Session Information
Date: Wednesday, June 22, 2016
Session Title: Phenomenology and clinical assessment of movement disorders
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: Since it has been argued that PD+FOG have greater sensory impairments compared to PD-FOG, the current study evaluated whether the modified Clinical Test of Sensory Interaction on Balance (m-CTSIB) could detect balance impairments in PD+FOG. Additionally, since it remains debatable how anti-Parkinson medication effects balance and sensory impairments, PD participants were also assessed on the m-CTSIB in both their ON and OFF medication states.
Background: Freezing of gait (FOG) is one of the most debilitating symptoms of Parkinson’s disease (PD) where patients report feeling as though their feet are glued to the floor and are unable to produce their next step when walking. FOG eventually develops in nearly 50% of individuals with PD, and is also one of the leading causes of falls in PD which has a huge impact on quality of life, morbidity and mortality. Although previous research has identified greater balance deficits in those with FOG (PD+FOG) compared to those without FOG (PD-FOG), there has been very little evidence that clinical balance tests can detect these differences, especially during quiet stance.
Methods: The modified Clinical Test of Sensory Interaction on Balance was carried out with fifty participants in total (21 older adults, 16 PD-FOG, 13 PD+FOG). All participants stood on a BioDex sensor plate in four different sensory feedback trials: (i) firm surface with eyes open, (ii) firm surface with eyes closed, (iii) foam surface with eyes open, (iv) foam surface with eyes closed.
Results: PD+FOG had significantly worse balance (i.e. greater sway index) compared to older adults but only when standing in their ON state on the firm surface with their eyes closed (F(2,49)=3.84, p=0.028). Additionally, anti-Parkinson medication significantly worsened balance in all PD participants (F(1,22)=8.48, p=0.008).
Conclusions: Although the m-CTSIB (specifically the eyes closed condition) was able to differentiate PD+FOG from healthy older adults and also detect worsening balance from anti-Parkinson medication, it was unable to discriminate between PD+FOG and PD-FOG. Since group differences were only detectable during the eyes closed condition in the ON state, future research may want to consider proprioceptive sensitive clinical measures to better quantify balance deficits in PD+FOG.
To cite this abstract in AMA style:
K.A. Ehgoetz Martens, C.G. Ellard, Q.J. Almeida. Improving clinical detection of balance deficits in individuals with Parkinson’s disease with and without freezing of gait and the effects of dopaminergic replacement therapy [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/improving-clinical-detection-of-balance-deficits-in-individuals-with-parkinsons-disease-with-and-without-freezing-of-gait-and-the-effects-of-dopaminergic-replacement-therapy/. Accessed May 13, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/improving-clinical-detection-of-balance-deficits-in-individuals-with-parkinsons-disease-with-and-without-freezing-of-gait-and-the-effects-of-dopaminergic-replacement-therapy/