An investigation into the postural control and balance of people with Parkinson's disease and possible therapeutic approaches to improve their postural instability and balance confidence

Liam Gerard Johnson

    Research output: ThesisDoctoral Thesis

    246 Downloads (Pure)

    Abstract

    [Truncated abstract] One of the classical and more debilitating symptoms of Parkinson's disease is postural instability. As a result of this impairment in balance, patients with Parkinson's disease experience restricted mobility, are prone to falls, display a reduced capacity to perform activities of daily living and have a reduced quality of life. This thesis reviews our current knowledge of Parkinson's disease in the context of the mechanisms regulating postural control and how impairments to these lead to postural instability. The thesis then examines the characteristics and assessment of patients with Parkinson's disease, with a history of falls or near falls compared to non-fallers and controls. Our first objective was to explore the circumstances surrounding fall and near fall events in a cohort of 130 patients with idiopathic Parkinson's disease using an approach based on a 16-item questionnaire. This survey – the largest of its kind undertaken to date – showed that over 50% of patients experienced one or more falls over the previous two years with over 80% experiencing near falls over the same period. Our study suggests that fear of falling is more prevalent in patients than previously thought and that a fear of falling, restrictions on activities and reduced participation in exercise correlate with falling and the number of falls experienced. From this initial cohort of patients, a smaller cohort of 48 patients was selected comprising two sub-groups, fallers and non-fallers. These were used to address the question of whether a multi-dimensional approach to assessing postural instability based on a combination of established clinical and functional measures, provides a more accurate and quantifiable assessment of an individual's balance and mobility compared to any single methodology. Fallers had longer disease duration compared to non-fallers but importantly could be discriminated from non-fallers by most of the individual assessment methodologi
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2012

    Fingerprint Dive into the research topics of 'An investigation into the postural control and balance of people with Parkinson's disease and possible therapeutic approaches to improve their postural instability and balance confidence'. Together they form a unique fingerprint.

    Cite this