Background: Many disease-specifc factors such as muscular weakness, increased muscle stiffness, varying postural strategies, and changes in postural refexes have been shown to lead to postural instability and fall risk in people with Parkinson’s disease (PD). Recently, analytical techniques, inspired by the dynamical systems perspective on movement control and coordination, have been used to examine the mechanisms underlying the dynamics of postural declines and the emergence of postural instabilities in people with PD. Methods: A wavelet-based technique was used to identify limit cycle oscillations (LCOs) in the anterior–posterior (AP) postural sway of people with mild PD (n = 10) compared to age-matched controls (n = 10). Participants stood on a foam and on a rigid surface while completing a dual task (speaking). Results: There was no signifcant difference in the root mean square of center of pressure between groups. Three out of 10 participants with PD demonstrated LCOs on the foam surface, while none in the control group demonstrated LCOs. An inverted pendulum model of bipedal stance was used to demonstrate that LCOs occur due to disease-specifc changes associated with PD: time-delay and neuromuscular feedback gain. Conclusion: Overall, the LCO analysis and mathematical model appear to capture the subtle postural instabilities associated with mild PD. In addition, these fndings provide insights into the mechanisms that lead to the emergence of unstable posture in patients with PD.
Balance, limit cycle, Parkinson's disease, posture, wavelets.
Date of this Version
Chagdes JR, Huber JE, Saletta M, Darling-White M, Raman A, Rietdyk S, Zelaznik HN, Haddad JM. The relationship between intermittent limit cycles and postural instability associated with Parkinson's disease. J Sport Health Sci. 2016 Mar;5(1):14-24. doi: 10.1016/j.jshs.2016.01.005. Epub 2016 Jan 11. PMID: 30356531; PMCID: PMC6188581.