Parkinson’s Patients with Tendency to Fall Control Balance Differently than Non-Fallers, Study Suggests

Parkinson's fall risk

Parkinson’s disease patients who have a tendency to fall use different strategies to control their balance than those who do not fall, according to a recent study.

The study, “Fallers with Parkinson’s disease exhibit restrictive trunk control during walking,” was published in Gait and Posture.

Due to Parkinson’s-related motor imbalance, falls are a common consequence of the disease, and the risk of falling increases as patients get older and as the disease progresses.

Parkinson’s patients are twice as likely to fall than older adults living independently, and are also nine times more likely to have recurrent falls.

Observational studies suggest these patients underestimate the amount of work necessary for their muscles to produce a certain movement. They compensate for this lack of motor and perceptual ability by adopting distinct postural strategies to keep their balance during both static and dynamic movements.

Static measures of posture control can distinguish Parkinson’s patients from healthy older adults, but not Parkinson’s fallers from non-fallers.

“A better understanding of the relationship between falls and static and dynamic movements may provide further insight into falls-risk assessment in this clinical population,” the researchers said.

To study this, researchers at the University of Ottawa in Canada conducted a study that recruited 25 Parkinson’s patients and 17 healthy older adults used as controls.

They analyzed postural differences between Parkinson’s fallers and non-fallers, based on the self-reported occurrence of falls in the previous three months, and between healthy controls.

Motor disability was measured using the Unified Parkinson’s Disease Rating Scale III, cognitive impairment by the Montreal Cognitive Assessment, and freezing of gait by the Freezing of Gait questionnaire.

Participants were given static and dynamic motor tasks, consisting of one quiet standing condition and one walking condition (walking 15 meters while looking straight ahead).

Both tasks were presented twice and lasted for 30 seconds. Testing was performed while patients were optimally medicated with dopaminergic therapies.

The standing test was sensitive enough to distinguish between Parkinson’s patients and healthy controls, but not between fallers and non-fallers with Parkinson’s disease. However, static tasks were less sensitive in differentiating between fallers and non-fallers with Parkinson’s disease and healthy older adults than dynamic tasks.

Fallers had difficulty controlling their upper body (torso) when walking, compared with non-fallers and the control group. This was also true for individuals with Parkinson’s disease versus older healthy adults.

Importantly, falling was associated with static and dynamic postural control in Parkinson’s patients, with fallers and non-fallers adopting different postural strategies to regulate balance.

“Overall, this study provides useful information for falls-risk assessments as well as for developing fall prevention program specific to fallers and non-fallers with PD,” the researchers concluded.

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Source: Parkinson’s News Today

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What Is Helping Me the Most in My Parkinson’s Battle?

 

No two Parkinson’s disease patients are alike

I am slowly coming to realize that each diagnosis of Parkinson’s disease (PD) is unique. PD patients suffer different symptoms and different rates of disease progression. Some remedies work for some, and not for others.

In many cases, those of us with PD are left to our own devices. Doctors can only suggest options for us. As for medications, in the end, we must listen to our bodies very carefully to determine what will and what won’t work. The ultimate goal is to find the right “cocktail” of drugs so that PD symptoms are masked and there are few or manageable side effects. Sadly, my experience has been that changes in medications and dosages have not given me aha! moments where I can see a significant reduction in symptoms. If there are any improvements, they are extremely subtle.

Is it the weather?

Many of my fellow PD sufferers have shared their struggles with the appearance of a possible new symptom or worsening of existing symptoms. Is it something we ate? Or do we chalk it up to a bad PD day? Could it be fluctuations in barometric pressure or is it part of the normal aging process? Is our disease progressing or have we taken our medications at the wrong times? Should we have eaten more food or had more water with our pills? Did we get enough sleep or are we too stressed? The list goes on and on. With PD, there is so much uncertainty. It is very difficult to determine what is helping my symptoms or slowing the disease progression, and what is not.

What do I think has helped me the most?

I leave no stone unturned in my efforts to combat this disease, especially when it comes to exercise and movement alternatives.

In September 2017, I started Rock Steady Boxing twice a week.

Boxing has been one of the most effective tools in my arsenal for fighting PD. It has given me the confidence to feel like the athlete I once was. Boxing helps me improve my stamina, speed, and strength, and the participants (everyone in the class has PD) offer great support and camaraderie. As I set out on my one-hour commute to Rock Steady Boxing class twice a week and put on my hand wraps and gloves, I truly feel like a warrior getting ready for battle.

helping
(Photo by Michael Heller)

Boxing and movement, in general, have helped me the most in my daily struggles with this disease. In no particular order, I also credit the following with helping me in my war against PD:

  • Physical therapy once a week (for balance)
  • Massage once or twice a week (for stiffness and rigidity)
  • Yoga two times per week and meditation for 20 minutes up to five times per week (to train me to be in the moment, and not focus on the prognosis of this disease)
  • Attitude adjustment (accepting that I have this disease and counting my blessings)
  • Sinemet (carbidopa-levodopa), medication to relieve internal tremors

Treating PD appears to be all about finding the right combination of some or all of the following components:

  • Exercise
  • Diet
  • Supplements
  • Prescription medications

A formula for one PD patient may not work for another PD patient, and the plan must continuously be tweaked. As difficult as it is, we must reduce our stress levels. I believe both good and bad stress exacerbate our symptoms.

In a future column, I will share some of my experiences with the Rock Steady Boxing classes.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

The post What Is Helping Me the Most in My Parkinson’s Battle? appeared first on Parkinson’s News Today.

 

2018 Parkinson’s Symposium

The Parkinson Association of Alabama (PAA) is again thrilled to host a Parkinson’s Symposium on Saturday, September 15 from 8:30AM to 2:00 PM at The Club (Ballroom) in Birmingham.

Our annual symposium draws PD patients, caregivers, and loved ones from all over Alabama to engage multiple thought leaders who are experts in Parkinson’s Disease research, treatment, care and other focus areas. Whether you’re a PD patient, caregiver, medical professionaladvocate, or simply want know more about this complex disease – the Parkinson’s Symposium offers something for everyone.

We encourage everyone interested in attending the Symposium to register online using this link. A registration fee of $20 per person is requested, but not required, and includes lunch.

Follow us on Facebook, Twitter, or Instagram for the latest Symposium news or email the PAA Executive Director, Mary T Miller, for more information.

Tanner Foundation Neurological Conference

The Tanner Foundation for Neurological Diseases will host its annual Neurological Conference on October 19, 2017 from 8am – 4pm at the Canterbury Methodist Church conference facility in Birmingham.

Approved CEU tracks will be available – ALS, MS and Parkinson’s Disease – with experts from each field of practice speaking in regard to the latest update in diagnosis and treatment practice parameters.

Click this link to register for the conference or obtain additional information. (Scroll to bottom of page for conference registration link)