Impaired vertical postural control and proprioceptive integration deficits in Parkinson's disease

The aim of the present study was to investigate how the orientation and stabilization components of postural control may be affected as the result of the impaired proprioceptive integration possibly occurring in Parkinson's disease. To determine the proprioceptive contribution to postural control, parkinsonian patients and control subjects were asked to maintain vertical stance while very slow sinusoidal oscillations were being applied in the lateral and antero-posterior planes to the platform on which they were standing. The amplitude and frequency of their movements were kept below the semicircular canal perception threshold. Data were collected with the ELITE automatic motion analyzer and the two postural components (orientation and segmental stabilization) were analyzed at head and trunk levels while the subjects were performing the task with their eyes open and closed. The results show that 1) the parkinsonian groups' performances were affected in terms of both the postural orientation and stabilization components in comparison with the control group, 2) the use of vision improved the parkinsonian patients' postural performances, and 3) both parkinsonian patients and control subjects achieved better postural performances when antero-posterior perturbations rather than lateral perturbations were applied to the foot support. These results suggest that Parkinson's disease is associated with proprioceptive impairment, which may be an important factor contributing to these patients' postural deficits. On the basis of these results, the visual dependence observed in parkinsonian patients is re-defined as an adaptive strategy partly compensating for the impaired proprioception.