Session Information
Date: Tuesday, June 21, 2016
Session Title: Parkinson's disease: Pathophysiology
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: The purpose of this investigation is to study both the sensory and motor aspects of voluntary and automatic postural control using static and dynamic Posturography in a group of fallers and non-fallers with Parkinson’s disease (PD) using Neurocom SMART Equitest.
Background: The sensorimotor control of posture involves a complex integration of multisensory inputs. All or some of the components of this system may be dysfunctional in PD, rendering postural instability one of the most disabling features of PD.
Methods: 31 subjects were examined in ON-meds state (12 fallers and 19 non-fallers). Two tests were utilized: Motor Control Test (MCT) and Sensory Organization Test (SOT). In SOT, six conditions were measured comprising 3 trials for 20 seconds each 🙁 1) Static balance with eyes open (2) eyes closed (3) Dynamic visual surround, eyes open (4) Dynamic platform eyes open (5) eyes closed (6) Dynamic platform, dynamic visual surround, eyes open. Postural instability and Center of gravity (COG) were compared under each condition. Sway and equilibrium scores were calculated as a percentage based on degree of sway from vertical (100% score represents perfect equilibrium & 0% represent fall).
Results: Data was analyzed using MANOVA. Fallers were older (70±2.7 years) than Non- fallers (64.8±2.16), had longer PD duration (3.5±1.2 vs 2.7±0.96) and higher UPDRS score (21±3.2 vs 14±2.6). Among the SOT, fallers were significantly different from non – fallers in condition 1(91.25 vs 94.05) and condition 6(30.5 vs 54.47). Among UPDRS subsets comparison between fallers and non-fallers, postural stability (1.18 vs 0.47), posture (1.18 vs 0.36) and gait (1.00 vs 0.47) were significantly impaired. Comparison among conditions 2, 3, 4 and 5 was non-significant. Among the MCT, faller performed worst anteroposterior direction sway/Sway_AP (7.17 cm vs 4.7 cm), root mean square anteroposterior RMS_AP (1.78 vs 1.14) and Strength symmetry with large back perturbation (89 vs 102.5).
| Conditions | Fallers | Non Fallers | MANOVA Analysis (p value) |
|---|---|---|---|
| Age (Years) | 70±2.7 | 64.8±2.16 | |
| PD Duration (Years) | 3.5±1.2 | 2.7±0.96 | |
| UPDRS (Motor Scores) | 21±3.2 | 14±2.6 | |
| Postural stability UPDRS subset | 1.18 | 0.44 | 0.0211* |
| Posture UPDRS subset | 1.18 | 0.36 | 0.004* |
| Gait UPDRS subset | 1.00 | 0.47 | 0.06 |
| Bradykinesia UPDRS subset | 0.36 | 0.26 | 0.628 |
| Arising from chair UPDRS subset | 0.45 | 0.10 | 0.1057 |
| Conditions (Sensory Organization test) | |||
| Condition 1 (Static balance eyes open) | 91.25 | 94.05 | 0.0454* |
| Condition 2 (Static balance eyes closed) | 87.58 | 85.5 | 0.749 |
| Condition 3 (Surrounding surface moves with eyes open/ altered vision) | 74.91 | 77.1 | 0.826 |
| Condition 4 (Floor moves with eyes open/ unsteady surface) | 60.66 | 72.21 | 0.172 |
| Condition 5 (Floor moves with eyes closed) | 31.5 | 49.58 | 0.09 |
| Condition 6 (Surrounding and floor moves with eyes open) | 30.5 | 54.47 | 0.0273* |
| Conditions (Motor Control Test) | |||
| Sway_AP (Centimeters) | 7.17 | 4.7 | 0.03* |
| RMS_AP (Centimeters) | 1.78 | 1.14 | 0.041* |
| Strength symmetry (Large perturbation backward) | 89 | 102.57 | 0.04* |
Conclusions: Our results indicate that the faller group has vestibular and visuospatial impairment as indicated by statistically significant difference in conditions 1 and 6. Further investigation utilizing Ocular vestibular-evoked myogenic potential (oVEMP) and Slip simulator will help in diagnosis and treatment of balance impairment.
To cite this abstract in AMA style:
A. Lieberman, C. Frames, A. Deep, M. McCauley, S. Shafer. Dynamic and static posturographic analysis among fallers and non- faller Parkinson’s disease (PD) patients using Neurocom SMART EquiTest [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/dynamic-and-static-posturographic-analysis-among-fallers-and-non-faller-parkinsons-disease-pd-patients-using-neurocom-smart-equitest/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/dynamic-and-static-posturographic-analysis-among-fallers-and-non-faller-parkinsons-disease-pd-patients-using-neurocom-smart-equitest/