Research Article

Experimental Brain Research

, Volume 183, Issue 1, pp 107-114

Assessment of postural instability in patients with Parkinson’s disease

  • J. W. BłaszczykAffiliated withFaculty of Physiotherapy, Academy of Physical EducationDepartment of Neurophysiology, Nencki Institute of Experimental Biology Email author 
  • , R. OrawiecAffiliated withFaculty of Physiotherapy, Academy of Physical Education
  • , D. Duda-KłodowskaAffiliated withNeurological Clinic of the Advanced Age, Central Clinic Hospital of the Silesian Medical School in Katowice
  • , G. OpalaAffiliated withNeurological Clinic of the Advanced Age, Central Clinic Hospital of the Silesian Medical School in Katowice

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Abstract

Postural instability is one of the most disabling features of idiopathic Parkinson’s disease (PD). In this study, we focused on postural instability as the main factor predisposing parkinsonians to falls. For this purpose, changes in sway characteristics during quiet stance due to visual feedback exclusion were studied. We searched for postural sway measures that could be potential discriminators for an increased fall risk. A group of 110 subjects: 55 parkinsonians (Hoehn and Yahr: 1–3), and 55 age-matched healthy volunteers participated in the experiment. Their spontaneous sway characteristics while standing quiet with eyes open and eyes closed were analyzed. We found that an increased mediolateral sway and sway area while standing with eyes closed are characteristic of parkinsonian postural instability and may serve to quantify well a tendency to fall. These sway indices significantly correlated with disease severity rated both by the Hoehn and Yahr scale as well as by the Motor Section of the UPDRS. A forward shift of a mean COP position in parkinsonians which reflects their flexed posture was also significantly greater to compare with the elderly subjects and exhibited a high sensitivity to visual conditions. Both groups of postural sway abnormalities identified here may be used as accessible and reliable measures which allow for quantitative assessment of postural instability in Parkinson’s disease.

Keywords

Parkinson’s disease Elderly Posture Balance Postural stability Falls