Characteristics Of Balance Function In Early Parkinson’s Disease And Parkinsonism

Background: With the progress of population aging,the world’s second-largest number of cases in neurodegenerative diseases of Parkinson’s disease(PD)increased gradually.What’s more,because of the high disability rate and the chronic characteristics,PD gradually aroused the attention of the society.Early diagnosis and timely treatment of PD is of great significance to delay the progression of the disease and reduce the probability of disability.However,in clinical practice,we have found that the clinical manifestations of P type of multi-system atrophy(MSA-P)and progressive supranuclear palsy(PSP)in patients with initial and atypical clinical symptoms are very similar to those of PD patients,and it is difficult to distinguish them,and there is no accurate early objective diagnostic index,which often requires3-5 years of observation for further confirmation.More importantly,clinicians often neglect the importance of early balance function assessment and intervention.In China,there are few studies on the objective differentiation and targeted training of balance function in patients with PD and atypical parkinsonism syndromes.Previous studies have shown that patients with Parkinson’s disease have experienced mild balance dysfunction in the early stage.In addition,the balance disorders of PD,MSA-P and PSP are characterized by different direction specificity and different progress speed.Therefore,we conducted relevant studies to try to find out the different characteristics of the balance of the three diseases,promote the refined development of rehabilitation treatment,and provide new ideas for early objective diagnosisObjective: The purpose of this study was to explore the severity of balance disorders in patients with early PD,MSA-P,and PSP,as well as the kinematic characteristics of standing balance under different visual conditions,and to explore the related factors affecting balance function in patients with early Parkinson’s disease.Methods: This study included 50 patients(30 patients with PD,10 patients with MSA-P and 10 patients with PSP)in the early stage(Hoehn-Yahr grade 1-2)and 30 healthy controls.They were divided into four groups according to the type of disease.The four groups had no statistically significant differences in age,gender,height,weight,course of disease and mental health.In this study,all the enrolled subjects were tested on the Berg balance scale score and Static balance test in standing position with eyes open and closed.The enrolled PD patients were individually tested for sitting and walking,five sitting and standing tests,six-minute walking test and Simple upper limb function check scale score.Use SPSS software(version 22.0,IBM)for statistical analysis.Among them,continuous variables are represented by mean ± standard deviation,and Shapro-Wilk is used to test whether the data conform to the normal distribution.Take P<0.05 as a statistically significant cutoff value.Results:1.Characteristics of balance function: the swinging area of PD patients with closed eyes was significantly greater than that of eyes open;the long axis swing velocity of PSP patients with closed eyes was significantly greater than that of eyes open;the BBS of MSA-P patients was lower than that of the other three groups(P<0.05)The anterior and posterior acceleration and short axis swing velocity of standing balance in MSA-P patients with both open and closed eyes were significantly higher than those in the other three groups(P<0.05).Short axis distance and left and right acceleration in MSA-P patients were significantly greater than those in healthy controls and progressive supranuclear palsy(P<0.05)2.Factors affecting balance: The results of correlation analysis show that the older the patients with early Parkinson’s disease are,the greater the forward and backward swing speed,acceleration and short axis swing speed(r=0.614,r=0.517,r=0.535).The longer the disease course,the lower the BBS(r=-0.459),and the greater the swing range and acceleration in the front and back,left and right directions.The higher the Hoehn-Yahr classification,the lower the BBS(r=-0.557).The longer the 6-minute walk distances,the better the standing balance;The higher the BBS,the lower the front and back range and the long axis of the COP when the eyes are opened(r=-0.368,r=-0.385).Conclusion:1.Patients with early Parkinson’s disease showed similar visual physiological dependence on standing static balance as normal people,while patients with Parkinson’s disease showed abnormally lower dependence on vision on standing static balance2.The standing balance of patients with early Parkinson’s disease and atypical Parkinsonism syndromes has its own characteristics,which may have clinical significance for the early identification of Parkinson’s disease and Parkinson’s syndrome subtypes,and accurate balance function training.3.Factors affecting the balance function of early Parkinson’s disease include age,course of disease and aerobic endurance,etc.,which may have certain clinical significance for the prevention and management of balance dysfunction in early PD patients.