Dynamic posturography and posturographic training for Parkinson's disease in a routine clinical setting.
Identifieur interne : 000017 ( Main/Corpus ); précédent : 000016; suivant : 000018Dynamic posturography and posturographic training for Parkinson's disease in a routine clinical setting.
Auteurs : Jan Raethjen ; Paul Raethjen ; Barbara Schmalbach ; Gunnar WasnerSource :
- Gait & posture [ 1879-2219 ] ; 2020.
Abstract
BACKGROUND
Postural instability in Parkinson's disease (PD) often is ill-responsive to drugs and DBS. Physiotherapy is recommended but practicability and cost effectiveness are debatable.
RESEARCH QUESTION
Can a simple 'plug and play' posturography system produce clinically meaningful measures and elicit postural motor learning in PD patients?
METHODS
40 moderately affected PD patients in a general neurology outpatient clinic who complained of postural instability were included to practice shifts and stabilization of the center of pressure (COP) in a low intensity (once weekly 20-25 minutes over 6 weeks) dynamic posturographic training using the Biodex balance system
RESULTS
Posturographic performance was significantly better with eyes open than closed and more so with explicit visual feedback of COP position (p < 0.005). Only with this latter type of feedback and only the deviation form the BOS in dynamic and static posturography was significantly correlated with BBS and UPDRS III (p < 0.001). The deviation from the BOS under explicit visual feedback significantly improved after training (p < 0.005) whereas BBS, FES-I and ABC-scale did not.
SIGNIFICANCE
Our posturography procedures were well applicable as a routine clinical tool. They yielded clinically valid measures when COP position was visible and directional shifts from the BOS centre were quantified. Our training was effective for this posturographic measure only. Its significance as a predictor for clinical efficacy of higher intensity and longer term training schedules is hypothesized and warrants further studies.
DOI: 10.1016/j.gaitpost.2020.09.013
PubMed: 33002838
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Electronic address: raethjen@neurologie-raethjen-wasner.de.</nlm:affiliation></affiliation></author><author><name sortKey="Raethjen, Paul" sort="Raethjen, Paul" uniqKey="Raethjen P" first="Paul" last="Raethjen">Paul Raethjen</name><affiliation><nlm:affiliation>Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Schmalbach, Barbara" sort="Schmalbach, Barbara" uniqKey="Schmalbach B" first="Barbara" last="Schmalbach">Barbara Schmalbach</name><affiliation><nlm:affiliation>Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Wasner, Gunnar" sort="Wasner, Gunnar" uniqKey="Wasner G" first="Gunnar" last="Wasner">Gunnar Wasner</name><affiliation><nlm:affiliation>Institute of Applied Neurology, Preußerstr. 1-9, 24105 Kiel, Germany; Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany; University of Kiel, Medical Faculty, Christian-Albrechts-Platz 4, 24116, Kiel, Germany.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:33002838</idno><idno type="pmid">33002838</idno><idno type="doi">10.1016/j.gaitpost.2020.09.013</idno><idno type="wicri:Area/Main/Corpus">000017</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000017</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Dynamic posturography and posturographic training for Parkinson's disease in a routine clinical setting.</title><author><name sortKey="Raethjen, Jan" sort="Raethjen, Jan" uniqKey="Raethjen J" first="Jan" last="Raethjen">Jan Raethjen</name><affiliation><nlm:affiliation>Institute of Applied Neurology, Preußerstr. 1-9, 24105 Kiel, Germany; Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany; University of Kiel, Medical Faculty, Christian-Albrechts-Platz 4, 24116, Kiel, Germany. Electronic address: raethjen@neurologie-raethjen-wasner.de.</nlm:affiliation></affiliation></author><author><name sortKey="Raethjen, Paul" sort="Raethjen, Paul" uniqKey="Raethjen P" first="Paul" last="Raethjen">Paul Raethjen</name><affiliation><nlm:affiliation>Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Schmalbach, Barbara" sort="Schmalbach, Barbara" uniqKey="Schmalbach B" first="Barbara" last="Schmalbach">Barbara Schmalbach</name><affiliation><nlm:affiliation>Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Wasner, Gunnar" sort="Wasner, Gunnar" uniqKey="Wasner G" first="Gunnar" last="Wasner">Gunnar Wasner</name><affiliation><nlm:affiliation>Institute of Applied Neurology, Preußerstr. 1-9, 24105 Kiel, Germany; Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany; University of Kiel, Medical Faculty, Christian-Albrechts-Platz 4, 24116, Kiel, Germany.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Gait & posture</title><idno type="eISSN">1879-2219</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Postural instability in Parkinson's disease (PD) often is ill-responsive to drugs and DBS. Physiotherapy is recommended but practicability and cost effectiveness are debatable.</p></div><div type="abstract" xml:lang="en"><p><b>RESEARCH QUESTION</b></p><p>Can a simple 'plug and play' posturography system produce clinically meaningful measures and elicit postural motor learning in PD patients?</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>40 moderately affected PD patients in a general neurology outpatient clinic who complained of postural instability were included to practice shifts and stabilization of the center of pressure (COP) in a low intensity (once weekly 20-25 minutes over 6 weeks) dynamic posturographic training using the Biodex balance system</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Posturographic performance was significantly better with eyes open than closed and more so with explicit visual feedback of COP position (p < 0.005). Only with this latter type of feedback and only the deviation form the BOS in dynamic and static posturography was significantly correlated with BBS and UPDRS III (p < 0.001). The deviation from the BOS under explicit visual feedback significantly improved after training (p < 0.005) whereas BBS, FES-I and ABC-scale did not.