A Prospective Study of Alterations in Balance among Patients with Parkinson’s Disease

Rossi, Mark D.; Soto, Alexandra I.; Santos, S.; Sesar, Ángel; Labella, T

doi:10.1159/000189270

Cited by 65 publications

(71 citation statements)

References 45 publications

(25 reference statements)

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“…Rossi [17], in a similar study, observed that while movement velocity was lower in the group with PD, there were no significant differences in the directional control parameter between PD patients and healthy control, which do not agree with our results. Beckley et al [37], applying also a RWS test observed a decrease in the amplitude and movement velocity values of early stages PD patients when compared with a healthy control group.…”

Section: ) Rws Testcontrasting

confidence: 91%

“…The Computerized Dynamic Posturography (CDP) has already proven to be useful for balance evaluation of PD patients [10,17] giving insights into the physiological correlates of postural stability, [18] and gait [19]. Different studies refer that quantitative measures are not correlated with other clinical scores listed (e.g., duration of the disease and UPDRS) [20], or weakly correlated with H&Y stages, [17].…”

Section: ) Rws Testmentioning

confidence: 99%

“…Different studies refer that quantitative measures are not correlated with other clinical scores listed (e.g., duration of the disease and UPDRS) [20], or weakly correlated with H&Y stages, [17]. Several studies have analyzed the postural sway characteristics of PD patients compared with age-matched controls [21,18,22], nevertheless changes of the posturographic parameters as a function of the disease severity have not been very well studied.…”

Section: ) Rws Testmentioning

confidence: 99%

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Postural behavior and Parkinson's disease severity

Godinho

Ferret-Sena

Brito

et al. 2016

2016 1st International Conference on Technology and Innovation in Sports, Health and Wellbeing (TISHW)

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Abstract-Progression of Parkinson disease (PD) increasessevere motor symptoms such as bradykinesia, tremor, gait disturbance and postural instability, interfering with patients' daily life autonomy. Clinical evaluation is based on specific Scales like Hoehn & Yahr (H&Y) or UPDRS scales. The main goal of the study was to identify motor changes in the kinematic parameters related to different stages of Parkinson's disease progression according to H&Y scale. A secondary goal was to determine more objectively the stage of the disease reducing the discomfort of scales subjectivity. Our sample integrated 103 patients (45 female and 58 male, 70.5±8.4 years) diagnosed with PD by neurologists specialized in movement disorders. Postural Behavior was evaluated using Computerized Dynamic Posturography equipment (Balance Master System). Postural behavior was based on posturographic analysis of the center of pressure (CoP) time series (corresponding to the vertical projection of the center of gravity) to determine kinematic parameter(s) considered suitable to identify postural behavior modification. The posturographic tests applied were: 1) modified Clinical Test of Sensory Interaction on Balance (mCTSIB); 2) Limits of Stability (LOS); 3) Rhythmic Weight Shift (RWS). The results, concerning four stages of the H&Y scale (I-IV), showed significant differences between groups/stages. Static balance parameters like velocity, total distance, amplitude and frequency of CoP sway, increase with disease severity. In early to medium stages (I-II) of the disease, CoP presents a projection backwards, while in stage IV, this projection showed a trend to change forwards. Concerning dynamic balance, LOS presents a reduction mainly in the forward direction in all stages. The directional control in anterior-posterior RWS decreases with disease progression.

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Section: ) Rws Testcontrasting

confidence: 91%

Section: ) Rws Testmentioning

confidence: 99%

Section: ) Rws Testmentioning

confidence: 99%

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Postural behavior and Parkinson's disease severity

Godinho

Ferret-Sena

Brito

et al. 2016

2016 1st International Conference on Technology and Innovation in Sports, Health and Wellbeing (TISHW)

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“…Studies of Ickenstein et al 7 . and Rossi et al 27 . pointed to the increase of visual dependence, as a compensation mechanism, and explained that the overload of the visual system can affect postural control, as detected by posturography.…”

mentioning

confidence: 91%

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

Barbosa

Souza

Chen

et al. 2015

Arq. Neuro-Psiquiatr.

