Vestibular induced postural responses in Parkinson's disease

Brain ◽  
1993 ◽  
Vol 116 (5) ◽  
pp. 1177-1190 ◽  
Author(s):  
M. A. Pastor ◽  
B. L. Day ◽  
C. D. Marsden
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Responses

scholarly journals Early Postural Instability in Parkinson’s Disease: A Biomechanical Analysis of the Pull Test

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Javier Ricardo Pérez-Sánchez ◽  
Francisco Grandas
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Healthy Subjects ◽  
Postural Instability ◽  
Biomechanical Analysis ◽  
Stage Iii ◽  
Clinical Test ◽  
Pull Force ◽  
Pull Test ◽  
Postural Responses

Postural instability in Parkinson’s disease (PD) is commonly assessed by the pull test. This clinical test may be biased by the variability of the pull force applied. Our objective was to study the postural responses elicited by reproducible pull forces in healthy subjects and PD patients at different stages of the disease. We performed a multimodal approach that included a systematic analysis of the pull force needed to reach the backward limit of stability (FBLoS) assessed by mechanically produced forces, the displacements of the center of pressure (CoP) recorded on a force platform, and the latencies and patterns of activation of the stabilizing muscles. Comparisons between groups were performed by univariate and multivariate statistical analyses. Sixty-four healthy subjects and 32 PD patients, 22 Hoehn–Yahr (H–Y) stages I-II and 10 H–Y stage III, were studied. In healthy subjects, FBLoS decreased with aging and was lower in females. Mean (SD) FBLoS was 98.1 (48.9) Newtons (N) in healthy subjects, 70.5 (39.8) N in PD patients H–Y stages I-II, and 37.7 (18.9) N in PD patients H–Y stage III. Compared to healthy subjects and when adjusted for age and gender, PD patients H–Y stages I-II exhibited the following: (a) a reduced FBLoS; (b) larger CoP displacements and higher velocities for the same applied force; and (c) combined ankle and hip strategies elicited by less intense pull forces. All of these abnormalities were more pronounced in H–Y stage III PD patients compared to H–Y stages I-II PD patients. In conclusion, patients in the early stages of PD already exhibit a degree of postural instability due to inefficient postural adjustments, and they can more easily be destabilized by small perturbations than healthy subjects. This balance impairment becomes more pronounced in more advanced PD. In the pull test, pull force to step back should be a variable to consider when testing balance in clinical practice.

Parkinson's disease versus ageing: different postural responses to soleus muscle vibration

2018 ◽  
Vol 65 ◽  
pp. 169-175 ◽  
Author(s):  
Diana Bzdúšková ◽  
Peter Valkovič ◽  
Zuzana Hirjaková ◽  
Jana Kimijanová ◽  
František Hlavačka
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Soleus Muscle ◽  
Muscle Vibration ◽  
Postural Responses

scholarly journals The interaction of postural and voluntary strategies for stability in Parkinson's disease

2012 ◽  
Vol 108 (5) ◽  
pp. 1244-1252 ◽  
Author(s):  
Andrea C. de Lima-Pardini ◽  
Selma Papegaaij ◽  
Rajal G. Cohen ◽  
Luis A. Teixeira ◽  
Beth A. Smith ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
External Perturbation ◽  
Down Low ◽  
Control Subjects ◽  
Healthy Elderly ◽  
Flat Side ◽  
Postural Responses ◽  
Low Constraint ◽  
Hip Flexion

This study assessed the effects of stability constraints of a voluntary task on postural responses to an external perturbation in subjects with Parkinson's disease (PD) and healthy elderly participants. Eleven PD subjects and twelve control subjects were perturbed with backward surface translations while standing and performing two versions of a voluntary task: holding a tray with a cylinder placed with the flat side down [low constraint (LC)] or with the rolling, round side down [high constraint (HC)]. Participants performed alternating blocks of LC and HC trials. PD participants accomplished the voluntary task as well as control subjects, showing slower tray velocity in the HC condition compared with the LC condition. However, the latency of postural responses was longer in the HC condition only for control subjects. Control subjects presented different patterns of hip-shoulder coordination as a function of task constraint, whereas PD subjects had a relatively invariant pattern. Initiating the experiment with the HC task led to 1) decreased postural stability in PD subjects only and 2) reduced peak hip flexion in control subjects only. These results suggest that PD impairs the capacity to adapt postural responses to constraints imposed by a voluntary task.

