Objective: To distinguish postural instability differences in Parkisnon disease patients and normal elderly patients with computerized dynamic posturography

Background: Postural instability is a core symptom of Parkinson disease. However, it is uneasy to clinically distinguish mild postural instability of early-stage PD patients from that of normal elderly. Using computerized dynamic posturography, we investigated diagnostic performance of sensory organization test(SOT) and limit of stability(LOS) for detecting subclinical postural instability of early stage PD patients

Methods: Patients with a diagnosis of idiopathic Parkinson’s disease, Hoehn-Yahr(H&Y) stage score less than 3, and non-faller were recruited consecutively from the outpatient neurologic clinic of Soonchunhyang University Bucheon Hospital. Total of 38patients (14 females and 24 males) in the age range 46-78 years (mean age: 64 years) and 29 age-matched controls participated in this study;mean duration of disease was 18.7 months (range 6-80 months). The targeted clinical measures included BMI, disease duration, H&Y staging, Schwab-England Activities of Daily Living scale, Unified Parkinson’s Disease Rating Scale motor subscore, gait and posture subscore, levodopa-equivalent daily doses, Beck anxiety inventory, and fear of fall. Sensory organization test and LOS were performed using computerized dynamic posturography (Smart Equi-test, Neurocom®, Clakoma, USA).All subjects were tested on their usual drug regimen 2 hours after taking medication. Diagnostic performance of SOT and LOS parameters for distinguishing patients from control in term of postural stability were evaluated by odds ratio obtained from the multiple logistic regression analysis, sensitivity, specificity, accuracy, and AUC.
 

Results: Most of the equilibrium scores and composite score of SOT were similar between patients and controls (p>0.05), while LOS variables showed significant differences between both groups (AUC 0.75-0.81,p<0.001). Among the LOS parameters, mean velocity revealed significant diagnostic performance in all directions.
 

Conclusions: Limit of stability is more powerful than sensory organization test in distinguishing subclinical postural instability of early-stage PD patient

References: 1.        Massano J, Bhatia KP. Clinical approach to Parkinson’s disease: features, diagnosis, and principles of management. Cold Spring Harbor perspectives in medicine 2012;2:a008870.
 

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MDS Abstracts - https://www.mdsabstracts.org/abstract/distinguishing-subclinical-postural-instability-in-early-stage-parkinson-disease-and-postural-instability-of-normal-elderly-using-sensory-organization-test-and-limit-of-stability/