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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Neurorehabilitation
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1528191
This article is part of the Research Topic Integrating Technology into Advanced Parkinson's Disease Management: From Screening and Evaluation to Treatment and Prevention View all articles

Instrumental Balance Assessment in Parkinson's Disease and Parkinsonism. A Systematic Review with Critical Appraisal of Clinical Applications and Quality of Reporting

Provisionally accepted
Andrea Merlo Andrea Merlo 1Lorenzo Cavazzuti Lorenzo Cavazzuti 1Maria Chiara Bò Maria Chiara Bò 2*Francesco Cavallieri Francesco Cavallieri 3Maria Chiara Bassi Maria Chiara Bassi 4Benedetta Damiano Benedetta Damiano 1Sara Scaltriti Sara Scaltriti 1Valentina Fioravanti Valentina Fioravanti 3Giulia Di Rauso Giulia Di Rauso 3Giacomo Portaro Giacomo Portaro 3Franco Valzania Franco Valzania 3Mirco Lusuardi Mirco Lusuardi 5Isabella Campanini Isabella Campanini 1
  • 1 LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Italy
  • 2 Merlo Bioengineering, Parma, Italy
  • 3 Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
  • 4 Medical Library, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
  • 5 Neuromotor and Rehabilitation Department, Azienda USL-IRCCS Reggio Emilia, Italy, Reggio Emilia, Italy

The final, formatted version of the article will be published soon.

    Patients with Parkinson's disease (pwPD) and atypical parkinsonism usually complain of impaired balance. Instrumental posturography is widely used to quantitatively assess static balance in pwPD but many posturographic parameters and protocols have been suggested. We aimed to appraise the use of static posturography in pwPD and atypical parkinsonism, and identify gaps hindering its translation into clinical routine.Methods: A systematic review on four databases. Study methodology, clinical aspects, assessment protocol, technical aspects, and transferability to clinical practice were critically appraised by a set of quality questions, scored on three levels (0, 0.5, 1). Total scores were used to assess overall studies' quality.Results: 132 studies were included. The majority (105/132) was rated medium-quality. The domains "transferability to clinical practice" and "assessment protocol" received the lowest scores. The main flaw hindering portability to clinical settings was the lack of a stated rationale behind the choice of a specific protocol and the selection of the posturographic parameters. Missing reporting about the technical aspects employed to manage posturographic data and comprehensive instructions given to the patients further contributed to lower quality.We provided recommendations for enhancing the clinical transferability of studies on static posturography to assess pwPD, including 1) discussing the rationale for choosing the assessment protocols and posturographic parameters, 2) detailing the inclusion criteria and select appropriate samples, and 3) reporting all the technical information to replicate the procedures and computations.

    Keywords: Parkinson's disease, Atypical Parkinsonism, posturography, static balance, Stabilometry

    Received: 14 Nov 2024; Accepted: 02 Jan 2025.

    Copyright: © 2025 Merlo, Cavazzuti, Bò, Cavallieri, Bassi, Damiano, Scaltriti, Fioravanti, Di Rauso, Portaro, Valzania, Lusuardi and Campanini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Maria Chiara Bò, Merlo Bioengineering, Parma, Italy

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