scholarly journals Agreement between measurements of stance width using motion capture and center of pressure in individuals with and without Parkinson’s disease

2017 ◽  
Author(s):  
J. Lucas McKay
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Center Of Pressure ◽  
Study Groups ◽  
Quiet Standing ◽  
Strongly Correlated ◽  
Kinematic Data ◽  
Source Data ◽  
Two Measures ◽  
Kinematic Measures

AbstractBackgroundMany individuals with Parkinson’s disease exhibit narrow stance width during balance and gait. Because of this, stance width is an important biomechanical variable in many studies. Measuring stance width accurately using kinematic markers in parkinsonian patients can be problematic due to occlusions by research staff who must closely guard patients to prevent falls.MethodsWe investigated whether a measure of stance width based on the mediolateral distance between the center of pressure under each foot could approximate stance width measured with kinematic data. We assessed the agreement between estimates of stance width obtained from simultaneous kinematic and center of pressure measures during quiet standing in 15 individuals (n=9 parkinsonian, n=6 age-similar neurotypical). The source data (1363 unique trials) contained observations of stance width varying between 75–384 mm (≈25-150% of hip width).FindingsStance width estimates using the two measures were strongly correlated (r = 0.98). Center of pressure estimates of stance width were 48 mm wider on average than kinematic measures, and did not vary across study groups (F2,12=1.81, P<0.21). The expected range of differences between the center of pressure and kinematic methods was 14–83 mm. Agreement increased as stance width increased (P<0.02).InterpretationIt is appropriate to define stance width based on center of pressure when it is convenient to do so in studies of individuals with and without Parkinson’s disease. When comparing results across studies with the two methodologies, it is reasonable to assume a bias of 48 mm.

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.

Prolonged Standing Task Affects Adaptability of Postural Control in People With Parkinson’s Disease

2020 ◽  
Vol 35 (1) ◽  
pp. 58-67
Author(s):  
Gabriel Felipe Moretto ◽  
Felipe Balistieri Santinelli ◽  
Tiago Penedo ◽  
Luis Mochizuki ◽  
Natalia Madalena Rinaldi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Control System ◽  
Postural Control ◽  
The Body ◽  
Quiet Standing ◽  
Body Sway ◽  
Control Group ◽  
Postural Control System ◽  
Prolonged Standing

Background Studies on short-term upright quiet standing tasks have presented contradictory findings about postural control in people with Parkinson’s disease (pwPD). Prolonged trial durations might better depict body sway and discriminate pwPD and controls. Objective The aim of this study was to investigate postural control in pwPD during a prolonged standing task. Methods A total of 26 pwPD and 25 neurologically healthy individuals performed 3 quiet standing trials (60 s) before completing a constrained prolonged standing task for 15 minutes. Motion capture was used to record body sway (Vicon, 100 Hz). To investigate the body sway behavior during the 15 minutes of standing, the analysis was divided into three 5-minute-long phases: early, middle, and late. The following body sway parameters were calculated for the anterior-posterior (AP) and medial-lateral (ML) directions: velocity, root-mean-square, and detrended fluctuations analysis (DFA). The body sway area was also calculated. Two-way ANOVAs (group and phases) and 1-way ANOVA (group) were used to compare these parameters for the prolonged standing and quiet standing, respectively. Results pwPD presented smaller sway area ( P < .001), less complexity (DFA; AP: P < .009; ML: P < .01), and faster velocity (AP: P < .002; ML: P < .001) of body sway compared with the control group during the prolonged standing task. Although the groups swayed similarly (no difference for sway area) during quiet standing, they presented differences in sway area during the prolonged standing task ( P < .001). Conclusions Prolonged standing task reduced adaptability of the postural control system in pwPD. In addition, the prolonged standing task may better analyze the adaptability of the postural control system in pwPD.

