AbstractsPsychology

The relationships between body composition phenotypes, postural instability and strength in people with idiopathic Parkinson’s disease

by Abdul Kareem Shehab Diab




Institution: University of Otago
Department:
Year: 0
Keywords: Body; composition; postural; instability; Strength; Parkinson's; disease
Record ID: 1315224
Full text PDF: http://hdl.handle.net/10523/5432


Abstract

Background and Aim Postural instability has been identified as one of the main causes for injurious falls in people with idiopathic Parkinson’s disease (IPD). Muscle weakness in older adults is one of the identified factors for reduced postural stability and falls in older adults and although postural instability is one of the cardinal signs of IPD, it is still not fully understood. Many contributing or associated factors for postural instability have been suggested and it is possible that the reason for postural instability may be multifactorial in nature. Muscle weakness in IPD is one of the identified factors for reduced postural stability and has been implicated as a falls risk factor in IPD. Different body composition phenotypes, determined by the proportion of fat, lean body mass, and bone density, have been implicated with low muscle strength, gait and balance deficits and falls in older adults, but this has not been investigated in people with IPD. This thesis explored the relationship of postural instability, muscle strength and body composition phenotypes in people with IPD and an age-matched control group. The primary aim of this study was to investigate the relationships between body composition phenotypes, postural stability and lower limb muscle strength in people with IPD compared to an age and sex matched control group. The aim was also to compare the number of falls experienced in a six months self-reported falls diary, falls related injuries and physical activity participation between the two groups. Methodology This thesis comprised two studies. Study one was a systematic review to answer the question: What are the factors contributing to or impacting on postural instability in IPD and what is the strength of evidence for these factors? The systematic review’s findings informed the development of the second study. The second study was a cross sectional study which investigated the relationship between postural instability, muscle strength and body composition phenotypes in people with IPD and an age and sex-matched control group. Participants for this study were recruited via the Neurology Department of the Dunedin Hospital, the Parkinson’s Society of New Zealand (Otago branch), and via public advertising. To be eligible, participants had to be diagnosed with IPD and be able to perform the required tests independently with or without assistive devices. Age and sex matched, sedentary control participants with no known neurological impairments were recruited via public advertising. For all tests, participants with IPD were assessed during the “on” state of medical therapy, and the degree of severity and staging of their IPD was assessed with the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). All participants were assessed with the following tests: Postural instability was measured with the Sensory Organisation Test (SOT) and the Motor Control Test using the NeuroCom® Smart EquiTest® version 8.4.0, the basic and the high cognitive Timed Up and Go Test (TUG…