Disentangling stability and flexibility degrees in Parkinson's disease using a computational postural control model.
Zahra Rahmati, Alfred C Schouten, Saeed Behzadipour and 2 others
PMID 31412926WHAT IT FOUND
Parkinson's patients improved balance scores after a multi-component training program.
A sway model suggested training increased corrective ankle control on foam and sway amplitude scaling on firm ground, but the program's parts cannot be separated.
Key findings
01After the 12-session balance-training program, Berg Balance Scale rose from 50.8 to 53.2, Functional Reach Test rose from 26.87 to 30.69 cm, and Timed Up and Go fell from 9.11 to 7.70 seconds, each with p<0.001.
02The model's corrective-torque parameter (Kp) was lower in patients before training and rose after training on foam tasks; the sway-amplitude parameter (Kn) was lower in patients before training and rose after training on firm-surface tasks.
03Only changes in Δtc on foam tasks correlated with improved Functional Reach Test scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a secondary analysis of data from an earlier randomised clinical trial, not a new trial that isolated the training effect. The training program combined balance exercises with different sensory stimulation and conventional rehabilitation, so the contribution of any single component cannot be separated. The sample was small and included few women: 40 patients and 20 controls, with 7 female patients and 4 female controls. Patients were tested only in the medication-on state, so the results may not apply to the medication-off state. The model used only a single-plane inverted pendulum and did not include hip strategy, sideways sway, or passive ankle stiffness and damping.
The easy way to misread this
Do not read the improved model parameters as evidence that a specific balance exercise caused the improvement. The patients received balance exercises with different sensory stimulation and conventional rehabilitation together, so the contribution of any single component cannot be separated.