Effect of Dopaminergic Medication on Postural Sway in Advanced Parkinson’s Disease

Details

• Personal Author:
  Bhattacharya, Amit ; Cox, Clinton ; Duker AP ; Gartner M ; Larsh TR ; Mani A ; Revilla FJ ; Succop P ; Tejada CJ
• Description:
  Background: The effect of dopaminergic therapy on balance in Parkinson's disease (PD) remains unclear, including previous studies that excluded the effect of dyskinesias or other involuntary movements on postural sway. Additionally, medication's effects may differ between fallers and non-fallers. In this study, the authors quantify the effect of dopaminergic medication on postural balance (sway) in advanced PD, with and without dyskinesias, and consider the patient's history of falls. Methods: In 24 patients with advanced idiopathic PD, postural balance was measured using a strain-gage force platform. Before and after taking dopaminergic medication, the patient's postural sway was measured at 30-s intervals to determine sway length (SL) and sway area (SA). Data analysis included the presence of dyskinesias during "ON" medication condition and history of previous falls. Results: No significant changes occurred in SL or SA with dopaminergic treatment for fallers without dyskinesias or non-fallers with dyskinesias. However, after dopaminergic treatment, SL and SA were 37.8 and 45% lower, respectively, in non-fallers without dyskinesias (indicating better balance) and were 87.4 and 162.8% higher, respectively, in fallers with dyskinesias (indicating poorer balance). In the ON-medication condition, SL and SA were larger in patients with dyskinesias when compared with patients without dyskinesias; SL was larger in fallers than non-fallers in both groups with or without dyskinesias. Conclusion: Dopaminergic medication effects on postural sway could be a predictive factor for fall risk in PD patients with and without dyskinesias: specifically, decreased sway could indicate minimal fall risk whereas no change or increased postural sway could indicate a high risk. [Description provided by NIOSH]
• Subjects:
  Accidental Falls Accidents Men Musculoskeletal System Occupational Health Risk Assessment Risk Factors Safety Women
• Keywords:
  Author Keywords: Parkinsons Disease Balance Body Mechanics Dopaminergic Dyskinesia Fall Falls Humans Levodopa Medical Treatment Parkinsons Disease Postural Posture Risk Factors Statistical Analysis Sway

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• ISSN:
  1664-2295
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; OSHA Region 3 ; OSHA Region 5 ; Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  4
• NIOSHTIC Number:
  nn:20050157
• Citation:
  Front Neurol 2013 Dec; 4:202
• Contact Point Address:
  Fredy J. Revilla, Department of Neurology, University of Cincinnati College of Medicine, 260 Stetson Street, Suite 2300, Cincinnati, OH 45219
• Email:
  ude.cu@alliver.yderf
• Federal Fiscal Year:
  2014
• Performing Organization:
  University of Cincinnati
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Frontiers in Neurology
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:eeba190e83a618f5726e73f66975c9bc42dd15791903534fe2d7614607a0b42ebeffa71ea8ba24451ad2172b18e15baf7accd9c41058fe9b5ff0f0e46bac9836
• Download URL:
  https://stacks.cdc.gov/view/cdc/210631/cdc_210631_DS1.pdf
• File Type:
  [PDF - 758.47 KB ]