Proprioceptive and Sensorimotor Performance in Parkinson's Disease

Abstract

We explored the effects of random whole-body vibration on leg proprioception in Parkinson's disease (PD). In earlier studies it was found that this treatment leads to improved postural control in these patients. Thus, one could speculate that these effects result from modified proprioceptive capabilities. Twenty-eight PD patients were subdivided in one experimental and one control group. Proprioceptive performance was analyzed using a tracking task basing on knee extension and flexion movements. Treatment consisted of 5 series of random whole-body vibration taking 60 seconds each. Control subjects had a rest period instead. Prominent over- and undershooting errors were found in both groups representing proprioceptive impairments. No significant differences became evident, however, either between pre- and post-tests or between experimental and control group. One might therefore conclude that spontaneous improvements in postural control are not directly connected with proprioceptive changes. Nevertheless, one also should keep in mind the general aspects and difficulties of analyzing proprioception.

Effect of whole body vibration in Parkinson's disease: A controlled study

“…Both studies were performed by applying five sets of 60 seconds each, at 6 Hz, employing stochastic vibration which was one of the key features advocated by the authors. 5 However, more recently, significant effects on Parkinsonian patients have been reported using nonstochastic vibration. 4 These authors showed the effect of 25 Hz stimulation (twice per day, 15 min./each) for 3 weeks which produced an improvement in a set of motor tests (Tinetti balance score, 6 gait velocity, stand-walk-sit test, UPDRS III ), although similar results were seen with conventional rehabilitation therapy (relaxation, occupational therapy, etc.).…”

Effects of Repeated Bouts of Segmental Vibration Therapy on Balance in Parkinsons Disease

“…Although the methods of applying WBV among these studies are variable, shortterm improvements in balance and motor function were documented after WBV. The mechanisms of these improvements are unknown but it possible that vibration stimuli enhance sensory processing in individuals in PD [8,9,26]. Another possibility is that WBV promotes activation of dopaminergic neurons, as has been shown in animal models [28].…”

“…Many studies have indicated that motor deficits in PD may be directly related to the underlying mismatch of proprioceptive feedback and peripheral discharge for adequate balance reactions [5][6][7][8]. However, there is conflicting evidence in the literature as to whether proprioceptive deficits in PD are due to faulty peripheral or central pathways [9]. In addition, physiological evidence has yet to show that proprioceptive disturbances exist because of defective muscle spindle sensitivity or discharge [10].…”

Que faut-il penser de l’utilisation des plateformes vibrantes chez les sujets âgés ?

“…Ces variations dans les protocoles utilisés s'expliquent en partie par les différences dans les objectifs cherchés par l'utilisation des plateformes vibrantes. Ainsi, les études destinées à améliorer la posture et la marche des malades parkinsoniens utilisent volontiers de faibles fréquences de vibration, inférieures à 10 Hz [3,4] alors que chez des femmes ménopausées la recherche d'une amélioration de la force musculaire fait généralement appel à des fréquences de vibration plus élevées, de 35 à 40 Hz [5,6]. Les caractéristiques des principales plateformes utilisées au cours d'études impliquant des sujets âgés figurent dans le tableau I.…”

“…Les auteurs notaient une amélioration de la stabilité posturale spontanée dans le groupe entraîné sur plateforme vibrante, suggérant que ce dispositif pouvait représenter une méthode additionnelle dans la rééducation des patients parkinsoniens [3]. Cette amélioration du contrôle postural chez les malades parkinsoniens serait indépendante des capacités proprioceptives [4]. La même équipe a évalué l'impact des vibrations corporelles totales sur les symptômes moteurs des malades parkinsoniens.…”