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Postural instability during reaching tasks in Parkinson's disease.
Emma Stack1, Ann Ashburn, Kate Jupp
1Neuro-Rehabilitation Research Group, University of Southampton, UK. els1@soton.ac.uk
Summary
People with severe Parkinson's disease (PD) struggle with reaching tasks, indicating a higher fall risk. Those appearing unstable during reaching are repeat fallers, suggesting a need for safety interventions.
Area of Science:
- Neurology
- Movement Disorders
- Gerontology
Background:
- Reaching and rising are activities frequently linked to falls in Parkinson's disease (PD) patients.
- Understanding movement strategies is crucial for fall prevention in PD.
Purpose of the Study:
- To analyze reaching strategies in moderate and severe Parkinson's disease (PD).
- To investigate the functional reach test and fall history of individuals exhibiting instability during reaching.
Main Methods:
- A cross-sectional study involving video recording of 51 participants with moderate to severe PD (Hoehn and Yahr Grade III-IV) performing reaching tasks at home.
- Blinded observers assessed stability, alignment, support use, and reach type, alongside measuring functional reach and interviewing participants about falls.
Main Results:
- Individuals with severe PD more frequently used support for high reaches and forward alignment for low reaches compared to those with moderate PD.
- Six participants (all with severe PD) showed instability during reaching, characterized by shorter functional reach (10 cm vs. 18 cm) and a history of frequent falls (median 5 falls/year).
Conclusions:
- Reaching movements significantly challenge postural stability in severe Parkinson's disease (PD).
- Individuals displaying instability during reaching are prone to recurrent falls and require targeted interventions.
- Further research should evaluate safety-enhancing strategies, including balance retraining, to mitigate fall risk in severe PD.