MANAGEMENT OF POSTURAL SENSORY CONFLICT AND DYNAMIC BALANCE CONTROL IN LATE-STAGE PARKINSON'S DISEASE

被引:42
作者
Colnat-Coulbois, S. [1 ,2 ,3 ]
Gauchard, G. C. [1 ,2 ]
Maillard, L. [4 ,5 ]
Barroche, G. [4 ]
Vespignani, H. [4 ]
Auque, J. [3 ]
Perrin, P. P. [2 ,6 ]
机构
[1] INSERM, Themat Grp Neurodegenerat Dis, Fac Med, U 954, Vandoeuvre Les Nancy, France
[2] Henri Poincare Univ Balance Control & Motor Perfo, Nancy Univ, UFR STAPS, Vandoeuvre Les Nancy, France
[3] Univ Hosp Nancy, Dept Neurosurg, Nancy, France
[4] Univ Hosp Nancy, Dept Neurol, Nancy, France
[5] Nancy Univ, CNRS, CRAN, UMR 7039, Nancy, France
[6] Univ Hosp Nancy, Dept ENT, Nancy, France
关键词
advanced Parkinson's disease; static and dynamic postural control; sensory conflict; postural sensorimotor strategies; STIMULATION IMPROVES; INSTABILITY; ADAPTATION; SWAY; EQUILIBRIUM; INTEGRATION; STRENGTH; DEFICITS; STANCE; FALLS;
D O I
10.1016/j.neuroscience.2011.04.043
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Parkinson's disease (PD) is known to affect postural control, especially in situations needing a change in balance strategy or when a concurrent task is simultaneously performed. However, few studies assessing postural control in patients with PD included homogeneous population in late stage of the disease. Thus, this study aimed to analyse postural control and strategies in a homogeneous population of patients with idiopathic advanced (late-stage) PD, and to determine the contribution of peripheral inputs in simple and more complex postural tasks, such as sensory conflicting and dynamic tasks. Twenty-four subjects with advanced PD (duration: median (M)=11.0 years, interquartile range (IQR)=4.3 years; Unified Parkinson's Disease Rating Scale (UPDRS): M "on-dopa"=13.5, IQR=7.8; UPDRS: M "off-dopa"=48.5, IQR=16.8; Hoehn and Yahr stage IV in all patients) and 48 age-matched healthy controls underwent static (SPT) and dynamic posturographic (DPT) tests and a sensory organization test (SOT). In SPT, patients with PD showed reduced postural control precision with increased oscillations in both anterior posterior and medial lateral planes. In SOT, patients with PD displayed reduced postural performances especially in situations in which visual and vestibular cues became predominant to organize balance control, as was the ability to manage balance in situations for which visual or proprioceptive inputs are disrupted. In OPT, postural restabilization strategies were often inefficient to maintain equilibrium resulting in falls. Postural strategies were often precarious, postural regulation involving more hip joint than ankle joint in patients with advanced PD than in controls. Difficulties in managing complex postural situations, such as sensory conflicting and dynamic situations might reflect an inadequate sensory organization suggesting impairment in central information processing. (C) 2011 Published by Elsevier Ltd on behalf of IBRO.
引用
收藏
页码:363 / 369
页数:7
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