Detection of postural control in early Parkinson’s disease: Clinical testing vs. modulation of center of pressure

Kamieniarz, Anna; Michalska, Justyna; Marszałek, Wojciech; Stania, Magdalena; Słomka, Kajetan J.; Gorzkowska, Agnieszka; Juras, Grzegorz; Okun, Michael S.; Christou, Evangelos A.

doi:10.1371/journal.pone.0245353

Cited by 39 publications

(41 citation statements)

References 40 publications

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“…Several investigations have proposed postural sway measures that could become markers of age effect on postural control or of increased fall risk in healthy ageing and in disease conditions [e.g., (14)(15)(16)(17)(18)(19)]. On a different vein, it has been suggested that sway may not be a reliable marker of functional balance performance (20), and it seems that traditional measures of postural sway are not always able to differentiate between healthy subjects and patients with movement disorders (21,22). These uncertainties are partly dependent on technical or practical reasons, such as the recording apparatus, the duration of the acquisition period (23,24), the frequency of sampling of the CoP excursions, the filtering procedures, and other confounding subject-related circumstances such as fatigue (25), not to speak of the instruction given to the participants and the ample interindividual variability (17,(26)(27)(28)(29)(30)(31)(32)(33)(34).…”

Section: Introductionmentioning

confidence: 99%

Incongruity of Geometric and Spectral Markers in the Assessment of Body Sway

Sozzi

Ghai²,

Schieppati

2022

Front. Neurol.

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Different measurements of body oscillations in the time or frequency domain are being employed as markers of gait and balance abnormalities. This study investigates basic relationships within and between geometric and spectral measures in a population of young adult subjects. Twenty healthy subjects stood with parallel feet on a force platform with and without a foam pad. Adaptation effects to prolonged stance were assessed by comparing the first and last of a series of eight successive trials. Centre of Foot Pressure (CoP) excursions were recorded with Eyes Closed (EC) and Open (EO) for 90s. Geometric measures (Sway Area, Path Length), standard deviation (SD) of the excursions, and spectral measure (mean power Spectrum Level and Median Frequency), along the medio-lateral (ML) and antero-posterior (AP) direction were computed. Sway Area was more strongly associated than Path Length with CoP SD and, consequently, with mean Spectrum Level for both ML and AP, and both visual and surface conditions. The squared-SD directly specified the mean power Spectrum Level of CoP excursions (ML and AP) in all conditions. Median Frequency was hardly related to Spectrum Level. Adaptation had a confounding effect, whereby equal values of Sway Area, Path Length, and Spectrum Level corresponded to different Median Frequency values. Mean Spectrum Level and SDs of the time series of CoP ML and AP excursions convey the same meaning and bear an acceptable correspondence with Sway Area values. Shifts in Median Frequency values represent important indications of neuromuscular control of stance and of the effects of vision, support conditions, and adaptation. The Romberg Quotient EC/EO for a given variable is contingent on the compliance of the base of support and adaptation, and different between Sway Area and Path Length, but similar between Sway Area and Spectrum Level (AP and ML). These measures must be taken with caution in clinical studies, and considered together in order to get a reliable indication of overall body sway, of modifications by sensory and standing condition, and of changes with ageing, medical conditions and rehabilitation treatment. However, distinct measures shed light on the discrete mechanisms and complex processes underpinning the maintenance of stance.

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Section: Introductionmentioning

confidence: 99%

Incongruity of Geometric and Spectral Markers in the Assessment of Body Sway

Sozzi

Ghai²,

Schieppati

2022

Front. Neurol.

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“…When the sway amplitude in the ML direction exceeds a threshold range, the intermittent control mechanism will be triggered ( 39 ). It has been reported that COP oscillations below 0.5 Hz were exacerbated in an early and moderate PD relative to the healthy group in the state of EO ( 40 ). Since all the participants were in an early or moderate stage of the disease, balance impairments in the ML direction were not obvious and could not be discriminated against during static standing.…”

Section: Discussionmentioning

confidence: 99%

Dynamic postural balance indices can help discriminate between patients with multiple system atrophy and Parkinson's disease

Bao

Li²,

Yang³

et al. 2023

Front. Neurol.

