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  Česky / Czech version Čes. a slov. Neurol. Neurochir., 67/100, 2004, No. 5, p. 347–353.
 
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
 


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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