes had lower range and higher fractal dimension of the COP. They had also higher peak frequency than control group in the ML plane only. The remaining COP indices including variability, mean velocity and mean frequency did not display any intergroup differences. Conclusion It can be assumed that due to the high motor requirements of their sport discipline Polish female volleyball players have developed a unique posture control. On the court they have to distribute their sensory resources optimally between balance control and actions resulting from the specifics of the volleyball game. There are no clearly defined criteria for optimal postural strategies for elite athletes, but they rather vary depending on a given sport. The results of our research confirm this claim. Trial registration The tests were previously approved by the Bioethical Commission of the Chamber of Physicians in Opole. (Resolution No. 151/13.12.2007). This study adheres to the CONSORT guidelines.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Jooeun Song ◽  
Susan Sigward ◽  
Beth Fisher ◽  
George J. Salem

Persons withearly-stageParkinson’s disease (EPD) do not typically experience marked functional deficits but may have difficulty with turning tasks. Studies evaluating turning have focused on individuals in advanced stages of the disease. The purpose of this study was to compare postural control strategies adopted during turning in persons with EPD to those used by healthy control (HC) subjects. Fifteen persons with EPD, diagnosed within 3 years, and 10 HC participated. Participants walked 4 meters and then turned 90°. Dynamic postural control was quantified as the distance between the center of pressure (COP) and the extrapolated center of mass (eCOM). Individuals with EPD demonstrated significantly shorter COP-eCOM distances compared to HC. These findings suggest that dynamic postural control during turning is altered even in the early stages of PD.


2017 ◽  
Vol 56 (02) ◽  
pp. 138-144 ◽  
Author(s):  
Sergio Albiol-Pérez ◽  
José-Antonio Gil-Gómez ◽  
Maria-Teresa Muñoz-Tomás ◽  
Hermenegildo Gil-Gómez ◽  
Raquel Vial-Escolano ◽  
...  

SummaryObjectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor clinical alterations among others. Postural problems have serious consequences for patients, not only limiting their daily life but also increasing some risks, like the risk of fall. Inadequate postural control and postural instability is a major problem in PD patients. A Virtual Motor Rehabilitation System (VMR) has been tested in patients with PD in the intervention period. Our purpose was to analyze the evolution of the spatial postural control during the intervention period, to see if there are any changes caused precisely by this intervention.Methods: Ten people with PD carried out 15 virtual rehabilitation sessions. We tested a groundbreaking system based on Virtual Motor Rehabilitation in two periods of time (baseline evaluation and final evaluation). In the training sessions, the participants performed a customizable treatment using a low-cost system, the Active Balance Rehabilitation system (ABAR). We stored the pressure performed by the participants every five hundredths of a second, and we analyzed the patients’ pressure when they maintained their body on the left, on the right, and in the center in sitting position. Our system was able to measure postural control in every patient in each of the virtual rehabilitation sessions.Results: There are no significant differences in the performance of postural control in any of the positions evaluated throughout the sessions. Moreover, the results show a trend to an improvement in all positions. This improvement is especially remarkable in the left/right positions, which are the most important positions in order to avoid problems such as the risk of fall. With regard to the suitability of the ABAR system, we have found outstanding results in enjoyment, success, clarity, and helpfulness.Conclusions: Although PD is a progressive neurodegenerative disorder, the results demonstrate that patients with PD maintain or even improve their postural control in all positions. We think that the main factor influencing these results is that patients use more of their available cognitive processing to improve their postural control. The ABAR system allows us to make this assumption because the system requires the continuous attention of patients, promoting cognitive processing.


Author(s):  
Pilar Serra-Añó ◽  
José Francisco Pedrero-Sánchez ◽  
Marta Inglés ◽  
Marta Aguilar-Rodríguez ◽  
Ismael Vargas-Villanueva ◽  
...  

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.


2014 ◽  
Vol 112 (10) ◽  
pp. 2638-2646 ◽  
Author(s):  
Cédrick T. Bonnet ◽  
Arnaud Delval ◽  
Luc Defebvre

Patients with Parkinson's disease display impairments of postural control most particularly in active, challenging conditions. The objective of the present study was to analyze early signs of disease-related and also age-related impairments in mediolateral body extension and postural control. Fifty-five participants (18 Hoehn and Yahr stage 2 patients in the off-drug condition, 18 healthy elderly control subjects, and 19 young adults) were included in the study. The participants performed a quiet stance task and two active tasks that analyzed the performance in mediolateral body motion: a limit of stability and a rhythmic weight shift task. As expected, the patients displayed significantly lower and slower body displacement (head, neck, lower back, center of pressure) than elderly control subjects when performing the two body excursion tasks. However, the behavioral variability in both tasks was similar between the groups. Under these active conditions, the patients showed significantly lower contribution of the hip postural control mechanisms compared with the elderly control subjects. Overall, the patients seemed to lower their performance in order to prevent a mediolateral postural instability. However, these patients, at an early stage of their disease, were not unstable in quiet stance. Complementarily, elderly control subjects displayed slower body performance than young adults, which therefore showed an additional age-related impairment in mediolateral postural control. Overall, the study illustrated markers of age-related and Parkinson's disease impairments in mediolateral postural control that may constrain everyday activities in elderly adults and even more in patients with Parkinson's disease.


Sign in / Sign up

Export Citation Format

Share Document