title: The effects of brain stimulation of subthalamic nucleus surgery on gait and balance performance in Parkinson disease. A pilot study.
abstract: BACKGROUND
  Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by tremor, rigidity and bradykinesia. Gait and postural difficulties supersede tremor, rigidity and bradykinesia as drivers of disease burden in patients with advanced PD. The aim of this study was to describe the effects of deep brain stimulation of the subthalamic nucleus on gait ability and balance performance in patients with PD.
  
  
  METHODS
  We studied 19 consecutive patients who underwent bilateral stimulation of the subthalamic nucleus. Patients were evaluated preoperatively and at the 5(th) day and 6(th) month after surgery. Timed Up and Go Test, 12 m Walking Test, Chair Stand Test and Berg Balance Scale (BBS) were used to assess mobility and balance performance. Unified Parkinson's Disease Rating Scale (UPDRS III) and Hoehn and Yahr Scale were also used.
  
  
  RESULTS
  All the patients' mobility ability and balance performance improved after surgery (p < 0.05). At the 6th month after surgery, the Timed Up and Go Test scores were decreased from 56.05 ±42.52 to 21.47 ±20.36, the 12 m Walking Test scores were decreased from 100.44 ±66.44 to 28.84 ±19.79, the Chair Stand Test scores were increased from 4.00 ±4.66 to 11.68 ±4.43 and the BBS score was increased from 12.84 ±6.89 to 38.89 ±8.79. UPDRS total scores were significantly improved 6 months after surgery (p < 0.001). UPDRS total scores were decreased from 98.26 ±37.69 to 39.36 ±18.85. The Hoehn and Yahr Scale score was significantly decreased after surgery (p < 0.05).
  
  
  CONCLUSIONS
  Surgical therapy is an effective treatment to improve gait ability and balance performance in Parkinson's patients.
authors.affiliation: School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Altuğ
authors.affiliation: Department of Neurosurgery, Pamukkale University, Denizli, Turkey.
authors.forename: Feridun
authors.initials: F
authors.lastname: Acar
authors.affiliation: Department of Neurology, Pamukkale University, Denizli, Turkey.
authors.forename: Göksemin
authors.initials: G
authors.lastname: Acar
authors.affiliation: School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey.
authors.forename: Uğur
authors.initials: U
authors.lastname: Cavlak
keywords: Parkinson's disease; balance performance; gait ability; subthalamic nucleus