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. 2011 Aug;17(7):557-62.
doi: 10.1016/j.parkreldis.2011.05.010. Epub 2011 Jun 8.

Trunk accelerometry reveals postural instability in untreated Parkinson's disease

Martina Mancini  1 , Fay B Horak, Cris Zampieri, Patricia Carlson-Kuhta, John G Nutt, Lorenzo Chiari
Affiliations

Trunk accelerometry reveals postural instability in untreated Parkinson's disease

Martina Mancini et al. Parkinsonism Relat Disord. 2011 Aug.

Abstract

While several studies have shown that subjects with advanced Parkinson's disease (PD) exhibit abnormalities in sway parameters during quiet standing, abnormalities of postural sway associated with untreated PD have not been reported. Although not clinically apparent, we hypothesized that spontaneous sway in quiet stance is abnormal in people with untreated PD. We examined 13 subjects, recently diagnosed with PD, who were not yet taking any anti-parkinsonian medications and 12 healthy, age-matched control subjects. Postural sway was measured with a linear accelerometer on the posterior trunk (L5 level) and compared with traditional force plate measures of sway. Subjects stood for 2 min under two conditions: eyes open (EO) and eyes closed (EC). One of the most discriminative measures of postural changes in subjects with untreated PD was the increased 'JERK' of lower trunk in the EO condition, measured with the accelerometer. Root mean square and the frequency dispersion of postural sway in the EO condition also discriminated sway in untreated PD subjects compared to control subjects. We conclude that accelerometer-based sway metrics could be used as objective measures of postural instability in untreated PD. Accelerometer-based analysis of spontaneous sway may provide a powerful tool for early clinical trials and for monitoring the effects of treatment of balance disorders in subjects with PD.

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Conflict of interest statement

This potential conflict of interest has been reviewed and managed by OHSU.

Figures

Figure 1
Figure 1
(A) Center of pressure and (B) corresponding lower trunk acceleration trajectories in the horizontal plane for two representative subjects in the eyes open condition. Left: control subject. Right: untreated PD (P2 in Table 1).
Figure 2
Figure 2
ROC curves in the eyes open condition for: A) COP parameters, B) lower trunk acceleration parameters. AUC= area under the curve for each parameter. CI=confidence interval.
Figure 3
Figure 3
Comparison of group mean JERK in PD and control subjects. The mean values (±S.E.M) of JERK of the lower trunk is presented. Significant differences, after Bonferroni correction, are showed with ** p<0.01.
Figure 4
Figure 4
UPDRS Motor score versus JERK in PD subjects.
See this image and copyright information in PMC

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