Journal of Neural Transmission

, 114:1333 | Cite as

Detecting asymmetries in balance control with system identification: first experimental results from Parkinson patients

  • H. van der Kooij
  • E. H. F. van Asseldonk
  • J. Geelen
  • J. P. P. van Vugt
  • B. R. Bloem
Article

Summary.

Cognitive processes can influence balance in various ways, but not all changes in postural performance can easily be identified with the naked clinical eye. Various studies have shown that dynamic posturography is able to detect more subtle changes in balance control. For patients with Parkinson’s disease (which is typically an asymmetric disease), changes in the symmetry of balance control might provide a sensitive measure of cognitive influences on balance. Here, we describe a new posturography technique that combines dynamic platform perturbations with system identification techniques to detect such asymmetries in balance control of two patients with Parkinson’s disease. Results were compared to those of six healthy controls. Our pilot data show clear asymmetries in dynamic balance control, even though patients themselves were not aware of this and had no subjective problems with stability or standing. We also found asymmetries in weight bearing, but the asymmetries in dynamic balance contribution were larger. Finally, asymmetries in weight bearing and dynamic balance in patients were not tightly coupled as in healthy controls. Future studies could incorporate this approach when examining the influence of mental decline on postural regulation.

Keywords: Parkinson; balance control; asymmetries; system identification; dynamic posturography 

References

  1. Blin, O, Ferrandez, AM, Serratrice, G 1990Quantitative analysis of gait in Parkinson patients: increased variability of stride lengthJ Neurol Sci989197CrossRefPubMedGoogle Scholar
  2. Bloem, BR, Grimbergen, YA, van Dijk, JG, Munneke, M 2006The “posture second” strategy: a review of wrong priorities in Parkinson’s diseaseJ Neurol Sci248196204CrossRefPubMedGoogle Scholar
  3. Djaldetti, R, Ziv, I, Melamed, E 2006The mystery of motor asymmetry in Parkinson’s diseaseLancet Neurol5796802CrossRefPubMedGoogle Scholar
  4. Fitzpatrick, RC, Burke, D, Gandevia, C 1996Loop gain of reflexes controlling human standing measured with the use of postural and vestibular disturbancesJ Neurophysiol7639944008PubMedGoogle Scholar
  5. Geurts, AC, Mulder, TW, Nienhuis, B, Rijken, RA 1992Postural reorganization following lower limb amputation. Possible motor and sensory determinants of recoveryScand J Rehabil Med248390PubMedGoogle Scholar
  6. Hausdorff, JM, Schaafsma, JD, Balash, Y, Bartels, AL, Gurevich, T, Giladi, N 2003Impaired regulation of stride variability in Parkinson’s disease subjects with freezing of gaitExp Brain Res149187194PubMedGoogle Scholar
  7. Hughes, AJ, Daniel, SE, Kilford, L, Lees, AJ 1992Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 casesJ Neurol Neurosurg Psychiatry55181184CrossRefPubMedGoogle Scholar
  8. Keus, SH, Bloem, BR, Hendriks, EJ, Bredero-Cohen, AB, Munneke, M 2006Evidence-based analysis of physical therapy in Parkinson’s disease with recommendations for practice and researchMov Disord22451460CrossRefGoogle Scholar
  9. Koopman, B, Grootenboer, HJ, de Jongh, HJ 1995An inverse dynamics model for the analysis, reconstruction and prediction of bipedal walkingJ Biomech2813691376CrossRefPubMedGoogle Scholar
  10. Marchese, R, Bove, M, Abbruzzese, G 2003Effect of cognitive and motor tasks on postural stability in Parkinson’s disease: a posturographic studyMov Disord18652658CrossRefPubMedGoogle Scholar
  11. Mitchell, SL, Collins, JJ, De Luca, CJ, Burrows, A, Lipsitz, LA 1995Open-loop and closed-loop postural control mechanisms in Parkinson’s disease: increased mediolateral activity during quiet standingNeurosci Lett197133136CrossRefPubMedGoogle Scholar
  12. Plotnik, M, Giladi, N, Balash, Y, Peretz, C, Hausdorff, JM 2005Is freezing of gait in Parkinson’s disease related to asymmetric motor function?Ann Neurol57656663CrossRefPubMedGoogle Scholar
  13. Rocchi, L, Chiari, L, Horak, FB 2002Effects of deep brain stimulation and levodopa on postural sway in Parkinson’s diseaseJ Neurol Neurosurg Psychiatry73267274CrossRefPubMedGoogle Scholar
  14. Samii, A, Nutt, JG, Ransom, BR 2004Parkinson’s diseaseLancet36317831793CrossRefPubMedGoogle Scholar
  15. Schoukens, JGP, Pintelon, R 1993

    Design of broadband excitation signals

    Keith, G eds. Perturbation signals for system identificationPrentice Hall, Englewood CliffsUSA
    Google Scholar
  16. Su, PC, Tseng, HM, Liou, HH 2002Postural asymmetries following unilateral subthalomotomy for advanced Parkinson’s diseaseMov Disord17191194CrossRefPubMedGoogle Scholar
  17. van Asseldonk, EH, Buurke, JH, Bloem, BR, Renzenbrink, GJ, Nene, AV, van der Helm, FC, van der Kooij, H 2006Disentangling the contribution of the paretic and non-paretic ankle to balance control in stroke patientsExp Neurol201441451CrossRefPubMedGoogle Scholar
  18. van der Kooij, H, van Asseldonk, E, van der Helm, FC 2005Comparison of different methods to identify and quantify balance controlJ Neurosci Methods145175203CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • H. van der Kooij
    • 1
  • E. H. F. van Asseldonk
    • 1
  • J. Geelen
    • 2
  • J. P. P. van Vugt
    • 2
  • B. R. Bloem
    • 3
  1. 1.Department of Biomechanical EngineeringUniversity of TwenteEnschedeThe Netherlands
  2. 2.Department of NeurologyMedisch Spectrum TwenteEnschedeThe Netherlands
  3. 3.Department of NeurologyRadboud University Nijmegen Medical CentreNijmegenThe Netherlands

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