Changes in postural control in patients with Parkinson's disease: a posturographic study

Changes in postural control in patients with Parkinson's disease: a posturographic study

Author Dona, F. Autor UNIFESP Google Scholar
Aquino, C. C. Autor UNIFESP Google Scholar
Gazzola, J. M. Google Scholar
Borges, V. Autor UNIFESP Google Scholar
Silva, S. M. C. A. Autor UNIFESP Google Scholar
Gananca, F. F. Autor UNIFESP Google Scholar
Caovilla, H. H. Autor UNIFESP Google Scholar
Ferraz, H. B. Autor UNIFESP Google Scholar
Abstract Objectives Postural instability is one of the most disabling features in Parkinson's disease (PD), and often leads to falls that reduce mobility and functional capacity. The objectives of this study were to analyse the limit of stability (LOS) and influence of the manipulation of visual, somatosensorial and visual vestibular information on postural control in patients with PD and healthy subjects. Design Cross-sectional. Setting Movement Disorders Unit, university setting. Participants Eighty-two subjects aged between 37 and 83 years: 41 with Parkinson's disease in the 'on' state and 41 healthy subjects with no neurological disorders. Both groups were matched in terms of sex and age. Main outcome measures Unified Parkinson's Disease Rating Scale (UPDRS)-motor score, modified Hoehn and Yahr staging, Dynamic Gait Index (DGI) and posturography with integrated virtual reality. The parameters analysed by posturography were LOS area, area of body centre of pressure excursion and balance functional reserve in the standing position in 10 conditions (open and closed eyes, unstable surface with eyes closed, saccadic and optokinetic stimuli, and visual vestibular interaction). Results The mean UPDRS motor score and DGI score were 27 [standard deviation (SD) 14] and 21 (SD 3), respectively. Thirteen participants scored between 0 and 19 points, indicating major risk of falls. Posturographic assessment showed that patients with PD had significantly lower LOS area and balance functional reserve values, and greater body sway area in all posturographic conditions compared with healthy subjects. Conclusions Patients with PD have reduced LOS area and greater postural sway compared with healthy subjects. The deterioration in postural control was significantly associated with major risk of falls. (C) 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Keywords Postural balance
Parkinson's disease
Accidental falls
Movement disorders
Language English
Date 2016
Published in Physiotherapy. Oxford, v. 102, n. 3, p. 272-279, 2016.
ISSN 0031-9406 (Sherpa/Romeo, impact factor)
Publisher Elsevier Sci Ltd
Extent 272-279
Access rights Closed access
Type Article
Web of Science ID WOS:000382257300012

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