Effects of a core stabilization training program on balance ability in persons with Parkinson’s disease: a randomized controlled trial

2020 ◽  
Vol 34 (6) ◽  
pp. 764-772
Author(s):  
Irene Cabrera-Martos ◽  
Ana Teresa Jiménez-Martín ◽  
Laura López-López ◽  
Janet Rodríguez-Torres ◽  
Araceli Ortiz-Rubio ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Center Of Pressure ◽  
Dynamic Balance ◽  
Controlled Trial ◽  
Core Stability ◽  
Control Group ◽  
Balance Confidence ◽  
Balance Ability ◽  
Experimental Group

Objective: To explore the effects of an eight-week core stability program on balance ability in persons with Parkinson’s disease. Design: Randomized controlled trial. Setting: A local Parkinson’s association. Subjects: A total of 44 participants with a clinical diagnosis of Parkinson’s disease were randomly assigned to an experimental ( n = 22) or control group ( n = 22). Intervention: The experimental group received 24 sessions of core training, while the control group received an intervention including active joint mobilization, muscle stretching, and motor coordination exercises. Main measures: The primary outcome measure was dynamic balance evaluated using the Mini-Balance Evaluation Systems Test. Secondary outcomes included the balance confidence assessed with the Activities-specific Balance Confidence Scale and standing balance assessed by the maximal excursion of center of pressure during the Modified Clinical Test of Sensory Interaction on Balance and the Limits of Stability test. Results: After treatment, a significant between-group improvement in dynamic balance was observed in the experimental group compared to the control group (change, 2.75 ± 1.80 vs 0.38 ± 2.15, P = 0.002). The experimental group also showed a significant improvement in confidence (change, 16.48 ± 16.21 vs 3.05 ± 13.53, P = 0.047) and maximal excursion of center of pressure in forward (change, 0.86 ± 1.89 cm vs 0.17 ± 0.26 cm, P = 0.048), left (change, 0.88 ± 2.63 cm vs 0.07 ± 0.48 cm, P = 0.010), and right (change, 1.63 ± 2.82 cm vs 0.05 ± 0.17 cm, P = 0.046) directions of limits of stability compared to the control group. Conclusion: A program based on core stability in comparison with non-specific exercise benefits dynamic balance and confidence and increases center of mass excursion in patients with Parkinson’s disease.

Flash Electroretinography Parameters and Parkinson’s Disease

2020 ◽  
pp. 1-9
Author(s):  
Roni Netser ◽  
Docia L. Demmin ◽  
Roseanne Dobkin ◽  
Ariel Goldstein ◽  
Matthew Roché ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Photoreceptor Cell ◽  
Implicit Time ◽  
Diagnostic Tools ◽  
Strongly Correlated ◽  
Clinical Scales ◽  
Retinal Structure ◽  
Non Motor Symptoms ◽  
Structure And Activity

Background: Parkinson’s disease (PD) is known to affect retinal structure and activity. As such, retinal evaluations may be used to develop objective and possibly early PD diagnostic tools. Objective: The aim of this study was to investigate the effects of Parkinson’s disease (PD) manifestation and treatment on retinal activity. Methods: Data were collected on 21 participants diagnosed with PD, including the number of medications taken, clinical scales and flash electroretinography (fERG) measurements, under light-adapted and dark-adapted conditions. The fERG parameters measured included a-wave and b-wave amplitude and implicit time (i.e., latency). First, we investigated correlations between symptom measure scores and the fERG parameters. Next, we divided participants into two groups based on their antiparkinsonian medication load and analyzed differences between these groups’ fERG parameters. Results: fERG parameters were strongly correlated with a number of clinical variables, including motor and non-motor symptoms and age at PD onset. Photoreceptor cell implicit time was longer among participants taking one or less antiparkinsonian medication as compared to those taking two or more. However, overall there was not strong evidence of a relationship between the number of antiparkinsonian medications taken and the fERG parameters. Conclusion: Findings suggest that fERG may be a useful, non-intrusive measure of retinal, and, perhaps overall CNS function, in PD. However, additional studies in larger samples are needed to clarify this association.

scholarly journals Levodopa Reduces Muscle Tone and Lower Extremity Tremor in Parkinson’s Disease

1995 ◽  
Vol 22 (4) ◽  
pp. 280-285 ◽  
Author(s):  
Anne Burleigh ◽  
Fay Horak ◽  
John Nutt ◽  
James Frank
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Lower Extremity ◽  
Muscle Activity ◽  
Center Of Pressure ◽  
Muscle Tone ◽  
High Amplitude ◽  
Trunk Muscles ◽  
Foot Pressure ◽  
Control Subjects

