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Time-dependent changes in postural control in early Parkinson’s disease: what are we missing?

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Abstract

Impaired postural control (PC) is an important feature of Parkinson’s disease (PD), but optimal testing protocols are yet to be established. Accelerometer-based monitors provide objective measures of PC. We characterised time-dependent changes in PC in people with PD and controls during standing, and identified outcomes most sensitive to pathology. Thirty-one controls and 26 PD patients were recruited: PC was measured with an accelerometer on the lower back for 2 minutes (mins). Preliminary analysis (autocorrelation) that showed 2 seconds (s) was the shortest duration sensitive to changes in the signal; time series analysis of a range of PC outcomes was undertaken using consecutive 2-s windows over the test. Piecewise linear regression was used to fit the time series data during the first 30 s and the subsequent 90 s of the trial. PC outcomes changed over the 2 mins, with the greatest change observed during the first 30 s after which PC stabilised. Changes in PC were reduced in PD compared to controls, and Jerk was found to be discriminative of pathology. Previous studies focusing on average performance over the duration of a test may miss time-dependent differences. Evaluation of time-dependent change may provide useful insights into PC in PD and effectiveness of intervention.

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Notes

  1. Axivity AX3, York, UK.

  2. PAL Technologies, Glasgow, UK.

  3. BSN Medical Limited, Hull, UK.

Abbreviations

ABCs:

Activities-specific balance confidence scale

ANCOVA:

Analysis of covariance

AP:

Anteroposterior

BMI:

Body mass index

CL:

Controls

f95%, CoP:

Centre of pressure frequency below which is 95 % of power of the acceleration power spectrum

GDS:

Geriatric Depression Scale

Hz:

Hertz

LEDD:

Levodopa equivalent daily dose

MDS-UPDRS:

Movement Disorder Society version of the Unified Parkinson’s Disease Rating Scale

m :

Slope

mins:

Minutes

ML:

Mediolateral

MMSE:

Mini mental state exam

MoCA:

Montreal cognitive assessment

n :

Number

ppm:

Parts per million

PC:

Postural control

PD:

Parkinson’s disease

PIGD:

Postural instability and gait disorder

RMS:

Root mean square

s:

Seconds

SD:

Standard deviation

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Acknowledgments

SDD is supported by the V-Time project, which is a European Union 7th Framework Programme (FP7) under the Health theme (FP7-278169). LR is an investigator on the V-Time project. LR, SL and AG are supported by the National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre and Unit based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University. The research was also supported by NIHR Newcastle CRF Infrastructure funding. The views expressed are those of the authors and not necessarily those of the NHS or NIHR or the Department of Health. The authors would like to thank Dr. Gordon Duncan together with Dr. Alison Yarnall for their help in patient recruitment as part of the ICICLE-PD project, and Mrs Dadirayi Mhiripiri for her assistance in data collection.

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Authors and Affiliations

  1. Clinical Ageing Research Unit, Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK

    Silvia Del Din, Alan Godfrey, Brook Galna, Sue Lord & Lynn Rochester

  2. Industrial Statistics Research Unit, Newcastle University, Herschel Building, Newcastle upon Tyne, NE1 7RU, UK

    Shirley Coleman

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  1. Silvia Del Din
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  2. Alan Godfrey
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  3. Shirley Coleman
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  4. Brook Galna
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  6. Lynn Rochester
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Correspondence to Lynn Rochester.

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Del Din, S., Godfrey, A., Coleman, S. et al. Time-dependent changes in postural control in early Parkinson’s disease: what are we missing?. Med Biol Eng Comput 54, 401–410 (2016). https://doi.org/10.1007/s11517-015-1324-5

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  • DOI: https://doi.org/10.1007/s11517-015-1324-5

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