Session Information
Date: Wednesday, June 7, 2017
Session Title: Phenomenology and Clinical Assessment Of Movement Disorders
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective:
To identify clinical determinants for postural instability and gait difficulty in persons with Parkinson’s disease (PD).
Background:
Gait deficits and postural instability in persons with Parkinson’s disease (PD) are common and inevitable problems, especially as PD progresses. Simple clinical tests can be used to quickly identify these deficits and can be helpful in providing proper management and quantify outcomes of clinical care. Such tests to predict the gait deficits and postural instability have not been reported in the literature yet.
Methods:
Cross-sectional study was performed in ninety-one persons (68 Males; 74.73%) with idiopathic PD. Their mean age was 68.73 ± 8.74 years. The average time since diagnosis was 7.69 ± 5.23 years. The average Hoehn and Yahr stage was 2.43 ± 0.44. Age, gender, disease duration, disease severity and motor impairment were recorded. Participants were asked to perform functional timed tests including timed 5-step test, turning, forward walk, backward walk, and sideways walk. The functional timed tests were investigated for their contribution to the prediction of postural instability and gait difficulty (PIGD). PIGD score was a composite score of five items (falling, freezing, walking, gait and postural stability) of the Unified Parkinson Disease Rating Scale (UPDRS).
Results:
PIGD score was significantly correlated with Hoehn and Yahr (P<.001), (UPDRS) motor score (P=.004), gait speed of forward, backward and sideways walks (P<.001 for all) and time to turn (P<.001). PIGD index was marginally significantly correlated with timed 5-step test (P=.05). After controlling for age, disease duration, disease severity and motor impairment, sideway gait speed (β =-.335; P=.022), timed 5-step test (β = -.397; P =.003) and time to turn (β=.288; P=.027) contributed significantly to postural instability and gait difficulty.
Conclusions:
Walking sideways, 5-step test and turning are significant predictors of PIGD index. These simple, timed tests can be quickly applied in clinical practice to determine postural instability and gait problems in persons with PD.
References: 1. Bronte-Stewart HM, Minn AY, Rodrigues K, et al. Postural instability in idiopathic Parkinson’s disease: the role of medication and unilateral pallidotomy. Brain 2002;125:2100–14.
2. Landers MR, Backlund A, Davenport J, et al. Postural instability in idiopathic Parkinson’s disease: discriminating fallers from nonfallers based on standardized clinical measures. J Neurol Phys Ther 2008; 32:56–61.
To cite this abstract in AMA style:
M. Bryant, J.-G. Hou, F. Jamal, G. Jackson, C. Workman, E. Protas. Predictive Ability of Clinical Timed Tests for Postural Instability and Gait Difficulty in Parkinson’s Disease [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/predictive-ability-of-clinical-timed-tests-for-postural-instability-and-gait-difficulty-in-parkinsons-disease/. Accessed June 14, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/predictive-ability-of-clinical-timed-tests-for-postural-instability-and-gait-difficulty-in-parkinsons-disease/