Karen Van Ooteghem1, James S Frank2, Fay B Horak3. 1. Department of Kinesiology, University of Waterloo, 200 University Ave. W., Waterloo, ON, N2L 3G1, Canada. Electronic address: kvanoote@uwaterloo.ca. 2. Department of Kinesiology, University of Waterloo, 200 University Ave. W., Waterloo, ON, N2L 3G1, Canada. 3. Department of Neurology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239-3098, USA; Research Dept., Portland VA Medical System, 3710 SW US Veterans Hospital Rd., Portland, OR, 97239-9264, USA.
Abstract
INTRODUCTION: Although balance training is considered the most effective treatment for balance impairments in Parkinson's disease (PD), few studies have examined if learning for balance control remains intact with PD. This study aimed to determine if learning for automatic postural responses is preserved in people with PD. METHODS: Eleven participants with moderate PD (68±6.4years; H&Y: 2-3) on their usual medication maintained balance on a platform that oscillated forward and backward with variable amplitude and constant frequency. Participants completed 42 trials during one training session, and retention and transfer tests following a 24-h delay. Performance was measured by comparing spatial and temporal measures of whole-body centre of mass (COM) with platform displacements. Learning was compared between participants with PD and previously reported, age-matched older adults (Van Ooteghem et al., 2010). RESULTS: Although postural responses in participants with PD were impaired compared to control participants, a majority of PD participants improved their postural responses with practice as revealed by reduced COM displacements and improved phase relationships between COM and platform motion. Rates of improvement were comparable between groups demonstrating preserved adaptive capacity for participants with PD. Similar to control participants, the PD group moved toward anticipatory COM control as a strategy for improving stability, exhibited short-term retention of performance improvements, and demonstrated generalizability of the learned responses. Rate of improvement with practice, but not retention, was related to severity of motor impairments. CONCLUSIONS: Patients with moderate PD on medication demonstrate retention of improvements in automatic postural responses with practice suggesting that intrinsic postural motor learning is preserved in this group.
INTRODUCTION: Although balance training is considered the most effective treatment for balance impairments in Parkinson's disease (PD), few studies have examined if learning for balance control remains intact with PD. This study aimed to determine if learning for automatic postural responses is preserved in people with PD. METHODS: Eleven participants with moderate PD (68±6.4years; H&Y: 2-3) on their usual medication maintained balance on a platform that oscillated forward and backward with variable amplitude and constant frequency. Participants completed 42 trials during one training session, and retention and transfer tests following a 24-h delay. Performance was measured by comparing spatial and temporal measures of whole-body centre of mass (COM) with platform displacements. Learning was compared between participants with PD and previously reported, age-matched older adults (Van Ooteghem et al., 2010). RESULTS: Although postural responses in participants with PD were impaired compared to control participants, a majority of PDparticipants improved their postural responses with practice as revealed by reduced COM displacements and improved phase relationships between COM and platform motion. Rates of improvement were comparable between groups demonstrating preserved adaptive capacity for participants with PD. Similar to control participants, the PD group moved toward anticipatory COM control as a strategy for improving stability, exhibited short-term retention of performance improvements, and demonstrated generalizability of the learned responses. Rate of improvement with practice, but not retention, was related to severity of motor impairments. CONCLUSIONS:Patients with moderate PD on medication demonstrate retention of improvements in automatic postural responses with practice suggesting that intrinsic postural motor learning is preserved in this group.