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An alternative clinical postural stability test for patients with Parkinson’s disease

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Abstract

We compared the sensitivity and consistency of a new Push and Release Test versus the Pull Test (item 30 of the Unified Parkinson’s Disease Rating Scale; UPDRS) as clinical measures of postural stability. Subjects with Parkinson’s disease and age-matched control subjects participated in 3 protocols investigating: (1) the sensitivity and specificity of the two tests related to the subjects’ balance confidence, as measured by the Activities-specific Balance Confidence (ABC) scale, (2) the inter-rater reliability of the two tests, and (3) the consistency of the perturbation forces applied to the subjects by each balance test. As a test for concurrent validity, the balance tests were also compared with the subjects’ retrospective reports of fall frequency. Compared with the Pull Test, the Push and Release Test was more sensitive to subjects with low balance confidence, but less specific for subjects with high balance confidence. The inter-rater correlations were higher with the Push and Release Test. Examiners applied more consistent perturbation forces to the subjects with the Push and Release Test than with the Pull Test. The Push and Release Test correlated better with self-reported falls. Therefore, the Push and Release Test provided a more sensitive and consistent test of postural stability than the Pull Test.

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Acknowledgement

The authors thank Maryann Seeger PT and Kevi Ames PT for serving as raters, Kate Doebke RN and the OHSU Movement Disorders clinicians for referring subjects, and Linda Kleen RN and the YMCA for referring subjects. The authors also thank Patricia Carlson-Kuhta PhD, Leta Guptill, and Triana Nagel-Nelson for help with data collection, Andrew Owings for assembling and testing the pressure-sensitive gloves, and Dawn Peters for statistical assistance. The authors extend deep gratitude to our subjects for their participation. This project was supported by NIH grant AG-06457.

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Authors and Affiliations

  1. Neurological Sciences Institute, Oregon Health & Science University, 505 NW 185th Avenue, Beaverton, OR, 97006-3499, USA

    Jesse V. Jacobs BA & Fay B. Horak PT. PhD

  2. Dept. of Neurology, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, Oregon, 97239, USA

    Fay B. Horak PT. PhD, K. Van Tran MD & John G. Nutt MD

  3. Dept. of Physiology & Pharmacology, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, Oregon, 97239, USA

    Fay B. Horak PT. PhD & John G. Nutt MD

  4. Portland VAMC Parkinson Disease Research, Education and Clinical Center, 3710 SW Veterans Hospital Road, Portland, OR, 97239, USA

    John G. Nutt MD

Authors
  1. Jesse V. Jacobs BA
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  2. Fay B. Horak PT. PhD
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  3. K. Van Tran MD
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  4. John G. Nutt MD
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Corresponding author

Correspondence to Fay B. Horak PT. PhD.

Additional information

Received in revised form: 2 March 2006

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Jacobs, J.V., Horak, F.B., Van Tran, K. et al. An alternative clinical postural stability test for patients with Parkinson’s disease. J Neurol 253, 1404–1413 (2006). https://doi.org/10.1007/s00415-006-0224-x

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  • DOI: https://doi.org/10.1007/s00415-006-0224-x

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