scholarly journals Altered Dynamic Postural Control during Step Turning in Persons with Early-Stage Parkinson’s Disease

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.

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 ◽  
Vol 30 (09) ◽  
pp. 2050044
Author(s):  
Diego Castillo-Barnes ◽  
Francisco J. Martinez-Murcia ◽  
Andres Ortiz ◽  
Diego Salas-Gonzalez ◽  
Javier RamÍrez ◽  
...  

Finding new biomarkers to model Parkinson’s Disease (PD) is a challenge not only to help discerning between Healthy Control (HC) subjects and patients with potential PD but also as a way to measure quantitatively the loss of dopaminergic neurons mainly concentrated at substantia nigra. Within this context, this work presented here tries to provide a set of imaging features based on morphological characteristics extracted from I[Formula: see text]-Ioflupane SPECT scans to discern between HC and PD participants in a balanced set of [Formula: see text] scans from Parkinson’s Progression Markers Initiative (PPMI) database. These features, obtained from isosurfaces of each scan at different intensity levels, have been classified through the use of classical Machine Learning classifiers such as Support-Vector-Machines (SVM) or Naïve Bayesian and compared with the results obtained using a Multi-Layer Perceptron (MLP). The proposed system, based on a Mann–Whitney–Wilcoxon U-Test for feature selection and the SVM approach, yielded a [Formula: see text] balanced accuracy when the performance was evaluated using a [Formula: see text]-fold cross-validation. This proves the reliability of these biomarkers, especially those related to sphericity, center of mass, number of vertices, 2D-projected perimeter or the 2D-projected eccentricity, among others, but including both internal and external isosurfaces.


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):  
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.


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.


2021 ◽  
pp. 1-17
Author(s):  
Yu-Yan Tan ◽  
Peter Jenner ◽  
Sheng-Di Chen

Monoamine oxidase-B (MAO-B) inhibitors are commonly used for the symptomatic treatment of Parkinson’s disease (PD). MAO-B inhibitor monotherapy has been shown to be effective and safe for the treatment of early-stage PD, while MAO-B inhibitors as adjuvant drugs have been widely applied for the treatment of the advanced stages of the illness. MAO-B inhibitors can effectively improve patients’ motor and non-motor symptoms, reduce “OFF” time, and may potentially prevent/delay disease progression. In this review, we discuss the effects of MAO-B inhibitors on motor and non-motor symptoms in PD patients, their mechanism of action, and the future development of MAO-B inhibitor therapy.


2014 ◽  
Vol 20 (1) ◽  
pp. 78-84
Author(s):  
Larissa Pires de Andrade ◽  
Natália Madalena Rinaldi ◽  
Flávia Gomes de Melo Coelho ◽  
Kátia Tanaka ◽  
Florindo Stella ◽  
...  

Patients with neurodegenerative diseases are required to use cognitive resources while maintaining postural control. The aim of this study was to investigate the effects of a frontal cognitive task on postural control in patients with Alzheimer, Parkinson and controls. Thirty-eight participants were instructed to stand upright on a force platform in two experimental conditions: single and dual task. Participants with Parkinson's disease presented an increase in the coefficient of variation greater than 100% in the dual task as compared to the single task for center of pressure (COP) area and COP path. In addition, patients with Parkinson's and Alzheimer's disease had a higher number of errors during the execution of the cognitive task when compared to the group of elderly without neurodegenerative diseases. The motor cortex, which is engaged in postural control, does not seem to compete with frontal brain regions in the performance of the cognitive task. However, patients with Parkinson's and Alzheimer's disease presented worsened performance in cognitive task.


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 novel 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 (did not change) 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.


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