Dynamic balance control during stair negotiation for older adults and people with Parkinson disease

Abstract

It is well understood that stability during ambulation is reliant upon appropriate control of the trunk segment, but research shows that the rhythmicity of this segment is significantly reduced for people with Parkinson's disease (PD). Given the increased risk associated with stair ambulation, this study investigated whether people with PD demonstrate poorer trunk control during stair ambulation compared with age-matched controls. Trunk accelerations were recorded for twelve PD patients and age-matched controls during stair ascent and descent. Accelerations were used to derive measures of harmonic ratios and root mean square (RMS) acceleration to provide insight into the rhythmicity and amplitude of segmental motion. Compared with what is typically seen during level-ground walking, gait rhythmicity during stair negotiation was markedly reduced for older adults and people with PD. Furthermore, both groups exhibited significantly poorer trunk movements during stair descent compared to stair ascent, suggesting that both populations may face a greater risk of falling during this task. As stair negotiation is a common activity of daily life, the increased risk associated with this task should be considered when working with populations that have an increased risk of falling.

A systematic review and meta-analysis comparing the effect of aquatic and land exercise on dynamic balance in older adults

“…Although different musculoskeletal or neurological disorders do not share identical signs or symptoms, dynamic balance is important across all older populations to prevent fall risk and to enhance rehabilitation from fall-related injuries. For example, Parkinson’s disease is a degenerative neurological disorder commonly reported in the senior population, and the risk of falls and fall-related injuries increase in this population due to deficits in motor functions and postural stability [ 41 ]. Osteoporosis, which is also common in the senior population, reduces the bone density and results in a higher risk of fractures caused by falling [ 42 ].…”

Exploring Risk of Falls and Dynamic Unbalance in Cerebellar Ataxia by Inertial Sensor Assessment

“…From the literature, we know that trunk acceleration smoothness during walking is predictive of gait dysfunction [37,38] and fall risk in older people [14,39]. Moreover, HR has already been found to be abnormal in patients who have suffered a stroke, Parkinson's disease, or multiple sclerosis [19,20,22,40].…”

Identificación de marcadores clínicos, cognitivos y motores en pacientes con enfermedad de Parkinson en estadios tempranos: evaluación clínica complementada con un dispositivo de análisis del movimiento

“…Las personas con EP pueden tener alteraciones en el balance dinámico que implican el ajuste del centro de masa ante tareas cambiantes, en especial en las escaleras, las cuales se asocian con la inestabilidad postural, y ella con la rigidez en el tronco [218]. Adicionalmente, fue evidente que los pacientes se sentían más seguros cuando se tomaban del pasamanos, lo cual podría asociarse con la mejoría del ritmo que se ha descrito cuando los pacientes con EP usan una baranda horizontal como una señal visual estática que puede ser efectiva para disminuir los síntomas motores que experimentan [219].…”