Objective: This study aimed to investigate the associations between balance confidence and gait difficulty, postural instability, and muscle weakness in people with Parkinson’s disease (PD).

Background: Balance confidence is a common and potentially serious problem related with fall risk in people with PD. Gait difficulty, postural instability, and knee muscle weakness are associated with balance confidence in people with PD. However, previous studies have included assessments of gait difficulty and postural instability commonly relying on the Unified Parkinson’s Disease Rating Scale or did not have a control group [1, 2]. Therefore, more research with more robust assessment methods and control group is required.

Method: Thirty-three people with PD and 33 age-gender-matched healthy controls were included. Balance confidence was assessed by the Activities-specific Balance Confidence (ABC) scale. Postural instability was assessed by the Postural Stability (PS) and Limits of Stability (LOS) Tests, administered with a computerized balance assessment device. Hip abductor and knee muscle strength were assessed by a hand-held dynamometer. The 10-meter Walk Test (10MWT) was used to assess gait difficulty. Fall history within the last 6 months was obtained retrospectively.

Results: There was significant difference in fall history, ABC, PST, hip abductor and knee muscle strength, and 10MWT between people with PD and healthy controls (p<0.05). The ABC score was significantly correlated with PS (r=-0.68), LOS (r=0.63), hip abductor muscle strength (r=0.55), and 10MWT (r=-0.79) in people with PD (p<0.05). The ABC scale score was significantly correlated with hip abductor (r=0.55) and knee extensor (r=0.55) muscle strength, and 10MWT (r=-0.52) in healthy controls (p<0.05). PS and fall history were independently associated with the ABC score, accounting for 46% of the variance (p<0.001) in people with PD; whereas, knee extensor muscle strength and 10MWT were independently associated with the ABC score, accounting for 44% of the variance (p<0.001) in healthy controls.

Conclusion: This study has shown that postural instability and fall history are important and independent determinants of balance confidence in people with PD. Improving postural stability could be crucial in promoting balance confidence in PD.

References: 1. Lee HK, Altmann LJ, McFarland N, Hass CJ. The relationship between balance confidence and control in individuals with Parkinson’s disease. Parkinsonism Relat Disord 2016; 26: 24-28. 2. Mak MK, Pang MY, Mok V. Gait difficulty, postural instability, and muscle weakness are associated with fear of falling in people with Parkinson’s disease. Parkinsons Dis 2012; 2012: 901721.

« Back to MDS Virtual Congress 2020

MDS Abstracts - https://www.mdsabstracts.org/abstract/associations-between-balance-confidence-gait-postural-stability-and-muscle-strength-in-people-with-parkinsons-disease/