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Systematic Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Aging Neurosci. | doi: 10.3389/fnagi.2018.00387

Quantifying Dynamic Balance in Young, Elderly and Parkinson's Individuals: A Systematic Reviw

Tarique Siragy1 and  Julie Nantel1*
  • 1Faculty of Health Sciences, University of Ottawa, Canada

Introduction: Falling is one of the primary concerns for people with Parkinson’s Disease and occurs predominately during dynamic movements such as walking. Several methods have been proposed to quantify dynamic balance and to assess fall risk. However, no consensus has been reached concerning which method is most appropriate for examining walking balance during unperturbed and perturbed conditions, particularly in Parkinson’s Disease individuals. Therefore, this systematic review aimed to assess the current literature on quantifying dynamic balance in healthy young, elderly and Parkinson’s individuals during unperturbed and perturbed walking.
Methods: The PubMed database was searched by title and abstract for publications quantifying dynamic balance during unperturbed and mechanically perturbed walking conditions in elderly adults and PD. Inclusion criteria required publications to be published in English, be available in full-text, and implement a dynamic balance quantification method. Exclusion criteria included clinical dynamic balance measures, non-mechanical perturbations, pathologies other than PD, and dual-tasking conditions. The initial database search yielded 280 articles, however, only 81 articles were included after title, abstract and full-text screening. Methodological quality and data were extracted from publications included in the final synthesis.
Results: The dynamic balance articles included 26 Coefficient of Variation of Spatiotemporal Variability, 10 Detrended Fluctuation Analysis, 20 Lyapunov Exponent, 7 Maximum Floquet Multipliers, 17 Extrapolated Center of Mass, 11 Harmonic Ratios, 4 Center of Mass-Center of Pressure Separation, 2 Gait Stability Ratio, 1 Entropy, 3 Spatiotemporal Variables, 2 Center of Gravity and Center of Pressure, and 2 Root Mean Square in the final synthesis. Assessment of methodological quality determined that 58 articles had a low methodological rating, a 22 moderate rating, and 1 having a high rating.
Conclusion: Careful consideration must be given when selecting a method to quantify dynamic balance because each method defines balance differently, reflects a unique aspect of neuromuscular stability mechanisms, and is dependent on the walking condition (unperturbed vs. perturbed). Therefore, each method provides distinct information into stability impairment in elderly and PD individuals.

Keywords: dynamic balance, Parkinson ' s disease, falls, Walking stability, perturbations, Slips, TRIPS

Received: 31 Jul 2018; Accepted: 05 Nov 2018.

Edited by:

France Mourey, Université de Bourgogne, France

Reviewed by:

Alexandre Kubicki, Université de Bourgogne, France
Bianca Callegari, Universidade Federal do Pará, Brazil
Jeannine Bergmann, Schön Klinik, Germany  

Copyright: © 2018 Siragy and Nantel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Julie Nantel, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada,