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It is well known that the patients with Parkinson's disease (PD) tend to fall backward due to the disorder of equilibrium function. There have been no quantitative methods for measuring the disorder of equilibrium function, and the risk factor of fall has only been judged according to the experiences of medical doctors and/or therapists. We have therefore developed a new method to measure the stability of the standing position (the ability to keep the standing position) against the tilting stimulation. This method was expected to reflect the risk factor of falls among the patients with PD. Subjects were 14 patients with PD (7 men and 7 women). In Yahr's classification, three were grade 11, eight were grade III, and three were grade IV. Seven healthy elderly subjects without neurological disturbances served as control group. Subjects were instructed to stand on a tilt table, the foot plate of the table was then inclined backward, and the maximum angle at which the subject could keep standing position was measured. With a videotaping from the side, the change of the ROM of the hip joint was recorded at the straight standing position and leaning to the back. Results indicated that the maximum angle of PD patients was significantly smaller than that of controls. Among PD patients, the grade IV group exhibited the tendency to fall backward at the smaller tilting angle compared with the grade II and III groups. Those subjects whose maximum angle was less than 6 degrees had all experienced backward falls. The grade IV group of PD patients showed forward flexion of the body at the straight standing position, and fell backward in the similar position to the straight standing with a small change in ROM of the hip joint. These results suggested usefulness of our new method to predict the risk factor of falls of PD patients.

Disorder of Equilibrium Function in Patient with Pakinson's Disease. Quantitative evaluation by Tilting interference.