[Postural strategies and falls in elderly and in parkinsonism].
OBJECTIVE
To use a posture analysis to show the evolution of postural pattern connected with falls.


METHODS
It is a prospective study on two groups of 16 persons of more than 60 years. A group concerns 16 small disability off drug parkinsonian patients, a group concerns 16 healthy witnesses. All the persons benefited from a posture recording by means of a force platform and were followed during 1 year.


RESULTS
Data analysis underlines three groups of persons corresponding to three postural patterns, independently of the presence of Parkinson disease. A group (n = 18) did not contain fallers, the second (n = 10 ) contained 20% of fallers, the third (n = 4) contained 100% of fallers. Differences between the groups were identified on 16 posturographic parameters.


CONCLUSIONS
A group has a good functional value and one does not record any fall. Its characteristics, which correspond to a category of persons who compensate well for the phenomena of ageing, are found in the literature. A group has an intermediate functional value and regrets 20% of fallers. Kinetic profile reveals a tendency to the stiffness of the posture. This group is going to operate rather ankle strategies. A group has an inferior functional value and regrets 100% of fallers. Kinetic profile seems disrupted and not to be able to adapt itself in a satisfactory way to the situation otherwise than by stereotypical reactions. This group is going to operate systematically much less stabilizing hip strategies.


CONCLUSIONS
A close determinism between physiological neuromotor ageing and Parkinson disease does exist. We showed with a prospective follow-up, the arisen of fall and showed the evolution of postural patterns related to fall. It appears as well that evolution mainly follows three stages leading from a small risk of fall gait pattern to a major risk of fall gait pattern.
Kemoun
G
G
Elan : Service de rééducation fonctionnelle et de réentraînement à l'effort, CH de Wattrelos, rue du Docteur Alexander-Fleming, France. gkemoun@nordnet.fr
Watelain
E
E
Defebvre
L
L
Guieu
J D
JD
Destee
A
A
D000058:Accidental Falls; D000368:Aged; D006233:Persons with Disabilities; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000150:complications*; D011187:Posture; D012307:Risk Factors