Objective: To determine: 1. Is there a correlation between central and peripheral proprioception in Parkinson’s disease? 2. Does postural instability increase with lack of vision relative to healthy controls? 3. Is a reduction in proprioception or postural stability correlated with rate or fear of falling in either condition?

Background: Parkinson’s disease (PD) is a degenerative condition characterized by progressive motor impairment as a result of dopamine depletion of the basal ganglia. Recent evidence has indicated that these motor impairments are in part due to sensory or perceptual deficits, such as proprioception. The way the proprioceptive deficit affects both the central and peripheral systems within an individual PD patient is not well understood, nor is the process by which this deficit occurs.

Methods: Cross sectional study of proprioception in Parkinson’s disease and healthy aged matched controls. Ankle proprioception was measured using the Active Movement Extent Discrimination Apparatus. Postural stability was measured by calculating the Centre of Pressure (CoP) deviation on force plate analysis. Falls were recorded from the previous 12 months and Falls Efficacy Scale questionnaire and Parkinson’s Disease Questionnaire-39 were administered.

Results: This study observed 26 participants, 11 with PD and 15 controls. A significant difference was observed in proprioception between control and PD groups, M = -0.048 (p = 0.047, 95% CI from -0.096 to -0.001). The mean difference in CoP also had a weak negative correlation with proprioception scores (R = 0.0134, p = 0.948). The mean difference in CoP between participants with PD and controls was significantly difference both with vision and without vision mean difference was 222.092 (p = 0.007, 95% CI from 66.078 to -378.105). A weak negative correlation was identified between proprioception and FES scores (R = -0.201, p = 0.325) and proprioception and rate of falls (R = 0.128, p = 0.533).

Conclusions: The results of this study confirmed impaired proprioception of the ankle in PD, and showed there was no significant difference in proprioceptive acuity between the most and least affected sides. This did not correlate significantly with CoP measurements, which indicates the central and peripheral systems are deteriorating at different rates. A greater understanding of these movement control mechanisms, can inform more effective rehabilitation for this condition.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/ankle-proprioception-and-postural-instability-in-parkinsons-disease/