Author: Abigail DeWitt

Publisher:

Published: 2017

Total Pages: 37

ISBN-13:

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Introduction: Postural instability is a known contributing factor to balance dysfunction and increased fall risk in those with Parkinson’s disease (PD). The NeuroCom Force Platform System (FP) can provide objective, quantitative information regarding balance impairments in voluntary and reactive postural strategies and sensory strategies. The purpose of this study was to examine balance performance as measured by the Limits of Stability (LOS), Sensory Organization Test (SOT), and Motor Control test (MCT) utilizing the FP system in persons with PD as compared to age-matched healthy adults. Secondarily, this study will examine if these FP measures provide diagnostic and clinically meaningful information about the underlying balance impairments in the PD population. Methods: Forty two individuals for the PD cohort (H&Y stage=2.33 + 0.77) and fifty five individuals for the age-matched healthy cohort enrolled in this study. Balance measures (SOT,MCT,LOS) were assessed in both cohorts using standardized procedures on FP system. Between group comparisons of FP performance were conducted using independent t-test, as well as ANCOVA controlling for age. Within group comparisons for the PD cohort were performed using the ANCOVA for comparing disease stage and age group, and the Mann Whitney U Test for comparing PD-subtypes. Results: Significant between group differences in FP performance were found for the SOT composite equilibrium (P=0.013, CI-95% 1.286 to 10.37), SOT vestibular ratio (P=0.027, CI-95%=0.12 to 0.185), SOT number of total falls (P=0.015, CI-95%=1.527 to -0.175) and LOS average movement velocity (P=0.001, CI-95%=0.597 to 1.595). ANCOVA analysis estimated that on average the healthy cohort scored 5.28 points higher in SOT composite equilibrium that on average the healthy cohort scored 5.28 points higher in SOT composite equilibrium than the PD cohort. Within group analysis revealed significant differences in FP performance based on age, stage and PD subtypes. Discussion: Individuals in the PD cohort demonstrated greater postural instability on SOT measures and slower movement velocity on LOS than healthy cohort, suggesting that these tests were sensitive to detect sensory integration and voluntary postural control deficits in the PD cohort. The SOT differentiated between H&Y stages 1-3, supporting the use of the SOT to identify decline in sensory processing and integration with advancing disease stage. The MCT was able to detect changes in reactive postural control mainly in later disease stages. The LOS and MCT distinguished between PD subtypes with the postural instability and gait difficulty subtype demonstrating poorer balance performance than the tremor dominant. These findings support that FP measures may provide clinically meaningful, diagnostic information in the examination of balance impairments in individuals with PD. Conclusion: In response to the high fall rate and devastating sequelae of falls in individuals with PD, FP measures may inform clinicians regarding intrinsic balance deficits and guide them in designing targeted balance interventions to reduce fall risk.

Download or read book Comparing balance performance on force platform measures in individuals with Parkinson's Disease and healthy adults written by Abigail DeWitt and published by . This book was released on 2017 with total page 37 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Postural instability is a known contributing factor to balance dysfunction and increased fall risk in those with Parkinson’s disease (PD). The NeuroCom Force Platform System (FP) can provide objective, quantitative information regarding balance impairments in voluntary and reactive postural strategies and sensory strategies. The purpose of this study was to examine balance performance as measured by the Limits of Stability (LOS), Sensory Organization Test (SOT), and Motor Control test (MCT) utilizing the FP system in persons with PD as compared to age-matched healthy adults. Secondarily, this study will examine if these FP measures provide diagnostic and clinically meaningful information about the underlying balance impairments in the PD population. Methods: Forty two individuals for the PD cohort (H&Y stage=2.33 + 0.77) and fifty five individuals for the age-matched healthy cohort enrolled in this study. Balance measures (SOT,MCT,LOS) were assessed in both cohorts using standardized procedures on FP system. Between group comparisons of FP performance were conducted using independent t-test, as well as ANCOVA controlling for age. Within group comparisons for the PD cohort were performed using the ANCOVA for comparing disease stage and age group, and the Mann Whitney U Test for comparing PD-subtypes. Results: Significant between group differences in FP performance were found for the SOT composite equilibrium (P=0.013, CI-95% 1.286 to 10.37), SOT vestibular ratio (P=0.027, CI-95%=0.12 to 0.185), SOT number of total falls (P=0.015, CI-95%=1.527 to -0.175) and LOS average movement velocity (P=0.001, CI-95%=0.597 to 1.595). ANCOVA analysis estimated that on average the healthy cohort scored 5.28 points higher in SOT composite equilibrium that on average the healthy cohort scored 5.28 points higher in SOT composite equilibrium than the PD cohort. Within group analysis revealed significant differences in FP performance based on age, stage and PD subtypes. Discussion: Individuals in the PD cohort demonstrated greater postural instability on SOT measures and slower movement velocity on LOS than healthy cohort, suggesting that these tests were sensitive to detect sensory integration and voluntary postural control deficits in the PD cohort. The SOT differentiated between H&Y stages 1-3, supporting the use of the SOT to identify decline in sensory processing and integration with advancing disease stage. The MCT was able to detect changes in reactive postural control mainly in later disease stages. The LOS and MCT distinguished between PD subtypes with the postural instability and gait difficulty subtype demonstrating poorer balance performance than the tremor dominant. These findings support that FP measures may provide clinically meaningful, diagnostic information in the examination of balance impairments in individuals with PD. Conclusion: In response to the high fall rate and devastating sequelae of falls in individuals with PD, FP measures may inform clinicians regarding intrinsic balance deficits and guide them in designing targeted balance interventions to reduce fall risk.