Assessment of the correlation between gait and balance disorders, and the severity of motor symptoms in Parkinson’s disease, depression and cognitive impairment.

Abstract

Introduction: Postural instability in patients with Parkinson’s disease (PD) is one of the major factors contributing to an increasing number of falls and fall related complications. Diagnosis of balance disorder is based on assessment of postural control by the biomechanical assessment of the musculoskeletal system, coordinating speed and precision of movements. The condition for the performance of precise and smooth movement is coordination of motor activity and sensory signals fl owing to the motor system. Study aim: The aim of the study is to assess the impact of non-motor symptoms (depression and cognitive impairment) and the impact of the severity of motor symptoms on the process of course of movement planning and control in Parkinson’s disease. Material and methods: The study involved 40 patients with idiopathic Parkinson’s disease, diagnosed according to the criteria adopted by the United Kingdom Parkinson’s Disease Society Brain Bank (UKPDSBB), with stage II or III severity of symptoms of the disease according to the Hoehn-Yahr sclae. All the patients underwent physical examination with an evaluation using the UPDRS (Unifi ed Parkinson’s Disease Rating Scale) and screening clinical trials were performed, evaluating cognitive functions (Montreal Cognitive Assessment, MoCA) and depressive disorders (Beck Depression Inventory, BDI). Evaluation of mobility, stability and motor control was done using the Berg Balance Scale (BBS), the Tinetti test, the Up and Go test (TUG) and the Dynamic Gait Index (DGI). Results: There was a signifi cant correlation between the level of severity of movement disorders (according to UPRDS ON part III) and the parameters defi ning motor skills in the DGI (R= -0.49, p<0.001), the TUG test evaluating mobility (R=0.4, p<0.01), and static and dynamic balance disorder using BBS (R=-0.44, p<0.004). The level of cognitive functioning had signifi cant impact on the mobility and stability of patients, and the occurrence of depressive disorder did not affect the deterioration of basic postural reactions in the group of patients with PD. Cite this article as: Czechowicz B., Siuda J., Bednar M., Nowakowska I., Rudzińska-Bar M. Assessment of the correlation between gait and balance disorders, and the severity of motor symptoms in Parkinson’s disease, depression and cognitive impairment. Med Rehabil 2016; 20(2): 13-19.

Keywords

• Parkinson’s disease
• cognitive functions
• postural control
• depressive disorders