Maladaptive One-Leg Balance Control in Parkinson’s Disease

Balance disorders are very frequent in Parkinson’s disease (PD). One-leg stance performance is a predictor of fall risk. We investigated one-leg stance strategies in people with PD. We hypothesized that patients would choose, and better perform on, the leg on the least affected body side. Fifty participants with 2 to 19 years of PD duration stood on one leg while ON medication. The leg spontaneously chosen was recorded. Performance was compared between the spontaneously chosen vs. contralateral, and most vs. least stable legs. Influence of disease duration, severity, age, cognition, and motor fluctuations was analyzed. Twenty-eight patients spontaneously stood on the leg of the least affected body side, which was not always the most stable one. The chosen standing leg was influenced by disease duration with a switch between the least vs. most affected body side after seven years of disease duration. Fourteen patients (28%) spontaneously stood on their least stable leg. Thus, some patients with PD choose the least stable leg when asked to perform one-leg stance. It is important to identify these patients since they may be at greater risk of falls and/or gait difficulties. Specific rehabilitation may help prevent such maladaptive strategy

Acute lethargy after abrupt apomorphine withdrawal in Parkinson's disease

- Continuous apomorphine infusion represents an established treatment for advanced Parkinson's Disease (PD). - Acute lethargy was repeatedly observed following abrupt apomorphine withdrawal. - Profound lethargy was not associated to severe akinetic state and was solved only after restoring apomorphine. - Lethargy might be a symptom of acute apomorphine withdrawal