Balance Dysfunction in Parkinson’s Disease: The Role of Posturography in Developing a Rehabilitation Program

Abstract

Balance dysfunction (BD) in Parkinson's disease (PD) is a disabling symptom, difficult to treat and predisposing to falls. The dopaminergic drugs or deep brain stimulation does not always provide significant improvements of BD and rehabilitative approaches have also failed to restore this condition. In this study, we investigated the suitability of quantitative posturographic indicators to early identify patients that could develop disabling BD. Parkinsonian patients not complaining of a subjective BD and controls were tested using a posturographic platform (PP) with open eyes (OE) and performing a simple cognitive task [counting (OEC)]. We found that patients show higher values of total standard deviation (SD) of body sway and along the medio-lateral (ML) axis during OE condition. Furthermore, total and ML SD of body sway during OE condition and total SD of body sway with OEC were higher than controls also in a subgroup of patients with normal Berg Balance Scale. We conclude that BD in Parkinsonian patients can be discovered before its appearance using a PP and that these data may allow developing specific rehabilitative treatment to prevent or delay their onset.

Neuroimaging correlates of lateral postural control in older ambulatory adults

“…We found that MPS was present in 31.1% of our cohort, consistent with prevalence estimates of 15–40% in older community-dwelling individuals [25]. A previous study showed impairments in postural sway along the mediolateral axis in Parkinson’s disease patients before the onset of clinical balance dysfunction symptoms [29]. We did not find MPS to be associated with posturography tasks in our study and presence of MPS did not attenuate the associations of regions of interest in the linear regression model (data not shown).…”

Relationship between Gait Parameters and Postural Stability in Early and Late Parkinson's Disease and Visual Feedback-Based Balance Training Effects

“…Other results were in agreement with our study, Others suggest that early rehabilitation treatment aimed to improve the balance control by several mechanisms have to include (a) stretching exercises to minimize the stiffness of the ankle, (b) a weight-shift training program, to improve balance control, (c) a proprioceptive-motor training, and (d) a balance training based on visual and auditory feedback [31]. Also, others found that gait training with visual cues for one month was successful in improvement in gait speed and step length and increasing the stability of the motor system [32].…”

Quantitative assessment of postural instability in spinocerebellar ataxia type 3 patients

“…This method can provide a visual representation of postural instability which is more objective than other methods and provided in real-time. 15,16 The balance assessment consists of static and dynamic stability measures which provide a foundation for characterizing patients' postural and balance instability. 17,18 Previous research suggests static stability may be correlated with disease severity.…”

“…17,18 Previous research suggests static stability may be correlated with disease severity. 15 In addition, ataxia patients may experience poor body control in dynamic balance. 19 However, the possible patterns of balance dysfunction used in posturography have not been thoroughly studied in SCA3 and the relationship between balance dysfunction and SCA3 phenotype remains unclear.…”