Postural sway in patients with early Parkinson’s disease performing cognitive tasks while standing

Abstract

Our results indicate that patients with early PD have subtle signs of postural instability when their attention is diverted or reduced. In addition, deficits of stereopsis may be common in early PD patients. St Abbreviations: ACC: Accelerometers; ANOVA: Analysis of variance; AP: Antero-posterior; COP: Center of pressure; EC: Eyes closed; ECDT: eyes closed with dual task; EO: Eyes open; EODT: Eyes open with dual task; GDS: Geriatric depression scale; JERK: Jerkiness of sway; ML: Medio-lateral; MMSE: Mini mental state examination; MoCA: Montreal cognitive assessment; PD: Parkinson's disease; PDAbS: PD Patients with abnormal stereopsis; PDNrS: PD Patients with normal stereopsis; PIGD: Postural instability and gait disorder; RMS: Root mean square; UPDRS: Unified Parkinson's disease rating scale.

An Evaluation of the Effect of Vision on Standing Stability in the Early Stage of Parkinson’s Disease

“…The results of current research demonstrated that in mild PD subjects, quiet stance COP sway increased as previous researches similarly reported [7,30], but COP complexity was similar to healthy individuals in these patients, which might change when imposing additional cognitive load or with increasing task difficulty [29,32]. Also, COP pattern irregularity in PD patients increases by disease progression as Morrison et al [33] found a positive correlation between COP ApEn and disease severity according to Unified PD Rating Scale (Motor).…”

“…It means that in this method, the excursion of COP is measured during a period of time [26,27], while in the nonlinear approach, the quality of the pattern of COP sway is evaluated [27,28]. Also, a recent study investigated postural stability in the patients with early PD using an accelerometer at the center of mass at the lower spine found no differences between this group and the healthy subjects in either OE or CE conditions [29]. ApEn has been used in some studies to evaluate the performance of neuromuscular system to control standing stability [28,30,31].…”

Choreographing life-experiences of balance control in people with Parkinson’s disease

“…One limitation was the fact that only one interview, at one point in time, was conducted, leaving a gap concerning the development of balance issues and how it affected functioning over time in PwPD. People in early stages of PD were included in this study since according to the latest research, balance deficits are common even in early stages of PD [4][5][6], which was also the case in our study. According to our testing 11 of 18 participants had a H&Y score of 1-2, and 10 of these had reduced balance according to one or more domains on the Mini-BESTest.…”

“…This could be explained by the fact that regulation of gait variability and rhythmicity is attention demanding for PwPD, and is more affected when a dual task is performed [50]. Moreover, reduced balance when attention is diverted have been reported in people in early stages of PD [6], implying the need to adress balance control as a matter of urgency in the newlydiagnosed. Further, dual-tasking can increase the risk of falling and affect the performance of turning in place and trigger FoG [51][52][53][54], which was reported among participants.…”

“…Postural instability, a hallmark feature of PD, predisposes people living with the disorder to experience difficulties with the execution of tasks and activities [3]. Gait and balance difficulties are complex in PD and are evident early in the disease and progresses over time [4][5][6]. Balance impairments such as anticipatory postural adjustments, sensory integration and dynamic gait are affected early in the disease [7,8], often resulting in a higher occurrence of falls in people with PD (PwPD) than healthy controls even before diagnosis [9].…”