Dynamic posturography and posturographic training for Parkinson’s disease in a routine clinical setting

Raethjen, Jan; Raethjen, P.; Schmalbach, Barbara; Wasner, Gunnar

doi:10.1016/j.gaitpost.2020.09.013

Cited by 2 publications

(3 citation statements)

References 27 publications

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“…Furthermore, since both of our patient groups reported significantly lower self-confidence in balance, additional co-contraction may have resulted from increased voluntary muscle activity due to fear of falling [ 67 ]. The effect of fear causing higher background muscle activity was measured in subjects who stood on an elevated platform or when the dimensions of the base of support were changed [ 60 , 65 , 107 , 108 , 109 , 110 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since it is generally known that muscle activity correlates with COP displacement, the increased background muscle activity of patients might help in the interpretation of the results we found for the COP ranges [ 111 , 112 ]. Knowing that postural instability in PD can be characterized by extensive postural sway, we expected patients to have increased COP ranges compared to healthy subjects, especially towards the anticipated perturbation directions, which we defined as the primary COP range [ 14 , 17 , 60 , 66 , 72 , 108 , 110 , 113 ]. Instead, we only found significantly higher values for both patient groups compared to the healthy subjects for the COP ranges perpendicular to the anticipated direction of perturbation, defined as the secondary COP range.…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that patients’ abnormal muscle activity can translate into extensive COP sway and higher COP velocities following perturbations. Therefore, we also assumed increased COP ranges for our patient groups compared to healthy subjects, especially towards the perturbation directions, which we defined as the primary COP range [ 12 , 14 , 17 , 21 , 34 , 60 , 65 , 66 , 72 , 78 , 98 , 108 , 110 , 113 ]. However, we could not confirm our assumption, as we did not detect any group differences between the primary COP ranges.…”

Section: Discussionmentioning

confidence: 99%

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Anticipatory Postural Adjustments and Compensatory Postural Responses to Multidirectional Perturbations—Effects of Medication and Subthalamic Nucleus Deep Brain Stimulation in Parkinson’s Disease

Heß

Oehlwein²,

Milani

2023

Brain Sciences

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Background: Postural instability is one of the most restricting motor symptoms for patients with Parkinson’s disease (PD). While medication therapy only shows minor effects, it is still unclear whether medication in conjunction with deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves postural stability. Hence, the aim of this study was to investigate whether PD patients treated with medication in conjunction with STN-DBS have superior postural control compared to patients treated with medication alone. Methods: Three study groups were tested: PD patients on medication (PD-MED), PD patients on medication and on STN-DBS (PD-MED–DBS), and healthy elderly subjects (HS) as a reference. Postural performance, including anticipatory postural adjustments (APA) prior to perturbation onset and compensatory postural responses (CPR) following multidirectional horizontal perturbations, was analyzed using force plate and electromyography data. Results: Regardless of the treatment condition, both patient groups showed inadequate APA and CPR with early and pronounced antagonistic muscle co-contractions compared to healthy elderly subjects. Comparing the treatment conditions, study group PD-MED–DBS only showed minor advantages over group PD-MED. In particular, group PD-MED–DBS showed faster postural reflexes and tended to have more physiological co-contraction ratios. Conclusion: medication in conjunction with STN-DBS may have positive effects on the timing and amplitude of postural control.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anticipatory Postural Adjustments and Compensatory Postural Responses to Multidirectional Perturbations—Effects of Medication and Subthalamic Nucleus Deep Brain Stimulation in Parkinson’s Disease

Heß

Oehlwein²,

Milani

2023

Brain Sciences

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Foot Anatomical Structural Variations Increase the Risk of Falls in Older Adults

et al. 2022

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Falls are common among older adults. The purpose of this study was to demonstrate the relationship between foot anatomical structural variations and balance in older adults and quantify foot posture and stabilometry as predictors of fall risk. This case-control study of older adults classified cases or controls according to falls in the last five years. All subjects were healthy women and men > 65 years old (n = 164), who were divided into two groups: 83 individuals who had suffered from a fall in the previous five years (case group) and 81 individuals who had not suffered from a fall (control group). Hallux abductus valgus (HAV) and tailor’s bunion are stability-determining factors. Women have a higher probability of falling. HAV (p = 0.042) and tailor’s bunion (p = 0.069) also increased the fall probability. Morphological foot variations (HAV and tailor’s bunion) linked to gender and age increase fall risk among older adults. In women fallers with HAV, there was a higher possibility of falling (63.9%). According to age, in older adults with HAV, the percentage of falls is high (62%). Fallers with tailor’s bunion (60.7%) are more numerous than fallers without this pathology. Older adults with HAV and tailor´s bunion had twice the probability of suffering a fall than older people without foot anatomical structural. Foot morphology is decisive in falling risk.

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Dynamic posturography and posturographic training for Parkinson’s disease in a routine clinical setting

Cited by 2 publications

References 27 publications

Anticipatory Postural Adjustments and Compensatory Postural Responses to Multidirectional Perturbations—Effects of Medication and Subthalamic Nucleus Deep Brain Stimulation in Parkinson’s Disease

Anticipatory Postural Adjustments and Compensatory Postural Responses to Multidirectional Perturbations—Effects of Medication and Subthalamic Nucleus Deep Brain Stimulation in Parkinson’s Disease

Foot Anatomical Structural Variations Increase the Risk of Falls in Older Adults

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