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postural stability in parkinsons disease

Eric N Beck, Quincy J Almeida
BACKGROUND: Parkinson's disease (PD) impairs control of well-learned movements. Movement control improvements are found when individuals complete tasks while focusing attention externally on manipulating an object, which is argued to occur due to automatic processing associated with well-learned movements. Focusing attention internally (on movements of ones' limbs) is believed to involve conscious control networks, and hinders movement performance. Previous work has found that an external focus of attention improved postural stability in individuals with PD (compared to internal), but this was when patients were taking dopamine medication, which modulates basal ganglia functioning responsible for well-learned movements...
October 6, 2016: Physical Therapy
Sarah J Ozinga, Susan M Linder, Jay L Alberts
OBJECTIVE: To determine the accuracy of inertial measurement unit data from a mobile device using the mobile device relative to posturography to quantify postural stability in individuals with Parkinson's disease (PD). DESIGN: Criterion standard. SETTING: Motor control laboratory at Cleveland Clinic. PARTICIPANTS: Fourteen mild to moderate individuals with PD and 14 healthy age-matched community dwelling controls completed the project...
September 23, 2016: Archives of Physical Medicine and Rehabilitation
Marcos Rossi-Izquierdo, Andrés Soto-Varela, Arne Ernst, Juan Pedro Rubio-Rodríguez, Sofía Santos-Pérez, Ángel Sesar, Miguel Alberte-Woodward, Mónica Guijarro-Del Amo, Elena San Román-Rodríguez, Ana Faraldo-García, Alfonso Zubizarreta-Gutiérrez, Dietmar Basta
OBJECTIVE: Impaired balance in patients with Parkinson's disease (PD) leads to loss of balance and frequent falls. Computerized dynamic posturography allows the assessment of stance tasks whereas mobile posturography analyzes the balance in free-field conditions, where falls among PD patients commonly occur (e.g. sitting down or standing up). The aim of the present study is to assess postural stability in PD patients with both techniques. STUDY DESIGN: Prospective study...
October 2016: Otology & Neurotology
Meng-Che Shih, Ray-Yau Wang, Shih-Jung Cheng, Yea-Ru Yang
BACKGROUND: The present study examined the effects of a balance-based exergaming intervention using the Kinect sensor on postural stability and balance in people with Parkinson's disease (PD). METHODS: We conducted a subject-blinded, randomized controlled study. Twenty people with PD (Hoehn and Yahr stages I through III) were recruited and randomly assigned to either a balance-based exergaming group (N = 10) or a balance training group (N = 10) for an 8-week balance training period...
2016: Journal of Neuroengineering and Rehabilitation
D S Peterson, F B Horak
Protective postural responses, including stepping, to recover equilibrium are critical for fall prevention and are impaired in people with Parkinson's disease (PD) with freezing of gait. Improving protective postural responses through training may reduce falls in this population. However, motor learning, the basis of neurorehabilitation, is also impaired in people with PD and, in particular, people with PD who experience freezing. It is unknown whether people with PD who freeze can improve protective postural responses, and whether these improvements are similar to nonfreezers...
August 13, 2016: Neuroscience
Katrijn Smulders, Marian L Dale, Patricia Carlson-Kuhta, John G Nutt, Fay B Horak
Gait impairments are a hallmark of Parkinson's disease (PD), both as early symptom and an important cause of disability later in the disease course. Although levodopa has been shown to improve gait speed and step length, the effect of dopamine replacement therapy on other aspects of gait is less well understood. In fact, falls are not reduced and some aspects of postural instability during gait are unresponsive to dopaminergic treatment. Moreover, many medications other than dopaminergic agents, can benefit or impair gait in people with PD...
October 2016: Parkinsonism & related Disorders
Cathy C Harro, Alicia Marquis, Natasha Piper, Chris Burdis
BACKGROUND: Complex movement and balance impairments in Parkinson's disease contribute to high fall risk. Comprehensive balance assessment is warranted to identify intrinsic fall risk factors and direct interventions. OBJECTIVE: The purpose of this study was to examine the test psychometric properties of three balance measures on the NeuroCom™ Force Platform (FP) system in persons with PD. METHODS: Forty two community-dwelling individuals with idiopathic PD completed the testing protocol...