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BackgroundPatients with Parkinson's disease (PD) and those with multiple system atrophy (MSA) show similar symptoms but have different clinical treatments. It will be helpful to discriminate between these two kinds of patients at an early or middle stage. The purpose of this study is to highlight the differences in posturographic characterization between patients with PD and those with MSA during quiet standing and perturbed standing.MethodsA total of clinically diagnosed 42 patients with PD and 32 patients with MSA participated in the experiment. Patients were asked to first stand on a static balance force platform and then on a dynamic balance (medial-lateral rocker) force platform to measure the center of pressure (COP) trajectory during an eyes-open (EO) state. The posturographic parameters were obtained under the two standing conditions for statistical analysis.ResultsFour posturographic variables were calculated and analyzed, namely, the standard deviation of COP position (SD), sway path of COP position (SP), an elliptical area covering the 95% COP position trajectory (EA), sway path of COP position (SP), and integral area of the power spectral density at 0–0.5 Hz frequency band (PSD). Except for variable EA, the other three variables are all in the medial-lateral (ML) direction. In the static balance experiment, there were no significant differences between the four variables between patients with PD and those with MSA. However, in the dynamic balance experiment, the obtained four variables all presented significant differences between patients with PD and those with MSA.ConclusionThe dynamic posturographic variables with significant differences between patients with PD and those with MSA imply that patients with MSA have worse postural control ability in the medial-lateral (ML) direction compared to patients with PD. The obtained dynamic indices may help supplemental clinical evaluation to discriminate between patients with MSA and those with PD.

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“… Sample entropy (SE): the sample entropy is a measure for assessing the regularity of a signal by calculating the probability that windows with length m remain similar within a tolerance r at the next data point [ 18 , 19 ]. We used input parameters m = 3 and r = − 0.2 as previously done [ 20 ]. …”

Section: Methodsmentioning

confidence: 99%

Influence of stance width on standing balance in healthy older adults

et al. 2022

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Posturography is an objective way to systematically interpret postural control. Recent evidence suggests self-selected stance width when conducting posturography in healthy young participants, as it is easy to perform yet standardized. It is unclear, if this is similarly applicable to healthy older adults which can better serve as comparison group for persons with specific impairments, like Parkinson’s disease, who might have problems with set foot distances. The aim of this study was to investigate the influence of different stance widths on a set of parameters in healthy older adults. Twenty-four healthy elderly (65.6 ± 5.0 years, BMI 26.2 ± 4.5 kg/m2) participated in the study. Posturographic measurement consisted of two tests (body sway, BS; limits of stability, LoS) each assessed in five stance widths on a force platform. A series of time domain and frequency domain parameters, such as BS and LoS range, sample entropy, mean velocity, and balance functional reserve were calculated. Anthropometric parameters and self-selected stance width (mean 17.7 ± 4.7 cm) showed positive correlation. One-way repeated measures MANOVA revealed significant differences between all parameters and foot positions. Except for sample entropy in A-P dimension, univariate analysis showed significant effects of stance widths on the parameters with stronger effects on M-L dimensions. Outcomes acquired in self-selected stance width provide comparable results to standardized stance widths 20 and 30 cm. The recommendation of self-selected stance width can be adopted to older healthy subjects. Furthermore, it reflects a natural stance and includes individual body composition.

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Detection of postural control in early Parkinson’s disease: Clinical testing vs. modulation of center of pressure

Cited by 39 publications

References 40 publications

Incongruity of Geometric and Spectral Markers in the Assessment of Body Sway

Incongruity of Geometric and Spectral Markers in the Assessment of Body Sway

Dynamic postural balance indices can help discriminate between patients with multiple system atrophy and Parkinson's disease

Influence of stance width on standing balance in healthy older adults

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