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Postural control in Parkinson's disease: Mechanisms, clinical characteristics and falls

Grant number: 22/14200-0
Support Opportunities:Scholarships in Brazil - Master
Effective date (Start): April 01, 2024
Effective date (End): March 31, 2025
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Sandra Maria Sbeghen Ferreira de Freitas
Grantee:Lucas Henrique Caetano Carmona dos Santos
Host Institution: Pró-Reitoria de Pós-Graduação, Pesquisa e Extensão. Universidade Cidade de São Paulo (UNICID). São Paulo , SP, Brazil
Associated scholarship(s):24/06357-2 - Influence of dyskinesia on falls and injuries caused by falls in people with Parkinson's disease: A PPMI prospective cohort study, BE.EP.MS

Abstract

Individuals with Parkinson's disease (PD) present postural control impairments, leading to decreased independence in daily life activities and an increased risk of falls. Although dopaminergic replacement therapy with levodopa improves PD symptoms, it has been suggested that it does not effectively enhance postural stability. Many clinical characteristics of PD, such as disease severity, fear of falling, and cognitive impairment, contribute to worsened postural control and an elevated risk of falls. Furthermore, the effects of freezing of gait (FOG) and dyskinesia on postural control remain controversial in the literature. Previous studies suggested that the absence of visual information, such as when individuals close their eyes, affects the postural control mechanisms due to sensorimotor deficits. Despite this, the influence of visual information on postural control mechanisms in PD individuals with different clinical characteristics has not been considered before. Therefore, the present research project aims to address these gaps. Three studies are being conducted: (i) a systematic review of observational studies to verify the relationship between dyskinesia and postural instability, balance, gait, and the risk of falls; (ii) an experimental study to examine the influence of visual information on postural control mechanisms in individuals with PD who experience FOG in both medication stages (On-Off); (iii) an experimental study to assess the correlation between disease severity, cognitive impairment, and fear of falling in the postural control of individuals with FOG and dyskinesia. Together, the findings of these studies will contribute to knowledge about the influence of clinical characteristics of PD on postural control mechanisms. Healthcare professionals and future studies can use manipulations (i.e., medication and/or sensory interventions) in individuals with PD with different clinical characteristics as interventional strategies to recruit postural control mechanisms alone and together to test specific outcomes related to postural control.

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