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Objectives: To estimate the impact of a sensory-motor-cognitive task on postural balance, in Parkinson disease patients (Hoehn and Yahr 2-3) and to investigate possible relationships between posturography and functional balance clinical scales. Method: Parkinson disease patients (n = 40) and healthy controls (n = 27) were evaluated with fluency tests, Berg Balance scale, Mini Best test and static posturography on the conditions eyes open, eyes closed and dual-task (simultaneous balance and fluency tasks). Results: Posturographic data showed that Parkinson disease patients performed worse than controls in all evaluations. In general, balance on dual-task was significantly poorer than balance with eyes closed. Posturographic data were weakly correlated to clinical balance scales. Conclusion: In clinical practice, Parkinson disease patients are commonly assessed with eyes closed, to sensitize balance. Our study showed that adding a cognitive task is even more effective. Static posturographic data should be carefully overgeneralized to infer functional balance impairments.

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“…A condição é dinâmica quando a plataforma é desnivelada ou móvel 8 ou quando o indivíduo realiza a máxima inclinação postural voluntária sem alterar a base de suporte 9 . O teste de limite de estabilidade (TLE) é dinâmico e quantifica o LE por meio da distância máxima que o indivíduo consegue movimentar-se intencionalmente, deslocando o CMC sob a base de suporte em diferentes direções, sem perder o equilíbrio 10 . Esse teste simula o que ocorre em situações de transição postural na direção ântero-posterior (AP) tanto no movimento de sentado para de pé ou na direção médio-lateral como em movimentos de alcance em ortostatismo e início da marcha 9,11 .…”

Section: Introductionunclassified

Redução do limite de estabilidade direção-específica em indivíduos leve a moderadamente afetados pela doença de Parkinson

Diniz

Lima²,

Cardoso³

et al. 2011

Fisioter. Pesqui.

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CONFLITO DE INTERESSE nada a declarar Parecer de aprovação no Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais (UFMG) -nº ETIC 444/05RESUMO: A instabilidade postural na doença de Parkinson (DP) tem sido associada a uma diminuição do limite de estabilidade (LE) na direção ântero-posterior (AP). Entretanto, ainda que possíveis alterações do LE na direção látero-lateral (LL) tenham sido sugeridas, tal direção não tem sido avaliada nos estudos com DP, principalmente quando o teste de limite de estabilidade (TLE) envolve movimentos intencionais que deslocam o centro de massa corporal (CMC). O objetivo do presente estudo foi investigar o LE na postura de pé durante movimentos voluntários que promovem deslocamento do CMC nas direções AP e LL de indivíduos com e sem a DP. Doze indivíduos com DP (Hoehn & Yahr=II, III) e 12 sem a doença realizaram o TLE nos sentidos anterior, posterior, direito e esquerdo. A velocidade de movimento (VM), excursão máxima (EM) e o controle direcional (CD) do CMC foram avaliados em cada sentido. Os indivíduos com DP foram significativamente mais lentos em todos os sentidos de deslocamento do CMC (p<0,05). Não houve diferença significativa na EM e CD no sentido anterior entre os grupos (p>0,05). Por outro lado, a EM e CD do CMC foram menores para o grupo DP no sentido posterior (P) e na direção LL (p<0,05). Indivíduos leves a moderadamente afetados pela DP apresentaram redução do LE no sentido P e na direção LL quando comparados ao grupo controle. Os resultados sugerem que tal direção e sentido devam ser treinados em ortostatismo, com movimentos que deslocam voluntariamente o CMC, desde fases iniciais da DP. The movement velocity (MV), maximum excursion (ME), and directional control (DC) of the COM were evaluated in all investigated directions. Individuals with PD demonstrated smaller COM displacements in all directions (p<0.05). There were no significant differences between the groups regarding the ME and DC in the anterior direction (p>0.05). However, the ME and DC of the COM were smaller for the PD group in the backward, right, and left directions (p<0.05). Individuals with mild to moderate PD demonstrated decreases in the LOS in the posterior and LL directions, when compared to individuals without the disease. These findings suggested that such directions should be trained in the standing position with voluntary movements of the COM from the early stages of PD.

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A Prospective Study of Alterations in Balance among Patients with Parkinson’s Disease

Cited by 65 publications

References 45 publications

Postural behavior and Parkinson's disease severity

Postural behavior and Parkinson's disease severity

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

Redução do limite de estabilidade direção-específica em indivíduos leve a moderadamente afetados pela doença de Parkinson

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