Robot-based assessment of sitting and standing balance: preliminary results in Parkinson's disease.

Postural responses to unstable conditions or perturbations are important predictors of the risk of falling and can reveal balance deficits in people with neurological disorders, such as Parkinson's Disease (PD). However, there is a lack of evidences related to devices and protocols providing a comprehensive and quantitative evaluation of postural responses in different stability conditions. We tested ten people with PD and ten controls on a robotic platform capable to provide different mechanical interactions and to measure the center of pressure displacement, while trunk acceleration was recorded with a sensor placed on the sternum. We evaluated performance while maintaining upright posture in unperturbed, perturbed, and unstable conditions. The latter was tested while standing and sitting. We measured whether the proposed exercises and metrics could highlight differences in postural control. Participants with PD had worse performance metrics when standing under unperturbed or unstable conditions, and when sitting on the unstable platform. PD subjects in response to a forward perturbation showed bigger trunk oscillations coupled with a sharper increase of the CoP backward displacement. These responses could be due to higher stiffness of lower limb which leads to postural instability. The exercises and the proposed metrics highlighted differences in postural control, hence they can be used in clinical environment for the assessment and progression of postural impairments.