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Edmundo de Drummond Alves Junior
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Kemoun G., Watelain E., Defebvre L., Guieu J.D., Destee A.
[Postural strategies and falls in elderly and in parkinsonism]
Ann Readapt Med Phys 2002 Dec;45(9):485-92.
OBJECTIVE: To use a posture analysis to show the evolution of postural pattern
connected with falls.MATERIAL AND METHOD: It is a prospective study on two
groups of 16 persons of more than 60 years. A group concerns 16 small
disability off drug parkinsonian patients, a group concerns 16
healthywitnesses. All the persons benefited from a posture recording by means
of a force platform and were followed during 1 year.RESULTS: Data analysis
underlines three groups of persons corresponding to three postural patterns,
independently of the presence of Parkinson disease. A group (n = 18) did not
contain fallers, the second (n = 10 ) contained 20% of fallers, the third (n =
4) contained 100% of fallers. Differences between the groups were identified on
16 posturographic parameters.DISCUSSION: A group has a goodfunctional value and
one does not record any fall. Its characteristics, which correspond to a
category of persons who compensate well for the phenomena of ageing, are found
in the literature. A group has an intermediate functional value and regrets 20%
of fallers. Kinetic profile reveals a tendencyto the stiffness of the posture.
This group is going to operate rather ankle strategies. A group has an inferior
functional value and regrets 100% offallers. Kinetic profile seems disrupted
and not to be able to adapt itself in a satisfactory way to the situation
otherwise than by stereotypical reactions. This group is going to operate
systematically much less stabilizing hip strategies.CONCLUSION: A close
determinism between physiological neuromotor ageing and Parkinson disease does
exist. We showed with a prospective follow-up, the arisen of fall and showed
the evolution of postural patterns related to fall. It appears as well that
evolution mainly follows three stages leading from a small risk of fall gait
pattern to a major risk of fall gait pattern.
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