Dataset Information

Disentangling stability and flexibility degrees in Parkinson's disease using a computational postural control model.

ABSTRACT:

Background

Impaired postural control in Parkinson's disease (PD) seriously compromises life quality. Although balance training improves mobility and postural stability, lack of quantitative studies on the neurophysiological mechanisms of balance training in PD impedes the development of patient-specific therapies. We evaluated the effects of a balance-training program using functional balance and mobility tests, posturography, and a postural control model.

Methods

Center-of-pressure (COP) data of 40 PD patients before and after a 12-session balance-training program, and 20 healthy control subjects were recorded in four conditions with two tasks on a rigid surface (R-tasks) and two on foam. A postural control model was fitted to describe the posturography data. The model comprises a neuromuscular controller, a time delay, and a gain scaling the internal disturbance torque.

Results

Patients' axial rigidity before training resulted in slower COP velocity in R-tasks; which was reflected as lower internal torque gain. Furthermore, patients exhibited poor stability on foam, remarked by abnormal higher sway amplitude. Lower control parameters as well as higher time delay were responsible for patients' abnormal high sway amplitude. Balance training improved all clinical scores on functional balance and mobility. Consistently, improved 'flexibility' appeared as enhanced sway velocity (increased internal torque gain). Balance training also helped patients to develop the 'stability degree' (increase control parameters), and to respond more quickly in unstable condition of stance on foam.

Conclusions

Projection of the common posturography measures on a postural control model provided a quantitative framework for unraveling the neurophysiological factors and different recovery mechanisms in impaired postural control in PD.

SUBMITTER: Rahmati Z

PROVIDER: S-EPMC6694532 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Disentangling stability and flexibility degrees in Parkinson's disease using a computational postural control model.

Rahmati Zahra Z Schouten Alfred C AC Behzadipour Saeed S Taghizadeh Ghorban G Firoozbakhsh Keikhosrow K

Journal of neuroengineering and rehabilitation 20190814 1

<h4>Background</h4>Impaired postural control in Parkinson's disease (PD) seriously compromises life quality. Although balance training improves mobility and postural stability, lack of quantitative studies on the neurophysiological mechanisms of balance training in PD impedes the development of patient-specific therapies. We evaluated the effects of a balance-training program using functional balance and mobility tests, posturography, and a postural control model.<h4>Methods</h4>Center-of-pressu ...[more]

PMID: 31412926

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Project description:Patients with Parkinson's disease have substantially impaired balance, leading to diminished functional ability and an increased risk of falling. Although exercise is routinely encouraged by health care providers, few programs have been proven effective.We conducted a randomized, controlled trial to determine whether a tailored tai chi program could improve postural control in patients with idiopathic Parkinson's disease. We randomly assigned 195 patients with stage 1 to 4 disease on the Hoehn and Yahr staging scale (which ranges from 1 to 5, with higher stages indicating more severe disease) to one of three groups: tai chi, resistance training, or stretching. The patients participated in 60-minute exercise sessions twice weekly for 24 weeks. The primary outcomes were changes from baseline in the limits-of-stability test (maximum excursion and directional control; range, 0 to 100%). Secondary outcomes included measures of gait and strength, scores on functional-reach and timed up-and-go tests, motor scores on the Unified Parkinson's Disease Rating Scale, and number of falls.The tai chi group performed consistently better than the resistance-training and stretching groups in maximum excursion (between-group difference in the change from baseline, 5.55 percentage points; 95% confidence interval [CI], 1.12 to 9.97; and 11.98 percentage points; 95% CI, 7.21 to 16.74, respectively) and in directional control (10.45 percentage points; 95% CI, 3.89 to 17.00; and 11.38 percentage points; 95% CI, 5.50 to 17.27, respectively). The tai chi group also performed better than the stretching group in all secondary outcomes and outperformed the resistance-training group in stride length and functional reach. Tai chi lowered the incidence of falls as compared with stretching but not as compared with resistance training. The effects of tai chi training were maintained at 3 months after the intervention. No serious adverse events were observed.Tai chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinson's disease, with additional benefits of improved functional capacity and reduced falls. (Funded by the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT00611481.).

Dataset Information

Disentangling stability and flexibility degrees in Parkinson's disease using a computational postural control model.

Background

Methods

Results

Conclusions

Publications

Disentangling stability and flexibility degrees in Parkinson's disease using a computational postural control model.

Similar Datasets

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