A multiple domain postural control assessment in people with Parkinson?s disease: traditional, non-linear, and rambling and trembling trajectories analysis

Abstract

Background: Postural impairment is one of the most debilitating symptoms in people with Parkinson's disease (PD), which show faster and more variable oscillation during quiet stance than neurologically healthy in-dividuals. Despite the center of pressure parameters can characterize PD's body sway, they are limited to uncover underlying mechanisms of postural stability and instability. Research question: Do a multiple domain analysis, including postural adaptability and rambling and trembling components, explain underlying postural stability and instability mechanisms in people with PD? Method: Twenty-four individuals (12 people with PD and 12 neurologically healthy peers) performed three 60-s trials of upright quiet standing on a force platform. Traditional and non-linear parameters (Detrended Fluctu-ation Analysis-DFA and Multiscale Entropy-MSE) and rambling and trembling trajectories were calculated for anterior-posterior (AP) and medial-lateral (ML) directions. Results: PDG's postural control was worse compared to CG, displaying longer displacement, higher velocity, and RMS. Univariate analyses revealed largely longer displacement and RMS only for the AP direction and largely higher velocity for both AP and ML directions. Also, PD individuals showed lower AP complexity, higher AP and ML DFA, and increased AP and ML displacement, velocity, and RMS of rambling and trembling components compared to neurologically healthy individuals. Significance: Based upon these results, people with PD have a lower capacity to adapt posture and impaired both rambling and trembling components compared to neurologically healthy individuals. These findings provide new insights to explain the larger, faster, and more variable sway in people with PD.