July 14, 2016: Physical Therapy
Preeti Umarao, Samrat Bose, Supti Bhattacharyya, Anil Kumar, Suman Jain
Parkinson's disease (PD) is a progressive neurodegenerative disorder affecting mainly the dopaminergic neurons of the substantia nigra leading to various motor and non-motor deficits. We explored the neuroprotective potential of superparamagnetic iron oxide nanoparticles (IONPs) along with exposure to EMF in 6-OHDA rat model of PD. IONPs were implanted at the site of lesion and 24 h thereafter the rats were exposed to magnetic fields 2 h/day for one week. Bilateral lesions of the striatum were made with 6-OHDA...
January 2016: Journal of Nanoscience and Nanotechnology
Michael H Cole, Geraldine A Naughton, Peter A Silburn
Background The trunk plays a critical role in attenuating movement-related forces that threaten to challenge the body's postural control system. For people with Parkinson's disease (PD), disease progression often leads to dopamine-resistant axial symptoms, which impair trunk control and increase falls risk. Objective This prospective study aimed to evaluate the relationship between impaired trunk muscle function, segmental coordination, and future falls in people with PD. Methods Seventy-nine PD patients and 82 age-matched controls completed clinical assessments and questionnaires to establish their medical history, symptom severity, balance confidence, and falls history...
June 27, 2016: Neurorehabilitation and Neural Repair
Asako Yoritaka, Hideo Mori, Nobutaka Hattori
BACKGROUND: Camptocormia in Parkinson's disease (PD) is unresponsive to various therapies and induced difficulties in their day-to-day life. OBJECTIVE: This study, an open trial, was aimed at assessing the efficacy of selegiline in the treatment of mild camptocormia in PD patients. METHODS: Participants were administered 5 mg of selegiline for the first 8 weeks and 7.5 mg for the second 8 weeks. RESULTS: As primary endpoints, the degree of thoracolumbar anteflexion decreased from 23...
2016: European Neurology
Ryan P Hubble, Peter A Silburn, Geraldine A Naughton, Michael H Cole
This cross-sectional study aimed to investigate the relationship between accelerometer-derived measures of movement rhythmicity and clinical measures of mobility, balance confidence and gait difficulty in people with Parkinson's disease (PD). Twenty-nine independently-living PD patients (Hoehn & Yahr Stages 1-3) with no history of significant injury or orthopaedic/deep brain stimulation surgery were recruited from a database of patients who had expressed an interest to participate in research. Participants completed clinical assessments of mobility, postural stability, balance confidence and symptom severity, while head and trunk rhythmicity was evaluated during gait using accelerometers...
September 2016: Gait & Posture
Daniel S Peterson, Bauke W Dijkstra, Fay B Horak
Protective postural responses to external perturbations are hypokinetic in people with Parkinson's disease (PD), and improving these responses may reduce falls. However, the ability of people with PD to improve postural responses with practice is poorly understood. Our objective was to determine whether people with PD can improve protective postural responses similarly to healthy adults through repeated perturbations, and whether improvements are retained or generalize to untrained perturbations. Twelve healthy adults and 15 people with PD underwent 25 forward and 25 backward translations of the support surface, eliciting backward, and forward protective steps, respectively...
August 2016: Journal of Neurology
Daniel S Peterson, Fay B Horak
Background The effect of levodopa on postural motor learning in people with Parkinson's disease is poorly understood. In particular, it is unknown whether levodopa affects improvement in protective postural responses after external perturbations such as a slip or trip, a critical aspect of fall prevention. Objective Determine the effect of levodopa on postural motor learning in people with Parkinson's disease. Methods We assessed improvement in protective postural responses in people with Parkinson's disease over short-term (1 day) perturbation training on and off levodopa...
