Objective: To assess disorders of VPC using the characteristics of the speed of voluntary movements in patients with PD.

Background: At the advanced stage of Parkinson’s disease (PD) voluntary postural control (VPC) is impaired. The leading disturbances of the VPC are inhibition and freezing [1,2]. Current diagnosis of the disorders of VPC based on an assessment of the pressure center (PC) displacement graph for estimation of voluntary movement. At the same time estimate the speed of the PC at a given point and return to its original position [3].

Method: We examined 52 (35 with tremor, 17 with bradykinesia-rigidity) PD patients. 28 male and 24 female, mean age 55,98±7,04 years, 32 patients–II stage of H&Y, 20–III. And 20 healthy people comparable in age and sex. Conducted a test patient’s PC change in the position of the target keeping it in this position. The target time in one position is 8 sec. Patients moved PC forward, then returned. Test was carried out on stabilographic platform with biofeedback. Speed of swing (SS), mm/sec and speed of throw (ST), mm/sec was evaluated [3].

Results: Me (LQ;UQ) of SS and ST at the stages of exposure compensation (stage I) and return (stage II) were significantly lower by U-test in PD patients than in healthy group. In PD patients SS on stage I was 11,02(3,83;24,3) mm/sec (U=136, р=0,017634), SS on stage II was 15,36(6,69;30,5) mm/sec (U=98, р=0,001932), ST on stage I was 15,5(8,4;32,7) mm/sec (U=157, р=0,048689), ST on stage II was 14,51(8,31;28,27) mm/sec (U=106, р=0,003205). In PD group, the Me (LQ;UQ)  of ST values at the stage II are significantly lower in patients with 3-4 stages of H&Y – 10.4 (4.9; 25.3) mm/sec than in patients with 2-2.5 H&Y – 18.9 (14.4; 36.3) mm/sec (U=212, p=0.025186).

Conclusion: The results revealed the prevalence of inhibition processes in patients with PD, which is reflected in a decrease in SS and ST. With the progression of the disease, the processes of inhibition are aggravated, which is reflected in a decrease in ST in patients 3-4 H&Y. The selected speed indicators allow us to evaluate and objectify disturbances of VPC in PD patients.

References: 1. Illarioshkin S.N., Yahno N.N. (2008) Parkinson’s disease and movement disorders. Мoscow: OOO Dialog. (in Russian). 2. Giladi N., Treves Т.А, Simon E.S. (eds.) (2001) Freezing of gait in patients with advanced Parkinson’s disease. J. Neural. Transm., vol. 108, pp. 53-61. 3. Stabilographic studies. The user manual “Stabilan-01-2”. – Taganrog, ZAO OKB «RITM». (in Russian).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/approaches-to-assessing-of-disorders-of-voluntary-posture-control-in-patients-with-parkinsons-disease/