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Can stooped posture explain multidirectional postural instability in patients with Parkinson’s disease?

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Abstract

To determine the effects of the stooped posture of patients with Parkinson’s disease (PD) on postural stability, we compared the kinetic, kinematic, and electromyographic responses of seven subjects with PD and 11 control subjects to eight directions of surface translations. Control subjects were studied in an upright posture and in a stooped posture that mimicked the posture of the PD subjects. When control subjects adopted a stooped posture, peak center of pressure displacements slowed and decreased, reducing stability margins toward values observed in PD subjects. Stooped control subjects, however, responded to translations with large joint angle displacements, whereas PD subjects exhibited small joint angle displacements. Stooping in control subjects did not lead to abnormally directed horizontal forces under each foot or antagonistic muscle co-activation at the hip and trunk, as seen in PD subjects. Upright and stooped control subjects never fell during the trials, whereas PD subjects fell in 16% of the trials. We conclude that stooped posture is a destabilizing posture, but it does not account for abnormal postural responses in PD.

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Acknowledgements

The authors thank Martine Mientjes for data analysis, Gary Sexton for advice on statistical procedures (supported by PHS grant 5 M01 RR000334); Jill Knop for figure graphics; and Sandra Oster, Leta Guptill, and Patricia Carlson-Kuhta for editorial assistance. This research was supported by NIH grant AG-06457 (Dr. Horak) and HSFPO SF0011/1999-B (Dr. Dimitrova).

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Authors and Affiliations

  1. Neurological Sciences Institute, Oregon Health& Science University, 505 NW 185th Avenue, Beaverton, Portland, OR, 97006-3499, USA

    Jesse V. Jacobs, Diana M. Dimitrova & Fay B. Horak

  2. Department of Neurology, Oregon Health& Science University, Portland, Ore., USA

    John G. Nutt & Fay B. Horak

  3. Department of Physiology& Pharmacology, Oregon Health& Science University, Portland, Ore., USA

    John G. Nutt & Fay B. Horak

  4. Portland VAMC Parkinson Disease Research, Education and Clinical Center, Portland, Ore., USA

    John G. Nutt

  5. Dept. of Biomedical Engineering, Oregon Health& Science University, Portland, Ore., USA

    Fay B. Horak

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  1. Jesse V. Jacobs
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  2. Diana M. Dimitrova
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  3. John G. Nutt
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  4. Fay B. Horak
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Correspondence to Fay B. Horak.

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Jacobs, J.V., Dimitrova, D.M., Nutt, J.G. et al. Can stooped posture explain multidirectional postural instability in patients with Parkinson’s disease?. Exp Brain Res 166, 78–88 (2005). https://doi.org/10.1007/s00221-005-2346-2

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  • DOI: https://doi.org/10.1007/s00221-005-2346-2

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