[논문]The effect of lateral wedge on postural sway in Parkinson's disease

Yoon, Ji-Yeon; Park, Jinse; Park, Kang Min; Ha, Sam Yeol; Kim, Sung Eun; Shin, Kyong Jin; Kim, Si Eun; Jo, Geunyeol

doi:10.14253/acn.2018.20.1.31

The effect of lateral wedge on postural sway in Parkinson's disease 원문보기

Annals of clinical neurophysiology : ACN, v.20 no.1, 2018년, pp.31 - 35

Abstract ▼ AI-Helper

Background: Although postural instability is one of the major symptoms of Parkinson's disease (PD), dopaminergic treatment is ineffective for treating postural instability. Recent reports have shown that somatosensory deficit is associated with postural instability, and that somatosensory input improved postural instability. The purpose of this study is to evaluate the effects of lateral wedges for quiet standing postural control in people with PD. Methods: Twenty-two patients who were diagnosed with PD were enrolled in this study. The participants stood on a force plate under two conditions (wedge and no wedge) with or without having their eyes open or closed. The center of pressure (COP) range and velocity were analyzed using a two-way repeated-measures analysis of variance. Results: The range and velocity of COP in the anterioposterior and mediolateral (ML) directions were significantly improved after the patients stood on the lateral wedge with their eyes closed (p < 0.05). The range in ML direction and velocity in both directions of COP were significantly decreased when their eyes were open (p < 0.05). Conclusions: Regardless of vision, standing on lateral wedges improved postural sway in people with PD.

주제어

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문제 정의

The primary aim of the study was to clarify the effect of lateral wedges on postural sway during quiet standing in people with PD. Our results demonstrated that standing on the lateral wedges could improve postural stability.
⁷ However, little research exists which investigates the effects of foot wedges on balance control in people with PD. The purpose of this study is to clarify whether lateral wedges under the feet can improve postural control during quiet standing in people with PD. We postulated that wedges under the lateral sides of the feet would improve postural instability in PD

제안 방법

All participants underwent a procedure of taking dopaminergic medicine that was clinically in the “on” state which was taking medicine.
Second, it was measured only in static standing without dynamic intervention and only the short-term effect was evaluated in this study; hence, we did not confirm dynamic balance and long-term effects.

대상 데이터

Twenty-two patients who were clinically diagnosed with PD were recruited for this study. The sample size was set based on a previous study.

데이터처리

1, Cary, NC, USA) was used to perform the statistical analysis. The outcome measures of the wedge and vision were compared using a twoway repeated measure ANOVAs. When interactions were not found, the main effects of the lateral wedge were reported, and a paired t-test was performed to confirm which vision or wedge differences existed.
The outcome measures of the wedge and vision were compared using a twoway repeated measure ANOVAs. When interactions were not found, the main effects of the lateral wedge were reported, and a paired t-test was performed to confirm which vision or wedge differences existed. The level of significance was set at p < 0.

성능/효과

In our results, the COP velocity and range were decreased in the ML direction, although only the COP velocity was decreased in the AP direction. People with PD have a tendency to be more rigid in the ML direction and more flexible in the AP direction.
Although the exact mechanism of our results cannot be fully understood, several possible explanations can be deduced based on previous researches. The first possible explanation of our results is that increased postural instability was associated with higher co-activation of the ankle muscles. While standing quietly, patients with PD have been reported to have an increase in tibialis anterior and soleus muscle activity compared to the controls, and to show higher postural sway.

후속연구

Third, we did not access the kinematic data of trunk, pelvis, hip, knee, and ankle joints; therefore we are necessarily limited in our explanation of changes in the joints during the standing time on the lateral wedge. Further studies are needed to evaluate the kinematic data including the ankle muscle activity while performing functional activities.
Thus, lateral wedges under the feet may be a useful tool in rehabilitation of balance in people with PD. Further study of continuous lateral wedge use for long-term rehabilitation, such as in shoe insoles, is needed.

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