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Balance Dysfunction in Parkinson’s Disease - 1st Edition - ISBN: 9780128138748, 9780128138755

Balance Dysfunction in Parkinson’s Disease

1st Edition

Basic Mechanisms to Clinical Management

Authors: Martina Mancini John G. Nutt Fay B. Horak
Paperback ISBN: 9780128138748
eBook ISBN: 9780128138755
Imprint: Academic Press
Published Date: 17th September 2019
Page Count: 226
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Balance Dysfunction in Parkinson’s Disease: Basic Mechanisms to Clinical Management presents the most updated information on a variety of topics. Sections help clinicians evaluate the types of balance control issues, dynamic balance dysfunction during turning, and the effects of medication, deep brain stimulation, and rehabilitation intervention on balance control. This book is the first to review the four main postural control systems and how they are affected, including balance during quiet stance, reactive postural adjustments to external perturbations, anticipatory postural adjustments in preparation for voluntary movements, and dynamic balance control during walking and turning.

In addition, the book's authors summarize the effects of levodopa, deep brain stimulation, and rehabilitation intervention for each balance domain. This book is recommended for anyone interested in how and why balance control is affected by PD.

Key Features

  • Provides the first comprehensive review of research to date on balance dysfunctions in Parkinson's disease
  • Discusses how to translate current neuroscience research into practice regarding neural control of balance
  • Provides evidence on the effects of current interventions on balance control


Neurologists, clinicians, translational neuroscientists, neurology researchers, and physical therapists

Table of Contents

1. How is Balance Controlled by the Nervous System?
2. Why is Balance so Important in Parkinson’s Disease?
3. How is Balance during Quiet Stance Affected by PD?
4. How are Postural Responses to External Perturbations Affected by PD?
5. How are Anticipatory Postural Adjustments in Preparation for Voluntary Movements Affected by PD?
6. How is Dynamic Balance During Walking Affected by PD?
7. How and Why Is Turning Affected By PD?
8. Is Freezing of Gait a Balance Disorder?
9. How Should the Clinician Approach Imbalance in PD?
10. Future Perspectives on Balance Disorders in PD


No. of pages:
© Academic Press 2020
17th September 2019
Academic Press
Paperback ISBN:
eBook ISBN:

About the Authors

Martina Mancini

Dr. Mancini received her PhD in bioengineering at University of Bologna in Italy, and completed a postdoctoral fellowship in the Department of Neurology at OHSU. Her translational biomedical research focuses on objectively characterizing, understanding and monitoring mobility impairments in patients with neurological disorders with wearable sensors in order to develop tailored rehabilitation intervention, such as biofeedback-based solutions. She has presented at national and international meetings on topics related to balance and gait impairments in subjects with Parkinson’s disease and Parkinsonism, as well as fall risk in healthy elderly subjects. She received an NIH K99-R00 award from the National center for Medical Rehabilitation Research to characterize the physiology of gait disturbances during locomotion with body-worn sensors, and to determine whether vibrotactile biofeedback improves gait disturbances in Parkinson’s disease in laboratory and home environments.

Affiliations and Expertise

Balance Disorders Laboratory, Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA

John G. Nutt

I have two main research areas. The first theme is the pharmacology of movement disorders. My studies have largely been proof of principle clinical trials of dopaminergic therapies. I have developed protocol using 2-hour levodopa infusions and four simple clinical tests (tapping speed, timed up and go tremor score and dyskinesia score) for investigating pharmacodynamics of levodopa and interactions between levodopa and other interventions. The second theme is gait and balance dysfunction with clinical interests in gait disorders and interests in the physiology of gait and balance in neurological disorders. David Marsden, Phillip Thompson and I introduced the concept of lower, middle and higher level gait disorders that is widely accepted today. Dr. Horak, with whom I have collaborated for over 30 years, and I have investigated the physiology of balance and gait disorders that characterizes Parkinson’s disease.

Affiliations and Expertise

Oregon Health and Science University, Parkinson Center for Health and Healing, Portland, OR, USA

Fay B. Horak

Dr. Horak holds a PhD in Physiology and Biophysics, an MS in Neurophysiology from University of Minnesota, and a BS in Physical Therapy from University of Wisconsin. Her background is in neural control of balance and gait and the effects of neurological disorders on motor control. She has received the prestigious MERIT award from the NIH, a rare Mary McMillan Research Award from the American Physical Therapy Association, and many national and international honorary research awards. She is past-president of the International Society of Posture and Gait Research and past-editor of Gait and Posture. She has over 250 peer-reviewed publications.

Affiliations and Expertise

Director of Balance Disorders Laboratory, Portland VA Medical System and Oregon Health and Science University, Portland, Oregon, USA

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