Objective: To explore the correlation between the Romberg test condition 4 and turn progression in most affected and least affected body side directions in people with Parkinson’s disease (PD).

Background: Vestibular impairment is a significant contributor to imbalance and falls in PD. Turning functions have a critical dependence on vestibular integrity because visual and proprioceptive leg feedback becomes largely unreliable. Therefore, abnormal turning functions may specifically associate with vestibular impairment.

Method: 29 people with PD underwent clinical vestibular and motor assessment at study entry and 2 years later. PwPD were instructed to make 180° turns in motor most affected and least affected body side direction on a rectangular electronic mat 1.2×2.4 mtr. Inertial sensors were used to collect data for vestibular Romberg 4 test condition (Eyes closed on foam surface for 30 sec). Difference values between baseline and follow-up were used to compute bivariate Pearson’s correlations.

Results: 29 people with PD (8F/21M, age 65.17±5.76 yrs, disease duration 5.34±4.28 yrs, median H&Y 2.5) were enrolled in the study. We found a negative correlation between Romberg 4 test performance and left steps outside turn zone and total steps outside turn zone in both most affected and least affected turn direction s(p<0.01). However, we found only left turn steps (p=0.001), total turn steps (p=0.001), turn duration (p<0.001), and turn step times (p=0.013) in the least affected side turn direction negatively correlated with the Romberg 4 test performance.

Conclusion: Vestibular impairment is more robustly associated with turning difficulties in the clinically least affected body side compared to the most affected body side direction in PwPD. Findings may have therapeutic implications for targeted physical therapy interventions in PwPD with a vestibulopathy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/vestibular-impairment-turning-direction-and-turn-progression-in-parkinsons-disease/