Deterioration of postural stability in the progression of Parkinson's
disease: A posturographic study
Valkovič P.1,2, Krafczyk S.2, Benetin J.1, Šaling M.1, Bötzel K.2
1Neurologická klinika FNsP akademika L. Dérera, Bratislava, 2Neurologische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München |
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Summary:
Introduction. Postural instability and falls reduce quality of life and increase morbidity and mortality
of the patients with Parkinson’s disease (PD). Recognition of the patients in the higher risk of falling
has individual, social and economic consequences. This study is aimed to the specification of postural
sway in the progression of PD and to define optimized posturographic measures which could predict
future falls in PD. Subjects and methods. Twelve early stage PD subjects without postural problems, 15
advanced PD patients with the history of falls and 13 age-matched controls participated in the study.
Postural sway in medio-lateral (ML) and antero-posterior (AP) directions while eyes open and closed
was measured by means of static posturography. Results.AdvancedPD patients were significantly more
unstable in both directions than patients in early stages and elderly controls which did not differ. Ratios
of ML and AP sway showed that patients in advanced stages of PD use distinct strategy of postural
stabilisation predilecting for ML instability versus AP postural activity. Conclusion. General increase
of the sway and ML instability in advanced PD patients with the history of falls seem to be special
variables, which could contribute to the identification of the persons in risk of falling. The ML sway is
controled by hip abductors and adductors, thus physiotherapy should by oriented to improve the
strength and elasticity of these muscles. Future research with the prospective design and larger subject
numbers is needed to confirm results of our study.
Key words:
Parkinson’s disease, postural instability, static posturography, falls
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