Session Information
Date: Tuesday, September 24, 2019
Session Title: Parkinsonisms and Parkinson-Plus
Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: To investigate whether Freezing of Gait (FoG) impacts functional Limits of Stability (fLoS) and postural sway during quiet stance and dynamic balance in a cohort of 144 people with Parkinson’s disease (PD).
Background: Balance is a complex construct with many contributing physiological systems. fLoS, defined as the voluntary maximum leaning forward or backward without taking a step, has been found to be related to perceived balance impairment in people with PD. People with PD experiencing FoG have worse perceived balance impairments compared to those who do not freeze. However, it is not clear if people with PD and FoG show worse balance impairments compared to people with PD with no reported FoG.
Method: Sixty-four people with FoG (PD+FoG, age: 68±8, MDS-UPDRS III: 46±12) and 80 non-freezers (PD-FoG, age: 69±8, MDS-UPDRS III: 36±11) were tested off medication and compared with 79 healthy control subjects (HC, age: 68±8). All participants wore inertial sensors while performing a standing balance and LoS task. Subjects were asked to lean forward and backward as far as possible in LoS task, and fLoS was defined by the maximum displacement in the forward and backward directions. In addition, sway area was measured both on firm and foam surfaces with eyes open. Standardized Mean Difference (SMD) was used to determine the effect size between each group. In addition, the Mini-BESTest was used as a clinical measure of dynamic balance.
Results: PD+FoG (21±7cm) had significantly smaller fLoS compared to PD-FoG (27±11cm, p=0.01, SMD=-0.58) and HC (29±11cm, p<0.001, SMD=-0.83). In addition, both of PD subgroups showed larger postural sway on foam surface (>0.3m2/s4, p < 0.05, SMD>0.5) compared to HC (<0.2 m2/s4), but there were no significant differences in postural sway between PD with and without FoG (p = 1.0). Lastly, PD+FoG (17±5) scored worse in the Mini-BESTest compared to PD-FoG (20±4) and HC (24±3).
Conclusion: As expected people with PD showed several balance impairments in fLoS, standing balance, and the clinical Mini-BESTest compared to HC. Interestingly, FoG seems to further impact specific domains of balance such as fLoS, but not postural balance during quiet stance.
To cite this abstract in AMA style:
N. Hasegawa, K. Maas, V. Shah, P. Carlson-Kuhta, J. Nutt, F. Horak, T. Asaka, M. Mancini. Functional Limits of Stability and Standing Balance in people with and without Freezing of Gait [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/functional-limits-of-stability-and-standing-balance-in-people-with-and-without-freezing-of-gait/. Accessed May 15, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/functional-limits-of-stability-and-standing-balance-in-people-with-and-without-freezing-of-gait/