Objective: To determine (1) whether people with Parkinson’s disease (PD) experience an impaired sense of proprioception in the ankles and (2) if this relates to their history of falls and quality of life.

Background: PD is a progressive neurological disorder frequently characterised by balance impairment and can present with a lack of both limb and trunk awareness, also known as proprioception. A reduction in, or lack of, proprioception is directly correlated with reduced independence and falls. The motor symptoms displayed in PD may be in part due to the failure to evaluate and map proprioceptive information onto motor commands. PD patients can still execute motor tasks but they lack precision and have altered postural reflexes to maintain balance during these tasks.

Methods: A cross-sectional observational study of ankle proprioception of people with mid stages Parkinson’s disease and healthy age-matched controls was carried out. Outcomes were measured on one occasion. Proprioception of ankle inversion/eversion and dorsiflexion/plantarflexion was measured bilaterally, with the participant in standing, using the Active Movement Extent Discrimination Assessment (AMEDA) device.

Results: 13 participants with mild to moderate PD (age M= 71.31) and 14 age matched controls (age M= 66.21) participated. Area under the ROC curve was calculated for each data set generated by the AMEDA. Unpaired t-tests were conducted, showing significance between scores of inversion on both feet (left p= 0.002, right p= 0.01). Confidence intervals (95%) for inversion are 0.07 (0.03-0.11) for the left foot and 0.07 (0.02-0.12) for the right, with the minimally important difference being 0.05. While approaching significance, it was not reached on scores of dorsiflexion (left p=0.349, right p= 0.204). An unpaired t-test was run to determine the difference between the two groups when all 4 AMEDA measurements for each participant were averaged and this was found to be statistically significant (p= 0.0162). No correlation was found between age and average AMEDA scores.

Conclusions: Proprioception of the ankle is impaired in people with PD compared with healthy aged matched controls. Further research to determine whether this can be trained, and whether training can reduce falls risk and increase quality of life, is warranted.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/active-movement-discrimination-of-the-ankle-in-parkinsons-disease/