Abstract Details

Title Effect of Balanced Based Torso Weighting on Gait in Parkinsonism.

Topic Movement Disorders

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-014

Objective To examine the immediate effect of Balance Based Torso Weighing (BBTW) on gait and balance outcomes in patients with parkinsonism (PWP) and balance difficulties.

Background Patients with Parkinsonian syndromes are at increased risk of fall due to postural instability. Common interventions in management of gait and balance, including medications, surgery and traditional physical therapy do not benefit all patients. There is unmet need for interventions that can improve balance in this population.

Design/Methods 20 patients with parkinsonism and postural instability completed three trials of WALK, SWAY and Timed Up and Go (TUG) using APDM mobility lab, a wearable system for quantitative gait and balance measurements. The trials were completed: 1) at baseline (using BBTW without weights), 2) BBTW with therapeutic weights, 3) BBTW with sham weights. The order of these conditions was randomized. Patient and clinician global impression of change (PGIC, CGI respectively) were used to evaluate changes in gait after each condition in addition to APDM monitors. Mixed-effect models were used accounting for repeated measurements over time and serial correlation within individual subjects.

Results All subjects were men, age 70.4±10. Anticipatory postural adjustment in WALK test, showed significant improvement with use of weights, (Mean ±SD at baseline: 0.52±0.35) and (Mean ±SD with weighted vest: 0.29±0.11) (P: 0.01). While mean of turn duration was significantly improved with both weight and sham in TUG (P= 0.02), this effect on turn duration was not observed in WALK test. (P = 0.73). Patients reported improvement with use of BBTW significantly more than the clinician( 13 patients had PGIC≥ 5 while only one patient had CGI≥5).

Conclusions BBTW significantly improves postural adjustment duration in PWP and postural instability. Patients’ sense of improvement in balance is much more than objective measures by APDM and clinician. Long-term studies will be helpful to show benefits of BBTW in home settings.

Authors/Disclosures
Delaram Safarpour, MD, MSCE, FAAN (Parkinson Center Oregon Health & Science University) PRESENTER	Dr. Safarpour has received personal compensation in the range of $500-$4,999 for serving as a Consultant for 2nd MD. Dr. Safarpour has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific. Dr. Safarpour has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Safarpour has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Insightec. Dr. Safarpour has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BlueRock. Dr. Safarpour has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. Dr. Safarpour has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Boston Scientific. The institution of Dr. Safarpour has received research support from Medtronic. The institution of Dr. Safarpour has received research support from Amneal. The institution of Dr. Safarpour has received research support from CND life science.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
John E. Duda, MD (Veterans Affairs Medical Center)	Dr. Duda has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Nature Publishing Group. The institution of Dr. Duda has received research support from Department of Veterans Affairs. The institution of Dr. Duda has received research support from Michael J. Fox Foundation. The institution of Dr. Duda has received research support from Innervace, Incorporated. The institution of Dr. Duda has received research support from National Institutes of Health.
James F. Morley, MD, PhD	Dr. Morley has nothing to disclose.

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