Lateral weight transfer deficits reveal balance vulnerability in early-stage Parkinson's disease during trip-perturbed walking.

The study excluded participants with freezing of gait, so findings do not apply to this common and high-risk subgroup. The perturbation was delivered after a fixed number of steps and in one direction, which may have allowed participants to anticipate the trip rather than relying solely on reactive balance. Medication doses were not systematically collected, so the influence of medication variability on balance performance cannot be ruled out. The sample size was small (16 per group), and the cross-sectional design cannot determine whether the observed deficits are primary impairments or compensatory strategies.

Funding was provided by the University of Maryland Advanced Neuromotor Rehabilitation Research Training, an NIA R36 Dissertation Grant, and the Claude D. Pepper Older Americans Independence Center. No commercial conflicts of interest were declared.

Do not assume that patients who pass standard clinical balance tests like the pull test are free from fall risk. This study found that half of the early Parkinson's participants failed to recover stability during a simulated trip despite being classified as having mild or no clinical impairment.