Minimal Detectable Change for Balance Using the Biodex Balance System in Patients with Parkinson Disease

Autor(es)

de Oliveira Lira, Jumes Leopoldino ^[1] ; Ugrinowitsch, Carlos ^[2] ; Fecchio, Rafael ^[3] ; Coelho, Daniel Boari ^[4] ; Moreira-Neto, Acacio ^[1] ; Germano, Renan ^[2] ; de Lima Miliatto, Angelo Correa ^[1] ; dos Santos Vieira Yano, Bianca Cristina ^[1] ; Silva-Batista, Carla ^{[1, 2]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Arts Sci & Humanities, Exercise Neurosci Res Grp, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Phys Educ & Sport, Lab Adaptat Strength Training, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sch Phys Educ & Sport, Exercise Hemodynam Lab, Sao Paulo - Brazil

^[4] Fed Univ ABC, Biomed Engn, Sao Bernardo Do Campo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: PM&R; v. 12, n. 3, p. 281-287, MAR 2020.
• Citações Web of Science: 0

Resumo

BackgroundMinimal detectable change (MDC) when assessing balance using the Biodex Balance System (BBS) in patients with Parkinson disease (PD) is currently unknown, limiting the interpretability of the scores. ObjectiveTo determine the MDC on the Anterior/Posterior Stability Index (APSI), Medial/Lateral Stability Index (MLSI), and Overall Stability Index (OSI) from postural stability and fall risk protocols of the BBS in patients with PD. DesignThis was a repeated-measures design (at a 1-week interval). SettingStrength training laboratory of a public university. Patients46 patients with PD (men and women) at stages 2 and 3 (67.97.4 years old) were assessed in the ``on{''} state (fully medicated). MethodsPatients performed three trials of 20s for each protocol. Main Outcome MeasurementsAbsolute and relative MDC (MDC%) calculated for APSI, MLSI, and OSI from the postural stability (stable condition) and fall risk protocols (unstable condition). ResultsFor the postural stability, the MDC and MDC% were 0.26 degrees and 17% for APSI, 0.41 degrees and 21% for MLSI, and 0.22 degrees and 12% for OSI, respectively. For the fall risk, the MDC and MDC% were 0.51 degrees and 18% for APSI, 0.21 degrees and 15% for MLSI, and 0.41 degrees and 20% for OSI, respectively. These results were considered acceptable, despite indices with high MDC for MLSI (postural stability) and APSI (fall risk). ConclusionsPatients with PD have more mediolateral and anteroposterior changes in the stable and unstable conditions, respectively. These abnormal balance strategies can occur principally due to postural instability of PD. However, our results demonstrated acceptable MDCs in both conditions in all of the assessed axes. Thus, BBS should be incorporated into the clinical evaluation to help therapists to determine if intervention-induced changes in balance are clinically significant or due to measurement error. Level of EvidenceII (AU)

• Processo FAPESP: 13/04970-4 - Influência dos treinamentos funcional e de força nas adaptações neuromusculares, funcionalidade e qualidade de vida em indivíduos com Doença de Parkinson
• Beneficiário: Carla da Silva Batista
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto
• Processo FAPESP: 16/13115-9 - Efeitos do treinamento de força com instabilidade sobre os desfechos clínicos, mecanismos espinhais e métricas cerebrais de indivíduos com bloqueio da marcha na doença de Parkinson
• Beneficiário: Carla da Silva Batista
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado