Static posturography in aging and Parkinson's disease

Abstract

Introduction: In clinical practice, evaluation of postural control is based on the neurological examination, including Romberg's test, examination of gait and performance of pull test as part of the Unified Parkinson's Disease Rating Scale (UPDRS). The goal of our study was to identify posturographic parameters since quantitative technical methods for the measurement of postural control are not established in clinical routine yet. Methods: In this cross-sectional study design we examined patients with Parkinson's disease (PD) (Hoehn and Yahr < 3; PD n = 12) on a static posturographic platform (eyes open and eyes closed), performing a standard Romberg's test during neurological examination and compared the results with an age-matched healthy adult control (HAC n = 10) and a healthy young control (HYC n = 21). Results: In the platform Romberg's test with open eyes, the patients with PD showed a significantly greater mean sway [PD: 14.98 vs. HAC: 8.77 (mm), p < 0.003 vs. HYC 7.80 (mm)], greater mean radius [PD: 28.31 vs. HAC: 16.36 (mm), p < 0.008 vs. HYC: 14.19 (mm)] and greater marked area [PD: 2.38 vs. HAC: 0.88 (cm2), p < 0.016 vs. HYC: 0.78 (cm2)] compared to the HAC. The Romberg's test with closed eyes revealed a significantly greater mean sway [PD: 13.83 vs. HAC: 10.12 (mm), p < 0.033 vs. HYC: 5.82 (mm)] and greater mean radius [PD: 25.03 vs. HAC: 18.15 (mm), p < 0.045 vs. HYC: 9.11 (mm)] compared to both groups. Conclusions: The platform Romberg-test with closed eyes detected significant differences in elderly people and patients with Parkinson's disease, which could be objectively quantified with static posturography testing. Age alone showed significant changes, only detectable with closed eyes. Therefore, balance testing with a new computerized approach could help to identify balance problems in a geriatric assessment in clinical routine, especially with the parameters marked area and mean sway.

Comparing postural balance among older adults and Parkinson's disease patients

“…The COP area of individuals with PD was significantly larger, which corresponds to greater postural instability. These results are in agreement with our study's findings in regard to balance among PD individuals 30 . We emphasize that we use the single-leg stance in our research in order to provide more appropriate information about balance, as individuals cannot be challenged enough when subjected to tests in bipedal stance 25 .…”

Vastly Different Exercise Programs Similarly Improve Parkinsonian Symptoms: A Randomized Clinical Trial

“…Secondary outcomes addressed life domains and included change scores for: (1) SE-ADL; (2) EQ-5D, to measure 5 aspects of health-related quality of life; (3) PDQ-39, a quality-of-life questionnaire; (4) BDI; (5) TAT, a valid and reliable (intraclass correlation R > 0.80) test in PD to asses gait and balance [14]; (6) BESTest, a valid and reliable (R > 0.90) test to asses 6 domains of balance control [15]; (7) BBS, a valid and reliable (R = 0.80) test to assess fall risk [16]; (8) DGI, a valid and reliable (R > 0.84) tool to asses gait adaptability [17]; (9) the 6MWT, a valid and reliable (R = 0.95) index of walking capacity [18,19], and (10) postural stability by the magnitude of center of pressure path in standing on a force platform (Posture Evaluation Platform; Med-Eval Co., Budapest, Hungary) in a wide, narrow, and tandem stance with eyes open or closed for 20 s after 1 familiarization trial in each condition [20]. Adverse events were not systematically assessed.…”

The competition with a concurrent cognitive task affects posturographic measures in patients with Parkinson disease

“…Loss of automation in performing postural changes can increase the dependence on visual information 26 . Studies of Ickenstein et al 7 . and Rossi et al 27 .…”

“…The mechanisms associated with postural instability are still not fully understood. Studies suggest that the dysfunctioning of the pedunculopontine nucleus, leads to the loss of anticipatory and compensatory postural responses automation, and disrupts sensory-motor integration (visual, proprioceptive and vestibular information processing and motor response selection) 3,7,8,9 . Postural control deficits enhance trunk and knees flexion and increase the need for attentional control over posture 4 .…”