Postural sway as a marker of progression in Parkinson's disease: A pilot longitudinal study
Open accessAbstract
Objective measures of postural control that are sensitive to Parkinson's disease (PD) progression would improve patient care and accelerate clinical trials. Although measures of postural sway during quiet stance in untreated PD have been shown to differ from age-matched control subjects, it is not known if sway measures change with disease progression in early PD. In this pilot study, we asked whether accelerometer-based metrics of sway could provide a practical tool for monitoring progression of postural dyscontrol in people with untreated or newly treated PD. We examined 13 subjects with PD and 12 healthy, age-matched control subjects. The PD subjects had been recently diagnosed and had not started any antiparkinsonian medications at the baseline session. All subjects were tested 3-6 months and 12 months after the baseline session. Subjects were asked to stand quietly for two minutes while wearing an inertial sensor on their posterior trunk that measured trunk linear acceleration. Our results suggested that objective sway measures deteriorated over one year despite minimal changes in UPDRS motor scores. Medio-lateral (ML) sway measures were more sensitive than antero-posterior sway measures in detecting progression. The ML JERK was larger in the PD group than the control group across all three testing sessions. The ML sway dispersion and ML sway velocity were also significantly higher in PD compared to control subjects by the 12-month evaluation. It is feasible to measure progression of PD prior to onset of treatment using accelerometer-based measures of quiet standing.
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In Parkinson's disease, wearables were used to detect and quantify cardinal motor symptoms including bradykinesia, tremor, and postural sway.
“In PD, wearables were used to detect and quantify cardinal motor symptoms including bradykinesia [19], tremor [20, 21], and postural sway [22, 23] as well as medication-evoked adverse symptoms such as dyskinesia [24–27] and motor fluctuations [28, 29].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [22]
Measures derived from wearables quantifying tremor, dyskinesia, postural sway, and spatiotemporal gait characteristics discriminated well between individuals with Parkinson's disease and healthy controls.
“Different measures derived from wearables quantifying tremor, dyskinesia, postural sway, and spatiotemporal gait characteristics discriminated well between individuals with PD and healthy controls [20, 22, 24, 26, 31]; dyskinesia measures discriminated also between patients with and without dyskinesia [24, 26].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [22]
Mediolateral sway and jerk derived from wearables were sensitive to detect progression of postural instability in Parkinson's disease over time.
“Postural sway measures derived from wearables have been examined for test–retest reliability (ICC 0.55–0.86) [23] and the mediolateral sway and jerk were shown to be sensitive to detect progression of postural instability in PD over time [22].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [22]
The postural sway measures in Parkinson's disease have been shown to be reliable and sensitive to longitudinal changes in laboratory settings.
“For example, the postural sway measures in PD have been shown to be reliable and sensitive to longitudinal changes in laboratory settings [22, 23].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [22]
Clinical scales may adequately reflect the patients' symptoms or disabilities, but they are often limited by the predefined ordinal scoring levels and lack sensitivity to more detailed and subtle changes in the clinical status.
“Although the clinical scales may adequately reflect the patients’ symptoms or disabilities, they are often limited by the predefined ordinal scoring levels and lack sensitivity to more detailed and subtle changes in the clinical status [22, 37, 70, 71].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [22]
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- Authors
- Mancini, M., Carlson-Kuhta, P., Zampieri, C., Nutt, J. G., Chiari, L., & Horak, F. B.
- Affiliations
- Oregon Health & Science University (US)
- National Institutes of Health (US)
- University of Bologna (IT)
- Corresponding author
- Mancini, Martina
- Venue
- Gait & Posture
- Publisher
- Elsevier BV
- Published
- 2012-07
- Volume
- 36
- Issue
- 3
- Pages
- 471-476
- ISSN
- 0966-6362 (ISSN-L)
- PMC
- PMC3894847
- OpenAlex
- W2067102702
- Cited by
- 221
- References
- 27
- Citations by year
- 2026: 3 · 2025: 12 · 2024: 19 · 2023: 14 · 2022: 27 · 2021: 25 · 2020: 25 · 2019: 12 · 2018: 17 · 2017: 10 · 2016: 16 · 2015: 19 · 2014: 12 · 2013: 10
- FWCI
- 32.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Gait & Posture (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Funders
- National Institutes of Health (5r37ag006457-28)
- U.S. Public Health Service (NIA 006457)
- National Institute on Aging (R37-AG006457, R01AG006457)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- Parkinson's disease, postural sway, disease progression, postural control, accelerometer, inertial sensors, quiet standing, trunk acceleration, early detection, UPDRS motor score
- MeSH terms
- Aged, Postural Balance, Female, Follow-Up Studies, Gait, Humans, Longitudinal Studies, Male, Middle Aged, Monitoring, Physiologic, Parkinson Disease, Pilot Projects, Severity of Illness Index, Biomarkers, Case-Control Studies, Disease Progression, Risk Assessment, Gait Disorders, Neurologic, Accelerometry
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