Relationship Between Brain Volumes and Objective Balance and Gait Measures in Parkinson’s Disease

2021 ◽  
pp. 1-12
Author(s):  
Anjanibhargavi Ragothaman ◽  
Oscar Miranda-Dominguez ◽  
Barbara H. Brumbach ◽  
Andrew Giritharan ◽  
Damien A. Fair ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scales ◽  
Freezing Of Gait ◽  
Time Variability ◽  
Healthy Controls ◽  
Brain Volumes ◽  
Step Initiation ◽  
Subcortical Region ◽  
Postural Responses

Background: Instrumented measures of balance and gait measure more specific balance and gait impairments than clinical rating scales. No prior studies have used objective balance/gait measures to examine associations with ventricular and brain volumes in people with Parkinson’s disease (PD). Objective: To test the hypothesis that larger ventricular and smaller cortical and subcortical volumes are associated with impaired balance and gait in people with PD. Methods: Regional volumes from structural brain images were included from 96 PD and 50 control subjects. Wearable inertial sensors quantified gait, anticipatory postural adjustments prior to step initiation (APAs), postural responses to a manual push, and standing postural sway on a foam surface. Multiple linear regression models assessed the relationship between brain volumes and balance/gait and their interactions in PD and controls, controlling for sex, age and corrected for multiple comparisons. Results: Smaller brainstem and subcortical gray matter volumes were associated with larger sway area in people with PD, but not healthy controls. In contrast, larger ventricle volume was associated with smaller APAs in healthy controls, but not in people with PD. A sub-analysis in PD showed significant interactions between freezers and non-freezers, in several subcortical areas with stride time variability, gait speed and step initiation. Conclusion: Our models indicate that smaller subcortical and brainstem volumes may be indicators of standing balance dysfunction in people with PD whereas enlarged ventricles may be related to step initiation difficulties in healthy aging. Also, multiple subcortical region atrophy may be associated with freezing of gait in PD.

Effect of functional NMDA-antagonist flupirtine on automatic postural responses in Parkinson's disease

2002 ◽  
Vol 249 (7) ◽  
pp. 824-828 ◽  
Author(s):  
Norman Putzki ◽  
Matthias Maschke ◽  
Johannes Drepper ◽  
Hans-Chr. Diener ◽  
Dagmar Timmann
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nmda Antagonist ◽  
Postural Responses ◽  
Automatic Postural Responses

scholarly journals How to Select Balance Measures Sensitive to Parkinson’s Disease from Body-Worn Inertial Sensors—Separating the Trees from the Forest

Sensors ◽  
2019 ◽  
Vol 19 (15) ◽  
pp. 3320 ◽  
Author(s):  
Naoya Hasegawa ◽  
Vrutangkumar V. Shah ◽  
Patricia Carlson-Kuhta ◽  
John G. Nutt ◽  
Fay B. Horak ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Inertial Sensors ◽  
Objective Measures ◽  
Healthy Controls ◽  
Postural Responses ◽  
Highly Correlated ◽  
Automatic Postural Responses ◽  
Dynamic Posture ◽  
Fold Cross Validation

This study aimed to determine the most sensitive objective measures of balance dysfunction that differ between people with Parkinson’s Disease (PD) and healthy controls. One-hundred and forty-four people with PD and 79 age-matched healthy controls wore eight inertial sensors while performing tasks to measure five domains of balance: standing posture (Sway), anticipatory postural adjustments (APAs), automatic postural responses (APRs), dynamic posture (Gait) and limits of stability (LOS). To reduce the initial 93 measures, we selected uncorrelated measures that were most sensitive to PD. After applying a threshold on the Standardized Mean Difference between PD and healthy controls, 44 measures remained; and after reducing highly correlated measures, 24 measures remained. The four most sensitive measures were from APAs and Gait domains. The random forest with 10-fold cross-validation on the remaining measures (n = 24) showed an accuracy to separate PD from healthy controls of 82.4%—identical to result for all measures. Measures from the most sensitive domains, APAs and Gait, were significantly correlated with the severity of disease and with patient-related outcomes. This method greatly reduced the objective measures of balance to the most sensitive for PD, while still capturing four of the five domains of balance.

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