title: Time-dependent changes in postural control in early Parkinson's disease: what are we missing?
abstract: Impaired postural control (PC) is an important feature of Parkinson's disease (PD), but optimal testing protocols are yet to be established. Accelerometer-based monitors provide objective measures of PC. We characterised time-dependent changes in PC in people with PD and controls during standing, and identified outcomes most sensitive to pathology. Thirty-one controls and 26 PD patients were recruited: PC was measured with an accelerometer on the lower back for 2 minutes (mins). Preliminary analysis (autocorrelation) that showed 2 seconds (s) was the shortest duration sensitive to changes in the signal; time series analysis of a range of PC outcomes was undertaken using consecutive 2-s windows over the test. Piecewise linear regression was used to fit the time series data during the first 30 s and the subsequent 90 s of the trial. PC outcomes changed over the 2 mins, with the greatest change observed during the first 30 s after which PC stabilised. Changes in PC were reduced in PD compared to controls, and Jerk was found to be discriminative of pathology. Previous studies focusing on average performance over the duration of a test may miss time-dependent differences. Evaluation of time-dependent change may provide useful insights into PC in PD and effectiveness of intervention.
authors.affiliation: Clinical Ageing Research Unit, Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
authors.forename: Silvia
authors.initials: S
authors.lastname: Del Din
authors.affiliation: Clinical Ageing Research Unit, Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Godfrey
authors.affiliation: Industrial Statistics Research Unit, Newcastle University, Herschel Building, Newcastle upon Tyne, NE1 7RU, UK.
authors.forename: Shirley
authors.initials: S
authors.lastname: Coleman
authors.affiliation: Clinical Ageing Research Unit, Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
authors.forename: Brook
authors.initials: B
authors.lastname: Galna
authors.affiliation: Clinical Ageing Research Unit, Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Lord
authors.affiliation: Clinical Ageing Research Unit, Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK. lynn.rochester@ncl.ac.uk.
authors.forename: Lynn
authors.initials: L
authors.lastname: Rochester
mesh_terms: D061725:Accelerometry / Q000295:instrumentation; D000368:Aged; D016022:Case-Control Studies; D003710:Demography; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D010300:Parkinson Disease / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology*; D013997:Time Factors
keywords: Accelerometer; Jerk; Parkinson’s; Postural control; Time series