Errors in cognitive performance trigger postural instability in Parkinson's disease.

Background: Globally, postural stability and cognitive performance are intimately linked in Parkinson's disease (PD). However, a fundamental gap exists in understanding the precise relationship between a disruption in executive function and its impact on postural stability.

Objective: This project aimed to determine the precise effects of cognitive errors on postural stability under dual-task conditions in participants with PD and controls.

Directional Stimulation in Parkinson's Disease and Essential Tremor: The Cleveland Clinic Experience.

Objective: To assess use of directional stimulation in Parkinson's disease and essential tremor patients programmed in routine clinical care.

Materials And Methods: Patients with Parkinson's disease or essential tremor implanted at Cleveland Clinic with a directional deep brain stimulation (DBS) system from November 2017 to October 2019 were included in this retrospective case series. Omnidirectional was compared against directional stimulation using therapeutic current strength, therapeutic window percentage, and total electrical energy delivered as outcome variables.

Quantifying turning behavior and gait in Parkinson's disease using mobile technology.

Gait and balance impairments associated with Parkinson's disease (PD) are often refractory to traditional treatments. Objective, quantitative analysis of gait patterns is crucial in successful management of these symptoms. This project aimed to 1) determine if biomechanical metrics from a mobile device inertial measurement unit were sensitive enough to characterize the effects of anti-parkinsonian medication during the Timed Up and Go (TUG) Test, and 2) develop the Cleveland Clinic Mobility and Balance application (CC-MB) to provide clinicians with objective report following completion of the TUG.

Normative Performance on the Balance Error Scoring System by Youth, High School, and Collegiate Athletes.

Context:   Annually, more than 1 million youth athletes in the United States receive or are suspected of receiving a concussion. The Balance Error Scoring System (BESS) is the most commonly used clinical balance evaluation designed to provide a better understanding of the motor-control processes of individuals with concussion. Despite the widespread use of the BESS, a fundamental gap exists in applying this tool to young athletes, as normative values are lacking for this population.

Cleveland Clinic Postural Stability Index Norms for the Balance Error Scoring System.

Introduction: Despite the widespread utilization of the Balance Error Scoring System (BESS) in the evaluation of concussion, it has been criticized for its error-based scoring that is susceptible to floor and ceiling effects and substantial inter-rater variability. A biomechanical outcome, Cleveland Clinic Postural Stability Index (CC-PSI), has been developed as an alternative to subjective BESS scoring. The CC-PSI uses inertial sensor data within a mobile device to provide an objective measure of postural sway during the BESS.

Three-dimensional evaluation of postural stability in Parkinson's disease with mobile technology.

Background: Postural instability is a hallmark of Parkinson's disease. Objective metrics to characterize postural stability are necessary for the development of treatment algorithms to aid in the clinical setting.

Objective: The aim of this project was to validate a mobile device platform and resultant three-dimensional balance metric that characterizes postural stability.

Use of Mobile Device Accelerometry to Enhance Evaluation of Postural Instability in Parkinson Disease.

Objective: To determine the accuracy of inertial measurement unit data from a mobile device using the mobile device relative to posturography to quantify postural stability in individuals with Parkinson disease (PD).

Design: Criterion standard.

Setting: Motor control laboratory at a clinic.

Objective assessment of postural stability in Parkinson's disease using mobile technology.

Background: A significant gap remains in the ability to effectively characterize postural instability in individuals with Parkinson's disease. Clinical evaluation of postural declines is largely subjective, whereas objective biomechanical approaches are expensive and time consuming, thus limiting clinical adoption. Recent advances in mobile devices present an opportunity to address the gap in the quantification of postural stability.

Quantification of postural stability in older adults using mobile technology.

Traditional biomechanical systems used to capture kinematic data have shown that declines in postural stability are frequently present in older adults and neurological populations. Recent advances in processor speed and measuring capabilities of on-board electronics within mobile devices present an opportunity to gather kinematic data and apply biomechanical analyses to potentially quantify postural stability. The aim of this project was to determine if the kinematic data gathered using a mobile device were of sufficient quantity and quality to characterize postural stability in older adults.