Table 1

Parkinson’s disease (PD) specificbalance components, constraints affectingbalance and exercises designedto reduce these constraints
Balance components Constraints in PD Exercise principles Exercise objectives
SENSORY INTEGRATION
Integration of sensory information (somatosensory, visual and vestibular) for estimation of body position - Impaired somatosensory integration Walking tasks on varying surface with or without visual constraints Improve interpretation of and reliance on somatosensory information
- Poor proprioception
- Visual dependency
APAs
Prediction and control of perturbation related to voluntary movements - Poorly timed and scaled APAs Voluntary arm/leg/trunk movements focusing on movement velocity and amplitude, and postural transitions Improve APA strategies regarding quality (timing, amplitude) and task- specific adaptation
- Bradykinesia
MOTOR AGILITY
Coordination between body parts and movement adaptation, e.g. regulation of movement and quick shifts between tasks - Bradykinesia Whole-body coordination during varying gait conditions and reciprocal movements. Quick shifts of movement characteristics (velocity, amplitude and direction) during predictable and unpredictable conditions Improve whole-body coordination, ability to adapt movement and quick shifts between different tasks
- Impaired whole-body coordination
- Biomechanical constraints
- Inflexible motor programming
STABILITY LIMITS
Whole-body regulation relative to the BoS - Reduced functional stability limits Voluntary leaning tasks in standing with varying BoS-stimulating weight shifts in multiple directions through arm and trunk movements Improve the ability to safely control CoM within BoS to increase functional limits of stability
- Biomechanical constraints
- Poor proprioception
- Impaired somatosensory integration

APAs = anticipatory postural adjustments; BoS = base of support; CoM = centre of mass.

Conradsson et al.

Conradsson et al. BMC Neurology 2012 12:111   doi:10.1186/1471-2377-12-111

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