Open-loop and closed-loop postural control mechanisms in Parkinson's disease: increased mediolateral activity during quiet standing.

Stabilogram-diffusion analysis was used to gain insights into how idiopathic Parkinson's disease (IPD) affects the postural control mechanisms involved in maintaining erect stance. Twenty-two subjects with IPD and twenty-four healthy elderly subjects were studied under eyes-open, quiet-standing conditions. The postural control mechanisms in the parkinsonian subjects, compared to the healthy elderly, were characterized by an increase in the effective stochastic activity in the mediolateral direction. Mediolateral posturographic measures were also associated with a history of falls and poor performance on clinical measures of balance. It is hypothesized that the increase in mediolateral activity in subjects with IPD may reflect an attempt to maintain potentially stabilizing movements during quiet standing in the face of impaired movement in the anteroposterior direction. This study supports the notion that mediolateral instability is an important posturographic marker of functional balance impairment in the elderly.