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Detecting and predicting balance decline in Parkinson disease: a prospective cohort study.
J Parkinsons Dis. 2015; 5(1):131-9.JP

Abstract

BACKGROUND

The natural progression of balance decline in individuals with Parkinson disease (PD) is not well understood.

OBJECTIVES

We aimed to: 1) compare the utility of three standardized clinical measures for detecting balance decline over 1-year, 2) identify components of balance susceptible to decline, and 3) identify factors useful for predicting future balance decline.

METHODS

Eighty people with PD (59% male; mean age 68.2 ± 9.3; Hoehn & Yahr range I-IV) completed Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Berg Balance Scale (BBS) assessments. Baseline predictor variables included the MDS-UPDRS III sub-score, presence of freezing, 6-month fall history, age, gender, and physical activity. Balance and MDS-UPDRS III assessments were repeated at 6 (n = 51) and 12 months (n = 44).

RESULTS

BESTest and Mini-BESTest score declined over 6 and 12 months (P < 0.01). Postural responses, stability limits, and sensory orientation were most susceptible to decline. BBS score did not change (P > 0.01). MDS-UPDRS III score was unchanged over 6 months (P > 0.01), but declined over 12 months (P < 0.01). Change in BESTest score over 6 months was related to baseline MDS-UPDRS III, H&Y, freezing, and fall history (P < 0.05). Change in BESTest score over 12 months was related to baseline MDS-UPDRS III and freezing (P < 0.05). Change in Mini-BESTest over 12 months was related to baseline MDS-UPDRS III and age (P < 0.05).

CONCLUSIONS

The BESTest and Mini-BESTest were responsive to balance decline in individuals with PD and helped to identify decline in underlying balance components. Disease severity and freezing most consistently predicted balance decline in persons with PD.

Authors+Show Affiliations

Washington University in St. Louis School of Medicine, Program in Physical Therapy, MO, USA Department of Neurology, Washington University in St. Louis School of Medicine, MO, USA.Rehabilitation Hospital of the Pacific, Department of Physical Therapy, HI, USA.Department of Physical Therapy, University of New England, ME, USA.Department of Physical Therapy, University of Utah, UT, USA.Department of Physical Therapy and Athletic Training, Boston University, MA, USA.Department of Physical Therapy, Samford University, AL, USA.Department of Physical Therapy, University of Utah, UT, USA.Washington University in St. Louis School of Medicine, Program in Physical Therapy, MO, USA Department of Anatomy & Neurobiology, Washington University in St. Louis School of Medicine, MO, USA Department of Neurology, Washington University in St. Louis School of Medicine, MO, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25514984

Citation

Duncan, Ryan P., et al. "Detecting and Predicting Balance Decline in Parkinson Disease: a Prospective Cohort Study." Journal of Parkinson's Disease, vol. 5, no. 1, 2015, pp. 131-9.
Duncan RP, Leddy AL, Cavanaugh JT, et al. Detecting and predicting balance decline in Parkinson disease: a prospective cohort study. J Parkinsons Dis. 2015;5(1):131-9.
Duncan, R. P., Leddy, A. L., Cavanaugh, J. T., Dibble, L. E., Ellis, T. D., Ford, M. P., Foreman, K. B., & Earhart, G. M. (2015). Detecting and predicting balance decline in Parkinson disease: a prospective cohort study. Journal of Parkinson's Disease, 5(1), 131-9. https://doi.org/10.3233/JPD-140478
Duncan RP, et al. Detecting and Predicting Balance Decline in Parkinson Disease: a Prospective Cohort Study. J Parkinsons Dis. 2015;5(1):131-9. PubMed PMID: 25514984.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detecting and predicting balance decline in Parkinson disease: a prospective cohort study. AU - Duncan,Ryan P, AU - Leddy,Abigail L, AU - Cavanaugh,James T, AU - Dibble,Leland E, AU - Ellis,Terry D, AU - Ford,Matthew P, AU - Foreman,K Bo, AU - Earhart,Gammon M, PY - 2014/12/18/entrez PY - 2014/12/18/pubmed PY - 2015/11/14/medline KW - Parkinson disease KW - outcome assessment KW - physical therapy KW - postural balance KW - rehabilitation SP - 131 EP - 9 JF - Journal of Parkinson's disease JO - J Parkinsons Dis VL - 5 IS - 1 N2 - BACKGROUND: The natural progression of balance decline in individuals with Parkinson disease (PD) is not well understood. OBJECTIVES: We aimed to: 1) compare the utility of three standardized clinical measures for detecting balance decline over 1-year, 2) identify components of balance susceptible to decline, and 3) identify factors useful for predicting future balance decline. METHODS: Eighty people with PD (59% male; mean age 68.2 ± 9.3; Hoehn & Yahr range I-IV) completed Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Berg Balance Scale (BBS) assessments. Baseline predictor variables included the MDS-UPDRS III sub-score, presence of freezing, 6-month fall history, age, gender, and physical activity. Balance and MDS-UPDRS III assessments were repeated at 6 (n = 51) and 12 months (n = 44). RESULTS: BESTest and Mini-BESTest score declined over 6 and 12 months (P < 0.01). Postural responses, stability limits, and sensory orientation were most susceptible to decline. BBS score did not change (P > 0.01). MDS-UPDRS III score was unchanged over 6 months (P > 0.01), but declined over 12 months (P < 0.01). Change in BESTest score over 6 months was related to baseline MDS-UPDRS III, H&Y, freezing, and fall history (P < 0.05). Change in BESTest score over 12 months was related to baseline MDS-UPDRS III and freezing (P < 0.05). Change in Mini-BESTest over 12 months was related to baseline MDS-UPDRS III and age (P < 0.05). CONCLUSIONS: The BESTest and Mini-BESTest were responsive to balance decline in individuals with PD and helped to identify decline in underlying balance components. Disease severity and freezing most consistently predicted balance decline in persons with PD. SN - 1877-718X UR - https://www.unboundmedicine.com/medline/citation/25514984/Detecting_and_predicting_balance_decline_in_Parkinson_disease:_a_prospective_cohort_study_ L2 - https://content.iospress.com/openurl?genre=article&amp;id=doi:10.3233/JPD-140478 DB - PRIME DP - Unbound Medicine ER -