</p></div><div type="abstract" xml:lang="en"><p><b>SIGNIFICANCE</b></p><p>Our posturography procedures were well applicable as a routine clinical tool. They yielded clinically valid measures when COP position was visible and directional shifts from the BOS centre were quantified. Our training was effective for this posturographic measure only. Its significance as a predictor for clinical efficacy of higher intensity and longer term training schedules is hypothesized and warrants further studies.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33002838</PMID><DateRevised><Year>2020</Year><Month>11</Month><Day>02</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-2219</ISSN><JournalIssue CitedMedium="Internet"><Volume>82</Volume><PubDate><Year>2020</Year><Month>Sep</Month><Day>20</Day></PubDate></JournalIssue><Title>Gait & posture</Title><ISOAbbreviation>Gait Posture</ISOAbbreviation></Journal><ArticleTitle>Dynamic posturography and posturographic training for Parkinson's disease in a routine clinical setting.</ArticleTitle><Pagination><MedlinePgn>281-286</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0966-6362(20)30558-0</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.gaitpost.2020.09.013</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Postural instability in Parkinson's disease (PD) often is ill-responsive to drugs and DBS. Physiotherapy is recommended but practicability and cost effectiveness are debatable.</AbstractText><AbstractText Label="RESEARCH QUESTION" NlmCategory="OBJECTIVE">Can a simple 'plug and play' posturography system produce clinically meaningful measures and elicit postural motor learning in PD patients?</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">40 moderately affected PD patients in a general neurology outpatient clinic who complained of postural instability were included to practice shifts and stabilization of the center of pressure (COP) in a low intensity (once weekly 20-25 minutes over 6 weeks) dynamic posturographic training using the Biodex balance system<sup>TM</sup>. Average deviations from mean COP position and from the center of the base of support (BOS) with different degrees of visual feedback in static and dynamic posturographic tasks other than the training tasks, the Berg-Balance-Scale (BBS) and patient self-ratings (FES-I, ABC scale) were assessed before and after training.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Posturographic performance was significantly better with eyes open than closed and more so with explicit visual feedback of COP position (p < 0.005). Only with this latter type of feedback and only the deviation form the BOS in dynamic and static posturography was significantly correlated with BBS and UPDRS III (p < 0.001). The deviation from the BOS under explicit visual feedback significantly improved after training (p < 0.005) whereas BBS, FES-I and ABC-scale did not.</AbstractText><AbstractText Label="SIGNIFICANCE" NlmCategory="CONCLUSIONS">Our posturography procedures were well applicable as a routine clinical tool. They yielded clinically valid measures when COP position was visible and directional shifts from the BOS centre were quantified. Our training was effective for this posturographic measure only. Its significance as a predictor for clinical efficacy of higher intensity and longer term training schedules is hypothesized and warrants further studies.</AbstractText><CopyrightInformation>Copyright © 2020. Published by Elsevier B.V.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Raethjen</LastName><ForeName>Jan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Institute of Applied Neurology, Preußerstr. 1-9, 24105 Kiel, Germany; Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany; University of Kiel, Medical Faculty, Christian-Albrechts-Platz 4, 24116, Kiel, Germany. Electronic address: raethjen@neurologie-raethjen-wasner.de.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Raethjen</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schmalbach</LastName><ForeName>Barbara</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wasner</LastName><ForeName>Gunnar</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Institute of Applied Neurology, Preußerstr. 1-9, 24105 Kiel, Germany; Neurology Outpatient Clinic, Preußerstr. 1-9, 24105 Kiel, Germany; University of Kiel, Medical Faculty, Christian-Albrechts-Platz 4, 24116, Kiel, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>20</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Gait Posture</MedlineTA><NlmUniqueID>9416830</NlmUniqueID><ISSNLinking>0966-6362</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Biodex balance system</Keyword><Keyword MajorTopicYN="N">Feasibility</Keyword><Keyword MajorTopicYN="N">Parkinson’s disease</Keyword><Keyword MajorTopicYN="N">Posturography</Keyword><Keyword MajorTopicYN="N">Training</Keyword><Keyword MajorTopicYN="N">Validation</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>08</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>09</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>10</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>10</Month><Day>1</Day><Hour>20</Hour><Minute>20</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33002838</ArticleId><ArticleId IdType="pii">S0966-6362(20)30558-0</ArticleId><ArticleId IdType="doi">10.1016/j.gaitpost.2020.09.013</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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