Donders Institute for Brain, Cognition and Behaviour
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Thesis defense Digna van de Bovenkamp (Donders series 292)

4 October 2017

Promotors: Prof. dr. A. Geurts, Prof. dr. B. Bloem
Copromotors: Dr. V. Weerdesteyn

Postural instability in people with chronic stroke and Parkinson’s disease: dynamic perspectives

Balance problems are common in neurological patients. Current treatment options are suboptimal because we do not fully understand the mechanisms underlying these balance problems. The aim of the work presented in this thesis was to identify mechanisms underlying balance impairments in people with stroke and Parkinson’s disease. This was done by measuring responses to balance perturbations induced by a moving platform on which participants were standing. Following large movements of the platform participants needed to take a step to recover balance. These stepping responses were of poor quality in both people with stroke and Parkinson’s disease. In Parkinson patients step quality did not improve by treatment with medication. In people with stroke it was found that impaired muscle reflexes contributed to a poorer step quality. The results of this study suggest that improving the quality of stepping responses is an important training target.