Upper body instability in people with Parkinson's disease: A kinematic study

Instabilities of the upper body affect posture and locomotion in people with Parkinson's disease (PD), but the responses of the torso to sudden perturbations have not yet been investigated. This study aimed to examine upper body stability using a wobbling seat encountering challenging perturbations in comparison to healthy age-matched controls. In this cross-sectional study, 12 people with PD and 12 healthy individuals sat on a wobbling seat and underwent quick release perturbations. Motion capture was used to assess upper body stability based on the kinematic data of sways in all directions. People with PD had greater upper body sways than the control group in all directions when faced with unexpected perturbations. The application of expected perturbations to people with PD caused approximately 2.4 times greater upper body sways in the flexion direction (p < 0.001). Maximum sway velocity was significantly greater (p = 0.001) and time-to-fall was significantly shorter (p = 0.004) in people with PD than in the control cohort. People with PD had upper body instability, specifically in the forward direction. They were unable to adapt their neuromuscular responses after repeated trials. Given the significance of upper body stability in performing daily physical activities, it is imperative to consider long-term trunk rehabilitation for people with PD.