Mobility in Parkinson's disease and computerized balance measurement
Parkinson's disease (PD) is characterized by a variety of motor and non-motor symptoms, including impaired balance and mobility. One of the most important tools for assessing balance and stability in PD is computerized posturography (CPG). This technology measures how the brain processes and coordinates different movement information to maintain balance under different conditions. Including movement signals from the balance organ in the inner ear (vestibular), movement signals from muscles and joints (proprioception), and visual orientation. These measurements provide valuable insight into postural control and its impact on mobility and fall risk. Research consistently shows a strong correlation between lower CPG measurements and reduced mobility in people with PD.
Balance and Parkinson's disease
Parkinson's disease disrupts the integration of sensory input - visual, vestibular and proprioceptive - which is essential for balance. Computerized posturography provides a measurable indicator of how well the brain is able to coordinate and process these systems together. Lower CPG measurements indicate significant challenges in maintaining stability, particularly in demanding situations such as standing on unstable surfaces or when visual impressions are limited. These deficits in postural stability highlight the challenges people with PD face in daily activities and their vulnerability to falls.
Walking and mobility problems
Poor postural control, which is reflected in low CPG measurements, is directly linked to gait pattern disturbances in PD. These include reduced stride length, slower walking speed and a common mobility problem known as freezing of gait (FoG). FoG episodes—when a person feels temporarily "stuck" and unable to move—are often exacerbated by impaired balance and sensory integration, both of which are captured in CPG analyses. Reduced CPG measurements therefore signal a decrease in total mobility and an increased risk of falls, which further affects independence and quality of life.
Cognitive and sensory contributions
In addition to physical impairments, CPG measurements also reflect cognitive and sensory challenges in Parkinson's disease. Tasks that require divided attention, such as walking while performing a cognitive task, are particularly challenging for people with low CPG measurements. This emphasizes the connection between cognitive, sensory and motor functions in maintaining mobility.
Disease severity and clinical correlates
Lower CPG readings have been correlated with higher readings on the Unified Parkinson's Disease Rating Scale (UPDRS), particularly in areas that assess postural instability and gait disturbances. These findings suggest that tCPG analyzes not only provide a snapshot of current mobility challenges, but also serve as an indicator of disease progression.
Research evidence
Several studies emphasize the importance of CPG for understanding mobility problems in Parkinson's disease:
- Mancini et al. (2012) : Found that lower CPG measurements were associated with reduced walking speed, variation in step length and fall frequency in people with PD.
- Palakurthi and Burugupally (2019) : Highlighted that CPG could predict mobility-related complications such as freezing of gait and reduced functional independence.
- King and Horak (2009) : Demonstrated that postural instability, as measured by CPG, is strongly correlated with impaired functional mobility and reduced quality of life in PD patients.
Clinical implications
Computer-based posturography has several practical applications in the management of Parkinson's disease:
1. Fall risk assessment :
CPG can help identify people at higher risk of falls so that early interventions can improve safety and reduce injuries.
2. Targeted rehabilitation :
Poor CPG measurements can guide the development of rehabilitation programs, including balance training, proprioceptive exercises, and vision therapy, to improve mobility and stability.
3. Monitoring of disease progression :
Repeated CPG analyzes can track changes in postural stability over time and provide a valuable tool for evaluating the effectiveness of interventions such as physiotherapy or drug adjustments.
Lower scores on computerized posturography provide a reliable and measurable indicator of reduced mobility in Parkinson's disease. These results reflect the interaction between parts of the brain that coordinate and process different sensory impressions to control balance, walking and postural control, as well as parts of the brain that are involved in cognitive and sensory challenges. Addressing these impairments through tailored neurological rehabilitation is crucial to improving mobility and quality of life in people with Parkinson's disease. As an essential part of the PD evaluation, the CPG not only helps with clinical decision-making, but also allows patients to better understand the complexity of their condition.
Brain Camp also uses computerized posturography as part of the standardized re-test to monitor whether the brain is responding as desired to the tailored neurological rehabilitation. Watch a video demonstrating how we use computerized balance measurement:
