Posturography and Parkinson's


by Kim Stob, PhD

It is not unusual for people with Parkinson's disease to have difficulties with balance, posture (stooped) and walking. For many who experience these particular symptoms, the risk of falling (and the potential injury associated with falls) becomes a serious concern.

Physicians often refer their patients for physical therapy in order to help them maintain or regain muscle tone, range of motion, or to learn adaptive techniques. Physical therapists can suggest strategies for balance compensation, introduce techniques to stimulate movement during slowdowns or freezes, and assess the need for aids such as canes or wheelchairs that can help people maintain their independence.

Technological advances are now making it possible for physical therapists to address balance-related issues in a new way. New tools are available which measure data about a patient's balance and can give therapists and doctors a more complete picture of their patient's ability (or inability) to move. These new tools may even help researchers develop new methods for treating stability issues.

The EquiTest® is an evaluation and treatment tool used to identify and treat the major components of balance including the body's sensory systems, ability to use information accurately in regards to the body's position and the muscles and joints that are required to maintain balance. It can be used to treat balance problems related to neurological conditions, such as Parkinson's disease.

Computerized dynamic posturography (CDP) is the actual testing performed on the EquiTest® machine. The CDP assesses balance difficulties that may be caused, by Parkinson's disease. This assessment can be done by a licensed physical therapist using the SMART EquiTest®, a technologically advanced system that performs computerized evaluations of patients' postural control and balance under dynamic conditions reflecting everyday activities. Therapists then provide treatment based on the results of the assessment.

The information that is provided by the CDP is compared to the balance you should normally have at your age. The results are combined with information from a patient's medical history, examination from physicians and physical therapists and any other lab tests that were performed. This enables the therapist to determine a specialized and unique treatment plan without any guesswork. The EquiTest® is then performed again after several weeks of treatment in order to determine progress and improved function.

CDP is a testing method validated by research to isolate the functional contributions that relate to falls and balance. Some physical therapists have been specialty trained and certified to use and interpret results of this testing method. The tests and treatments are non-invasive, safe and painless. The test takes about 45 minutes to complete.

The EquiTest® is considered the "gold standard" for assessment of balance. The goa! of treatment is to improve balance, decrease falls, improve ambulation and, in some cases, return the patient to normal daily function. While the EquiTest® can provide helpful information, it is not appropriate for everyone. Some people with Parkinson's are simply too unsteady to be tested. If you think you could benefit from this type of assessment, discuss it with your doctor or consult with a physical therapy clinic experienced in using the equipment to assess Parkinson's-related balance issues.

Kim Stob is a Doctor of Physical Therapy at Central DuPage Hospital in Winfield, IL.


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