Background: Subthalamic nucleus deep brain stimulation (STN-DBS) has been an established method in improvement of motor disabilities in Parkinson's disease (PD) patients. It has been also claimed to have an impact on balance and gait disorders in PD patients, but the previous results are conflicting.Objective: The aim of this prospective controlled study was to evaluate the impact of STN-DBS on balance disorders in PD patients in comparison with Best-Medical-Therapy (BMT) and Long-term-Post-Operative (POP) group.Methods: DBS-group consisted of 20 PD patients (8F, 12M) who underwent bilateral STN DBS. POP-group consisted of 14 post-DBS patients (6F, 8M) in median 30 months-time after surgery. Control group (BMT-group) consisted of 20 patients (11F, 9M) who did not undergo surgical intervention. UPDRS III scale and balance tests (Up And Go Test, Dual Task- Timed Up And Go Test, Tandem Walk Test) and posturography parameters were measured during 3 visits in 9 ± 2months periods (V1, V2, V3) 4 phases of treatment (BMT-ON/OFF, DBS-ON/OFF).Results: We have observed the slowdown of gait and postural instability progression in first 9 post-operative months followed by co-existent enhancement of balance disorders in next 9-months evaluation (p < 0.05) in balance tests (Up and Go, TWT) and in posturography examination parameters (p < 0.05). The effect was not observed neither in BMT-group nor POP-group (p > 0.05): these groups revealed constant progression of static and dynamic instability (p > 0.05).Conclusions: STN-DBS can have modulatory effect on static and dynamic instability in PD patients: it can temporarily improve balance disorders. mainly during first 9 post-operative months, but with possible following deterioration of the symptoms in next post-operative months.

Streszczenie Wstęp: Zaburzenia stabilności są istotnym elementem obrazu klinicznego pacjentów z chorobą Parkinsona (PD). Celem pracy jest ocena stabilometryczna postawy pacjentów z chorobą Parkinsona w porównaniu z osobami zdrowymi. Materiał i metody: W badaniach wzięły udział 43 osoby z (PD) oraz 46 osób zdrowych. Do oceny stabilometrycznej zastosowano platformę „TecnoBody”. Pomiarów stabilności postawy dokonywano z kontrolą, a następnie bez kontroli wzroku. Pacjentów z PD badano w stanie „on”. Wyniki: U osób z PD w badaniu z otwartymi oczami uzyskano wartości: średnia prędkość przemieszczania środka masy ciała w płaszczyźnie strzałkowej (P-T)11,86±12,5 m/s, w płaszczyźnie czołowej (P-B) 8,49±7,4 m/s, perimetr 385,3 ±368,2mm, pole elipsy 388,58 ±658,6 mm2. W teście bez kontroli wzroku uzyskane średnie wartości to: P-T prędkość 20,44±18 m/s, P-B prędkość 13,09±10,5 m/s, perimetr 637,21 ±530,9 mm, pole elipsy 756,16±888,7 mm2. U osób zdrowych w badaniu z otwartymi oczami uzyskano: średnia P-T prędkość wyniosła 5,23±2 m/s, P-B prędkość 4,26±1,7 m/s, perimetr 176,67±66mm, pole elipsy 100,23 ±71,1mm2. W teście bez kontroli wzroku uzyskano średnie: P-T prędkość 10,28±4,4m/s, P-B prędkość 5,91±3 m/s, perimetr 296,26±123,9mm, pole elipsy 218,5 ±140,7mm2. Stwierdzono istotne statystycznie różnice (p<0,05) pomiędzy grupami we wszystkich czterech parametrach stabilometrycznych w obu testach. Wnioski: Zwiększone wychylenie środka ciężkości ciała odnotowane u osób z chorobą Parkinsona powoduje zaburzenia równowagi, co może być przyczyną upadków. Zaobserwowana dodatnia korelacja pomiędzy wiekiem, a wartościami perimetru w grupie kontrolnej w próbie z kontrolą i bez kontroli wzroku, czego nie odnotowano w grupie badanej, świadczy o zaburzeniach stabilności postawy już w początkowym stadium choroby.

Introduction: A stroke is one of the causes of disability in the world. The occurrence of a stroke leads to many complications in a patient’s physical and mental sphere. In patients after a stroke, whose muscle tone is reduced, a lower subluxation in the glenohumeral joint may be observed. The glenohumeral joint cannot be considered as an independent joint, but as the whole intricate shoulder complex. Materials and Methods: The study included the results of 40 patients after an ischemic stroke with a reduced muscle tone and muscle strength of an upper limb. In the examined group, an original application of Kinesiology Taping of the shoulder girdle was used. The examination evaluated the articular space of the glenohumeral joint, the relative length of the shoulder and the distance of the lower shoulder blade from the line of spinous processes. Results: In the whole examined group, lower subluxation was noted in 32,5% of patients. The study demonstrated that Kinesiology Taping affects the shoulder’s linear measurements and shoulder blade arrangement in people with reduced muscle tone after a stroke. The distance between the shoulder blade’s angle and the spine decreases, while the relative value of the shoulder’s length is reduced in people, on whom the application was used. Conclusions: The original Kinesiology Taping application turned out to be an effective preventive measure of a lower subluxation in the glenohumeral joint.

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