title: Changes in postural control in patients with Parkinson's disease: a posturographic study.
abstract: OBJECTIVE
  Postural instability is one of the most disabling features in Parkinson's disease (PD), and often leads to falls that reduce mobility and functional capacity. The objectives of this study were to analyse the limit of stability (LOS) and influence of the manipulation of visual, somatosensorial and visual-vestibular information on postural control in patients with PD and healthy subjects.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Movement Disorders Unit, university setting.
  
  
  METHODS
  Eighty-two subjects aged between 37 and 83 years: 41 with Parkinson's disease in the 'on' state and 41 healthy subjects with no neurological disorders. Both groups were matched in terms of sex and age.
  
  
  METHODS
  Unified Parkinson's Disease Rating Scale (UPDRS)-motor score, modified Hoehn and Yahr staging, Dynamic Gait Index (DGI) and posturography with integrated virtual reality. The parameters analysed by posturography were LOS area, area of body centre of pressure excursion and balance functional reserve in the standing position in 10 conditions (open and closed eyes, unstable surface with eyes closed, saccadic and optokinetic stimuli, and visual-vestibular interaction).
  
  
  RESULTS
  The mean UPDRS motor score and DGI score were 27 [standard deviation (SD) 14] and 21 (SD 3), respectively. Thirteen participants scored between 0 and 19 points, indicating major risk of falls. Posturographic assessment showed that patients with PD had significantly lower LOS area and balance functional reserve values, and greater body sway area in all posturographic conditions compared with healthy subjects.
  
  
  CONCLUSIONS
  Patients with PD have reduced LOS area and greater postural sway compared with healthy subjects. The deterioration in postural control was significantly associated with major risk of falls.
authors.affiliation: Movement Disorders Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil, São Paulo, SP, Brazil; Balance Rehabilitation and Social Inclusion Post-Graduation Program, Universidade Anhanguera de São Paulo, Brazil, São Paulo, SP, Brazil. Electronic address: flavia.dona@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Doná
authors.affiliation: Movement Disorders Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil, São Paulo, SP, Brazil.
authors.forename: C C
authors.initials: CC
authors.lastname: Aquino
authors.affiliation: Physical Therapy Department, Universidade Federal do Rio Grande do Norte, Brazil, Natal, RN, Brazil.
authors.forename: J M
authors.initials: JM
authors.lastname: Gazzola
authors.affiliation: Movement Disorders Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil, São Paulo, SP, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Borges
authors.affiliation: Movement Disorders Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil, São Paulo, SP, Brazil.
authors.forename: S M C A
authors.initials: SM
authors.lastname: Silva
authors.affiliation: Otorhinolaryngology and Head and Neck Surgery Department, Universidade Federal de São Paulo, Brazil, São Paulo, SP, Brazil.
authors.forename: F F
authors.initials: FF
authors.lastname: Ganança
authors.affiliation: Otorhinolaryngology and Head and Neck Surgery Department, Universidade Federal de São Paulo, Brazil, São Paulo, SP, Brazil.
authors.forename: H H
authors.initials: HH
authors.lastname: Caovilla
authors.affiliation: Movement Disorders Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil, São Paulo, SP, Brazil.
authors.forename: H B
authors.initials: HB
authors.lastname: Ferraz
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology*; D011187:Posture; D012720:Severity of Illness Index
keywords: Accidental falls; Movement disorders; Parkinson's disease; Postural balance