Risk of falls using the Biodex Balance System in non-faller patients with Parkinson Disease

Abstract

Purpose

Biodex Balance System (BBS) is a low-cost platform used to assess balance in different populations. However, no study has used this tool to evaluate the risk of falls related to balance changes in non-faller individuals with Parkinson Disease (PD).

Objective

The aim of this study was to determine the changes in the balance in non-faller individuals with mild to moderate PD compared to healthy elders.

Methods

Forty-six PD patients at stages 2 and 3 were assessed in the ‘on’ state (fully medicated) as well as 31 age-matched healthy controls. They were submitted to the fall risk protocol of BBS and performed three 20-s trials and a 60-s rest interval between the trials.

Results

Non-faller PD patients had an increased instability when compared to the healthy controls in the anteroposterior (controls: 1.54 ± 1.00 vs. PD patients: 2.91 ± 0.93) and mediolateral directions (controls: 1.21 ± 0.57 vs. PD patients: 1.42 ± 0.46), resulting in a great overall instability in the PD patients (controls: 1.28 ± 0.61 vs. PD patients: 4.09 ± 1.22). A significant correlation between overall instability and UPDRS-III (motor symptoms) in individuals with PD was observed.

Conclusion

BBS was able to identify the risk of falls in non-fallers, showing that PD patients have a greater risk of falls in unstable conditions than age-matched healthy elders, mainly due to the large sway in the anteroposterior direction. Furthermore, the severity of motor symptoms was related to overall instability which can increase the risk of falls in PD patients.

Keywords:

• Balance
• risk of falls
• Parkinson Disease

Acknowledgements

The authors are grateful to the research group of the Laboratory of Neuromuscular Adaptations to Strength Training at the School of Physical Education and Sport – University of São Paulo.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo [FAPESP – 2013/04970-4; 2016/13115-9], the Coordenação de Aperfeiçoamento de Nível Pessoal [CAPES – 3095/2015-00], the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) – [406609/2015-2; 03085/2015-0; 407781/2017-0], Santander Schorlarship Program (Iniciação Científica) [2018/2019] and the PROAP CAPES BRASIL [001].