title: Effects of Levodopa on Postural Strategies in Parkinson's disease.
abstract: Altered postural control and balance are major disabling issues of Parkinson's disease (PD). Static and dynamic posturography have provided insight into PD's postural deficits; however, little is known about impairments in postural coordination. We hypothesized that subjects with PD would show more ankle strategy during quiet stance than healthy control subjects, who would include some hip strategy, and this stiffer postural strategy would increase with disease progression. We quantified postural strategy and sway dispersion with inertial sensors (one placed on the shank and one on the posterior trunk at L5 level) while subjects were standing still with their eyes open. A total of 70 subjects with PD, including a mild group (H&Y≤2, N=33) and a more severe group (H&Y≥3, N=37), were assessed while OFF and while ON levodopa medication. We also included a healthy control group (N=21). Results showed an overall preference of ankle strategy in all groups while maintaining balance. Postural strategy was significantly lower ON compared to OFF medication (indicating more hip strategy), but no effect of disease stage was found. Instead, sway dispersion was significantly larger in ON compared to OFF medication, and significantly larger in the more severe PD group compared to the mild. In addition, increased hip strategy during stance was associated with poorer self-perception of balance.
authors.affiliation: Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy. Electronic address: Chiara.baston@unibo.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Baston
authors.affiliation: Veterans Affairs Portland Health Care System, 3710 SW Us Veteran Hospital Rd, Portland, OR 97239, USA. Electronic address: mancinim@ohsu.edu.
authors.forename: Martina
authors.initials: M
authors.lastname: Mancini
authors.affiliation: Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy. Electronic address: l.rocchi@unibo.it.
authors.forename: Laura
authors.initials: L
authors.lastname: Rocchi
authors.affiliation: Veterans Affairs Portland Health Care System, 3710 SW Us Veteran Hospital Rd, Portland, OR 97239, USA; Department of Neurology, School of Medicine, Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR 97239-3098, USA. Electronic address: horakf@ohsu.edu.
authors.forename: Fay
authors.initials: F
authors.lastname: Horak
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004856:Postural Balance / Q000187:drug effects*; D011187:Posture
chemical_list: D007980:Levodopa
keywords: Levodopa; Parkinson's disease; Postural strategy