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J Neurol (2006) 253 : 14041413 DOI 10.1007/s00415-006-0224-x
ORIGINAL COMMUNICATION
Jesse V. Jacobs Fay B. Horak Van K. Tran John G. Nutt
An alternative clinical postural stability test for patients with Parkinsons disease
Received: 17 October 2005 Received in revised form: 2 March 2006 Accepted: 10 March 2006 Published online: 20 June 2006
j Abstract We compared the sensitivity and consistency of a new Push and Release Test versus the Pull Test (item 30 of the Unied Parkinsons Disease Rating Scale; UPDRS) as clinical measures of postural stability. Subjects with Parkinsons disease and age-matched control subjects participated in 3 protocols investigating: (1) the sensitivity and specicity of the two tests related to the subjects balance condence, as measured by the Activities-specic Balance Condence (ABC) scale, (2) the inter-rater reliability of the two tests, and (3) the consistency of the perturbation forces applied to the subjects by each balance test. As a test for concurrent validity, the balance tests were also compared with the subjects retrospective reports of fall frequency. Compared with the Pull Test, the Push and Release Test was more sensitive to subjects with low balance condence, but less specic for subjects with high balance condence. The inter-
rater correlations were higher with the Push and Release Test. Examiners applied more consistent perturbation forces to the subjects with the Push and Release Test than with the Pull Test. The Push and Release Test correlated better with self-reported falls. Therefore, the Push and Release Test provided a more sensitive and consistent test of postural stability than the Pull Test.
J.V. Jacobs, BA F.B. Horak, PT. PhD (&) Neurological Sciences Institute Oregon Health & Science University 505 NW 185th AvenueBeaverton, OR 97006-3499, USATel.: +1-503/418-2600Fax: +1-503/418-2501E-Mail: [email protected]
V.K. Tran, MD J.G. Nutt, MD F.B. Horak, PT. PhDDept. of Neurology Oregon Health & Science University 3181 S.W. Sam Jackson Park Road Portland, Oregon 97239, USA
F.B. Horak, PT. PhD J.G. Nutt, MD Dept. of Physiology & Pharmacology Oregon Health & Science University 3181 S.W. Sam Jackson Park Road Portland, Oregon 97239, USA
J. G. Nutt, MD Portland VAMC Parkinson Disease Research Education and Clinical Center 3710 SW Veterans Hospital Road Portland, OR 97239, USA
j Key words Parkinsons disease posture balance UPDRS push and release test
Introduction
Evaluation...