Reliability and Validity of Force Platform Measures of Balance Impairment in Individuals With Parkinson Disease

Harro, Cathy C.; Marquis, Alicia; Piper, Natasha; Burdis, Chris

doi:10.2522/ptj.20160099

Cited by 33 publications

(31 citation statements)

References 44 publications

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“…This study was part of a larger study examining the reliability and concurrent validity of FP measures in individuals with PD, with detailed description of the full study's methods published by Harro et al [31]. Data were collected in the university's biomechanics laboratory, a quiet, controlled environment.…”

Section: Methodsmentioning

confidence: 99%

“…These FP measures are also supported as reliable and valid measures of underlying postural control deficits across neurological populations [27–30]. Specific to the PD population, Harro et al [31] reported excellent test-retest reliability for these FP measures, and fair to moderate correlation between the SOT and LOS test and clinical balance measures.…”

Section: Introductionmentioning

confidence: 99%

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Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson’s Disease and Healthy Adults

Harro

Kelch

Hargis

et al. 2018

Parkinson's Disease

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Introduction Postural instability is a known contributing factor to balance dysfunction and increased fall risk in those with Parkinson's disease (PD). Computerized posturography employing a force platform system provides objective, quantitative assessments of postural control impairments. This study examines balance performance as measured by force platform (FP) tests in persons with PD compared to age-matched healthy adults. Secondarily, we examine if these FP measures provide diagnostic and clinically meaningful information about the underlying balance impairments in the PD population. Methods Participants—42 individuals with PD (Hoehn and Yahr stage = 2.33 ± 0.77) and 55 age-matched healthy adults—were assessed on three standardized balance measures on a computerized force platform system. Between groups, comparisons of FP performance were analyzed using independent t-test. Within the group, comparisons for the PD cohort were analyzed using ANOVA for comparing disease stage and Mann–Whitney U test for PD subtypes. Results The PD cohort demonstrated significantly greater postural instability on the sensory organization test (SOT) measures (P=0.013, CI-95% = 1.286 to 10.37) and slower movement velocity on the limits of stability (LOS) test (P=0.001, CI-95% = 0.597 to 1.595) than the healthy cohort, suggesting that these tests were sensitive to detect sensory integration and voluntary postural control deficits in the PD cohort. Within the PD group, the SOT differentiated between H&Y stages 1–3. The motor control test (MCT) detected changes in reactive postural control mainly in later disease stages. All three FP tests distinguished between PD subtypes, with the Posture Gait Instability subtype demonstrating poorer balance performance than Tremor Dominant subtype. Conclusion These findings suggest FP measures provide clinically meaningful, diagnostic information in the examination of balance impairments in individuals with PD. FP measures may inform clinicians regarding intrinsic balance deficits and guide them in designing targeted balance interventions to reduce fall risk in persons with PD.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson’s Disease and Healthy Adults

Harro

Kelch

Hargis

et al. 2018

Parkinson's Disease

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“…Notably, the numerical difference between CD adults and persons with PD was observed in ES(CON5), which was 21.8, much larger than the established minimal clinical difference of 13.33.24 Several studies in persons with PD revealed similar results, with greater deficits in ES (CON5) and SA (VES) ratio scores than ES and SA scores in their respective studies. 23,25 To shed light on the differences between both groups, all CS for CD elderly adults were above the cutoff score for falls (cut off score CS<67)3, while 50% of persons with PD scored below the cut off score. Given these results, the 60-70 year old individuals with PD display substantial deficits across all conditions in comparison to same age healthy CD adults.…”

Section: Discussionmentioning

confidence: 99%

“…22 Test-retest reliability of the SOT stated good to excellent reliability (ICC=.78-.90) for individuals with PD. 23 Testing of participants took place at California State University, Fresno in the Department of Physical Therapy laboratory. For safety purposes, each participant donned a harness prior to the initiation of the SOT.…”

Section: Instrumentationmentioning

confidence: 99%

Does a multi-modal intervention program influence sensory systems in persons with parkinson’s disease

Rivera

2019

IPMRJ

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Background: Persons with Parkinson's disease (PD) display a progressive decline in function, particularly in postural control. There are however, limited investigations on the sensory deficits contributing to postural dysfunction. The Sensory Organization Test (SOT) is an outcome measure that quantifies the sensory systems. Many researchers implement the SOT in research with persons with PD, however there are limited SOT studies that compare persons with PD to same age community dwelling (CD) adults. In addition, few PD intervention studies have used the SOT as an outcome measure. Objective: To determine if there are significant differences in the SOT between 60-70 year old persons with PD and same age CD adults. Second, to determine if there are significant gains in the SOT after a five-week multimodal intervention program in individuals with PD. Methods and materials: In a one-group pre-post intervention design, twelve participants with PD participated in a five-week multimodal intervention program. Participants completed the pre and post-test SOT protocol, which produced an equilibrium score (ES), composite score (CS) and sensory analysis (SA) ratio score. In addition, ten CD 60-70-yearold adults completed the SOT protocol. Analysis: The Mann-Whitney U test will analyze if there are significant differences in SOT scores between CD 60-70 year old adults compared to same age persons with PD. The Wilcoxon Signed Ranks test will analyze if there are significant differences in SOT scores pre and post intervention. IBM SPSS 26 will analyze the data. p value set at <.05 Results: The Mann-Whitney U revealed significant differences between 60-70 year old CD adults and the PD group in SOT ES 1-3 and CS, P<.05 There were no significant differences between pre and post intervention SOT scores. However, condition five ES and the SA vestibular ratio score exhibited large gains from pre to post intervention. Discussion: The comparison results revealed significant difference in static and dynamic postural controls. In PD participants, the vestibular system displays more deficits compared to other sensory systems, but also demonstrates the capacity for larger gains after a multimodal intervention.

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“…In general, maintaining a normative eased upright stance requires the symmetric distribution of body weight; when challenged, the resultant anterior-posterior or bilateral compensatory motion can be captured using a force platform to record changes in the body's center of pressure [27], [28]. For the present work, this assessment was achieved using a customized platform system developed at the Department of Solid Mechanics, Lund Institute of Technology in Sweden [3].…”

Section: B Posturography Measurementmentioning

confidence: 99%

Postural Control Adaptation and Habituation During Vibratory Proprioceptive Stimulation: An HD-EEG Investigation of Cortical Recruitment and Kinematics

Barollo

Frioriksdottir

Edmunds

et al. 2020

IEEE Trans. Neural Syst. Rehabil. Eng.

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The objective of the present work is to measure postural kinematics and power spectral variation from HD-EEG to assess changes in cortical activity during adaptation and habituation to postural perturbation. To evoke proprioceptive postural perturbation, vibratory stimulation at 85 Hz was applied to the calf muscles of 33 subjects over four 75-second stimulation periods. Stimulation was performed according to a pseudorandom binary sequence. Vibratory impulses were synchronized to highdensity electroencephalography (HD-EEG, 256 channels). Changes in absolute spectral power (ASP) were analyzed over four frequency bands (Δ: 0.5-3.5 Hz; θ: 3.5-7.5 Hz; α: 7.5-12.5 Hz; β: 12.5-30 Hz). A force platform recorded torque actuated by the feet, and normalized sway path length (SPL) was computed as a construct for postural performance during each period. SPL values indicated improvement in postural performance over the trial periods. Significant variation in absolute power values (ASP) was found in assessing postural adaptation: an increase in θ band ASP in the frontal-central region for closed-eyes trials, an increase in θ and β band ASP in the parietal region for open-eyes trials. In habituation, no significant variations in ASP were observed during closed-eyes trials, whereas an increase in θ, α, and β band ASP was observed with open eyes. Furthermore, open-eyed trials generally yielded a greater number of significant ASP differences across all bands during both adaptation and habituation, suggesting that following cortical activity during postural perturbation may be up-regulated with the availability of visual feedback. These results altogether provide deeper insight into pathological postural control failure by exploring the dynamic changes in both cortical activity and postural kinematics during adaptation and habituation to proprioceptive postural perturbation. Index Terms-Balance, cerebral cortex, HD-EEG, kinematics, postural control, power spectral density I. INTRODUCTION UMAN posture is a complex and naturally unstable physiological process that requires the continuous integration of compensatory mechanisms to maintain an Manuscript received MM DD, YY. Date of publication MM DD, YY.

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Reliability and Validity of Force Platform Measures of Balance Impairment in Individuals With Parkinson Disease

Cited by 33 publications

References 44 publications

Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson’s Disease and Healthy Adults

Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson’s Disease and Healthy Adults

Does a multi-modal intervention program influence sensory systems in persons with parkinson’s disease

Postural Control Adaptation and Habituation During Vibratory Proprioceptive Stimulation: An HD-EEG Investigation of Cortical Recruitment and Kinematics

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