Effect of Externally Cued Training on Dynamic Stability Control During Sit-to-Stand in Patients With Parkinson Disease

Background

Previous studies have shown that people with Parkinson's disease (PwPD) have difficulty performing the sit-to-stand task, due to mobility and stability-related impairments. Despite its importance, limited literature exists on quantification of dynamic stability control in PwPD during this task.

Objective

To examine (1) differences in the control of dynamic stability between PwPD and healthy controls, and (2) the extent to which externally-cued training can improve such control during sit-to-stand in PwPD.

Design

Quasi-experimental controlled trial.

Methods

Performance of 21 PwPD was compared with 12 community-dwelling older adults. PwPD were randomly assigned to a non-training control group or a group receiving audio-visual-cued training for speeding up sit-to-stand performance, 3 times/week for 4 weeks. Outcome measures recorded at baseline and after 4 weeks included the center-of-mass position, its velocity, and the stability against either backward or forward balance loss (backward and forward stability) at seat-off and movement termination.

Results

Compared to healthy controls, PwPD had a greater backward stability resulting from a more anterior center-of-mass position at seat-off and lower velocity (p < 0.05). This feature, combined with a decreased forward stability at movement termination, increased their risk of forward balance loss at movement termination. Post-training, the PwPD achieved greater backward stability (p < 0.05) by increasing their forward center-of-mass velocity at seat-off; while achieving a posterior shift in center-of-mass position to reduce their likelihood of forward balance loss at movement termination.

Conclusions

PwPD increase their postural stability against backward balance loss during task initiation at the expense of possible forward balance loss at task termination. Task-specific training with preparatory audio-visual cues improves their overall dynamic stability against both forward and back balance loss.

Source: http://ptjournal.apta.org/cgi/content/short/ptj.20100423v1?rss=1

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