AbstractObjectiveWe have quantified the effects of levodopa treatment in Parkinsonian subjects during maintained stance.MethodsElectromyographic muscle activity during quiet stance was assessed in subjects with Parkinson’s disease, who exhibited a fluctuating response to levodopa, and in age-matched control subjects. Stance stability was also assessed from mean displacement and velocity of the center of pressure excursions during stance.ResultsLower extremity and trunk muscles showed high amplitude activity in all Parkinson’s subjects when “off”, and a 4–5 Hz tremor in three of these subjects. When “on”, the amplitude of muscle activity was reduced in the distal muscles more than the proximal, while tremor was suppressed in all muscles. Corresponding to the excessive muscle activity, the Parkinson’s subjects had increased velocity and variability of velocity in the anterior-posterior center of foot pressure excursions, but the mean displacement of the center of pressure excursion was not different from the controls. The velocity of center of pressure excursions in the Parkinson’s subjects “on”, approached those of the control subjects suggesting that the excessive distal muscle amplitude and tremor contributed to the high velocity of the center of pressure.ConclusionsThese findings suggest that dopaminergic systems are involved in the regulation of muscle tone during stance. Depletion of dopaminergic transmission results in increased muscle tone and tremor in the lower extremities which may contribute to changes in posture and stability.

scholarly journals A New Postural Stability-Indicator to Predict the Level of Fear of Falling In Parkinson’s Disease Patients

2020 ◽  
Author(s):  
Ehsan Pourghayoomi ◽  
Saeed Behzadipour ◽  
Mehdi Ramezani ◽  
Mohammad Taghi Joghataei ◽  
Gholamali shahidi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Stability ◽  
Human Error ◽  
Fear Of Falling ◽  
Center Of Pressure ◽  
Threshold Level ◽  
Berg Balance Scale ◽  
Self Report ◽  
Timed Up And Go

Abstract Background Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. 70% of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error. Objectives In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRi’s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF related behavior(s). Results FTR 1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = − 0.63, P < 0.001), Pull Test (r = − 0.65, P < 0.001), Timed Up and Go test (r = − 0.57, P < 0.001), and Berg Balance Scale (r = 0.62, P < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions Using the proposed assessment technique we can accurately predict the intensity of FoF in PD patients. Also, The FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

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 Immediate effects of an approach in high cervical and occipitomastoidon postural control and mobility of individuals with parkinson’s disease: case series

2020 ◽  
pp. 1-7
Author(s):  
Alexandre Rodrigues Severo ◽  
Mateus Corrêa Silveira ◽  
Carlos Bolli Mota ◽  
Eduardo Costa Rhoden ◽  
Nadiesca Taisa Filippin
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Manual Therapy ◽  
Center Of Pressure ◽  
Lateral Displacement ◽  
Case Series ◽  
Functional Mobility ◽  
Disease Case ◽  
High Cervical

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.

Non‐motor symptom burden is strongly correlated to motor complications in patients with Parkinson’s disease

2020 ◽  
Vol 27 (7) ◽  
pp. 1210-1223 ◽  
Author(s):  
D. Santos‐García ◽  
T. Deus Fonticoba ◽  
E. Suárez Castro ◽  
A. Aneiros Díaz ◽  
D. McAfee ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Symptom Burden ◽  
Motor Symptom ◽  
Strongly Correlated ◽  
Motor Complications

scholarly journals A 9-Week Nordic and Free Walking Improve Postural Balance in Parkinson’s Disease

2018 ◽  
Vol 02 (02) ◽  
pp. E28-E34 ◽  
Author(s):  
Leandro Franzoni ◽  
Elren Monteiro ◽  
Henrique Oliveira ◽  
Rodrigo da Rosa ◽  
Rochelle Costa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Center Of Pressure ◽  
Neuroprotective Effect ◽  
Functional Mobility ◽  
Nordic Walking ◽  
Promising Alternative ◽  
Functional Balance ◽  
Eyes Closed ◽  
Eyes Open

AbstractAerobic training has a neuroprotective effect in people with Parkinson’s disease. Recent evidence indicates that Nordic walking seems a promising alternative due to positive outcomes in functional mobility. However, the effects of Nordic walking compared to free walking on static and functional balance parameters are still unknown. The aim of this study was to evaluate the effects of nine weeks of Nordic and free walking training on static and functional balance. The sample size was 33 individuals with eight dropouts, leaving 25 individuals in the final sample (Nordic Walking, n=14, Free Walking, n=11). The participants underwent two evaluations in the present randomized clinical trial, pre- and post-training, to determine average velocity and root-mean-square values from center of pressure with eyes open and eyes closed. The functional balance showed approximately 5% improvement for the two groups (p=0.04). The results indicate that nine weeks of Nordic and free walking training were enough to induce improvements in the proprioceptive system and functional balance.

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