Assessment of postural asymmetry in mild to moderate Parkinson's disease

Geurts, A.C.H.; Boonstra, Tjitske; Voermans, Nicol C.; Diender, Marije G.; Weerdesteyn, Vivian; Bloem, Bastiaan R.

doi:10.1016/j.gaitpost.2010.09.018

Cited by 42 publications

(47 citation statements)

References 12 publications

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“…This is in keeping with a study by Rocchi et al (31) who found a differential contribution of lower limbs in balance control in PD when subject's performance was measured with dual force plate platform. Similarly, Geurts et al (32) reported that postural asymmetry corresponded to the most affected side as assessed with clinical scales. Subjects with PD were also characterized by increased high-frequency power considered an indicator of increased stiffness of postural muscles or postural tremor (33).…”

Section: Comparison Of Balance Between Groupsmentioning

confidence: 88%

Comparison of upright balance in stroke, Parkinson and multiple sclerosis

et al. 2015

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Section: Comparison Of Balance Between Groupsmentioning

confidence: 88%

Comparison of upright balance in stroke, Parkinson and multiple sclerosis

et al. 2015

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“…Distinguishing between the balance contribution of both legs and sensory reweighting of individual limbs also may have clinical applications for certain neurological disorders, such as Parkinson's disease (Geurts et al 2011;van der Kooij et al 2007) and stroke (Geurts et al 2005), possibly aiding in the development and evaluation of treatments. In both disorders, it has been shown that asymmetry in balance control is an issue.…”

Section: Discussionmentioning

confidence: 99%

Sensory reweighting of proprioceptive information of the left and right leg during human balance control

Pasma

Boonstra

Campfens

et al. 2012

Journal of Neurophysiology

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Pasma JH, Boonstra TA, Campfens SF, Schouten AC, Van der Kooij H. Sensory reweighting of proprioceptive information of the left and right leg during human balance control. J Neurophysiol 108: 1138-1148, 2012. First published May 23, 2012 doi:10.1152/jn.01008.2011.-To keep balance, information from different sensory systems is integrated to generate corrective torques. Current literature suggests that this information is combined according to the sensory reweighting hypothesis, i.e., more reliable information is weighted more strongly than less reliable information. In this approach, no distinction has been made between the contributions of both legs. In this study, we investigated how proprioceptive information from both legs is combined to maintain upright stance. Healthy subjects maintained balance with eyes closed while proprioceptive information of each leg was perturbed independently by continuous rotations of the support surfaces (SS) and the human body by platform translation. Two conditions were tested: perturbation amplitude of one SS was increased over trials while the other SS 1) did not move or 2) was perturbed with constant amplitude. With the use of system identification techniques, the response of the ankle torques to the perturbation amplitudes (i.e., the torque sensitivity functions) was determined and how much each leg contributed to stabilize stance (i.e., stabilizing mechanisms) was estimated. Increased amplitude of one SS resulted in a decreased torque sensitivity. The torque sensitivity to the constant perturbed SS showed no significant differences. The properties of the stabilizing mechanisms remained constant during perturbations of each SS. This study demonstrates that proprioceptive information from each leg is weighted independently and that the weight decreases with perturbation amplitude. Weighting of proprioceptive information of one leg has no influence on the weight of the proprioceptive information of the other leg. According to the sensory reweighting hypothesis, vestibular information must be up-weighted, because closing the eyes eliminates visual information. system identification; system identification; posture; asymmetry BALANCE IS DESCRIBED as the ability to maintain upright posture in a gravitational field (Niam et al. 1999) and is involved in many daily life activities, such as bipedal stance, walking, and cycling. For small deviations, the gravitational pull effectively is a negative stiffness; a deviation from a perfect upright position results in a torque that accelerates the body further away from this position. External mechanical disturbances, such as a misstep or a slip, and conflicting information of the sensory systems can disturb the equilibrium of the balance system. The central nervous system (CNS) has to cope with these disturbances to maintain the body in upright position.The CNS receives feedback about the body orientation from three main sensory systems: the visual, proprioceptive, and vestibular systems. The CNS integrates this sensory feedback and subseq...

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“…In particular, early PD patients have been found to have infraclinical postural instability as manifested by dynamic postural asymmetry, a larger center foot pressure sway area with both eyes closed and eyes opened under the static condition, and a greater sway area under the dynamic condition when compared to control subjects [10][11][12][13]. Although sway parameters increase with disease severity, no direct correlation has been made with PI [14].…”

Section: Introductionmentioning

confidence: 99%