PERFORMANCE ON CLINICAL-TESTS BALANCE IN PARKINSONS-DISEASE

Background and Purpose. Due to the high incidence of falls in people w ith idiopathic Parkinson's disease (PD), the assessment of standing ba lance is a key component of physical therapist evaluation. This study investigated performance on clinical tests of standing balance in subj ects with and without PD. Subjects. The subjects were 10 persons with PD who had a history of falls (age range=60-80 years), 10 persons with PD who had no history of falls (age range=63-79 years), and 10 person s with no known neurological impairment (age range=60-78 years) who se rved asa comparison group. Methods. Subjects were tested on their abil ity to maintain stability in 3 conditions: (1) steady standing (feet a part, feet together, tandem stance, step stance, and single-limb stanc e), (2) in response to perturbations generated by self-initiated movem ents (arm raise, functional reach, bend-reach, and step tests), and (3 ) in response to an external perturbation to upright stance (shoulder tug). Balance was measured at peak dosage in the levodopa medication c ycle tin the morning) and 7 days later. Results. The mean Hoehn and Ya hr Disability Scale score was 3.0 for the fallers with PD and 2.5 for the nonfallers with PD. Performance on the tandem stance, single-limb stance, functional reach, and shoulder tug tests demonstrated differen ces between the subjects with PD and the comparison group and between the fallers and nonfallers with PD. The results of these tests were hi ghly repeatable over 7 days (ICC=.61-.94). Conclusion and Discussion. Although there was a small sample size, performance was highly consist ent across 7 days when testing occurred during peak dosage of levodopa . A small battery of tests were sensitive enough to discriminate betwe en people with PD who fall and those with no history of falls.