May 9, 2016: Neurorehabilitation and Neural Repair
Tanya Simuni, Chelsea Caspell-Garcia, Christopher Coffey, Shirley Lasch, Caroline Tanner, Ken Marek
OBJECTIVE: To determine the frequency and stability over time of the subgroup characterization of the tremor dominant (TD) versus postural instability gait disorder dominant (PIGD) Parkinson's disease (PD) in de novo patients. BACKGROUND: There is a substantial body of literature on the clinical sub classification of PD into TD versus PIGD subtype. However, there are limited data on the stability of this classification especially in early disease. METHODS: Parkinson's Progression Markers Initiative (PPMI) is a longitudinal case control study of de novo, untreated PD participants at enrollment...
July 2016: Parkinsonism & related Disorders
Sabato Mellone, Martina Mancini, Laurie A King, Fay B Horak, Lorenzo Chiari
BACKGROUND: The ability to turn while walking is essential for daily living activities. Turning is slower and more steps are required to complete a turn in people with Parkinson's disease (PD) compared to control subjects but it is unclear whether this altered strategy is pathological or compensatory. The aim of our study is to characterize the dynamics of postural stability during continuous series of turns while walking at various speeds in subjects with PD compared to control subjects...
2016: Journal of Neuroengineering and Rehabilitation
Sungjae Hwang, Peter Agada, Stephen Grill, Tim Kiemel, John J Jeka
Parkinson's disease (PD) is a progressive degenerative disease manifested by tremor, rigidity, bradykinesia, and postural instability. Deficits in proprioceptive integration are prevalent in individuals with PD, even at early stages of the disease. These deficits have been demonstrated primarily during investigations of reaching. Here, we investigated how PD affects sensory fusion of multiple modalities during upright standing. We simultaneously perturbed upright stance with visual, vestibular, and proprioceptive stimulation, to understand how these modalities are reweighted so that overall feedback remains suited to stabilizing upright stance in individuals with PD...
August 2016: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Marisa Brum, Sofia Reimão, Djalma Sousa, Rui de Carvalho, Joaquim J Ferreira
Multiple system atrophy (MSA) is characterized clinically by parkinsonism, cerebellar, autonomic, and corticospinal features of variable severity. When the presentation is only parkinsonism, the disease might be difficult to differentiate from Parkinson's disease (PD). We present a case of an 80-year-old man with previous diagnosis of PD. One year after the diagnosis, he had a whiplash cervical trauma due to a tricycle accident caused by a hole in the road. This low-energy trauma caused an unstable C4-C5 cervical fracture with spinal cord injury, which required surgical decompression and stabilization...
2016: Frontiers in Neurology
Ali Falaki, Xuemei Huang, Mechelle M Lewis, Mark L Latash
BACKGROUND: Postural instability is one of most disabling motor symptoms in Parkinson's disease. Indices of multi-muscle synergies are new measurements of movement and postural stability. OBJECTIVES: Multi-muscle synergies stabilizing vertical posture were studied in Parkinson's disease patients without clinical symptoms of postural instability (Hoehn-Yahr ≤ II) and age-matched controls. We tested the hypothesis that both synergy indices during quiet standing and synergy adjustments to self-triggered postural perturbations would be reduced in patients...
February 2016: Gait & Posture
Wen-Chieh Yang, Wei-Li Hsu, Ruey-Meei Wu, Tung-Wu Lu, Kwan-Hwa Lin
BACKGROUND: Axial rigidity and postural instability in people with Parkinson's disease (PD) may contribute to turning difficulty. This study examined the rotation of axial segments and gait instability during turning in people with PD. METHODS: Thirteen PD and twelve age-matched healthy adults were recruited. Participants performed the timed Up-and-Go test and were recorded by a 3D motion capture system. Axial rotation was evaluated by the rotation onset of the head, thorax and pelvis...
February 2016: Gait & Posture
Janusz W Błaszczyk
Force-plate posturography is a simple method that is commonly used in the contemporary laboratory and clinic to assess postural control. Despite the obvious advantages and popularity of the method, universal standards for posturographic tests have not been developed thus far: most postural assessments are based on the standard spatiotemporal metrics of the center-of-foot pressure (COP) recorded during quiet stance. Unfortunately, the standard COP characteristics are strongly dependent on individual experimental design and are susceptible to distortions such as the noise of signal digitalization, which often makes the results from different laboratories incomparable and unreliable...
February 2016: Gait & Posture
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