A neuromechanical model characterizing the motor planning and posture control in the voluntary lean in Parkinson's disease.

Parkinson's disease targets patients' cognitive and motor abilities, including postural control. Many studies have been carried out to introduce mathematical models for a better understanding of postural control in such patients and the relation between the model parameters and the clinical assessments. So far, these studies have addressed this connection merely in static tests, such as quiet stance. The aim of this study is to develop a model for voluntary lean, and as such, identify the model parameters for both PD patients and healthy subjects from experimental data. The proposed model comprises planning and control sections. The model parameters for the planning section were extracted from the time response characteristics. Parameters for the control section were identified based on the spatial characteristics of the center-of-pressure (COP) response using an optimization process. 24 PD patients along with 24 matched healthy subjects participated in the study. The results showed a significant difference between the two groups in terms of temporal parameters for the planning section. This difference emphasizes bradykinesia as an essential symptom of PD. Also, differences were found for the postural control section. In all directions, the proportional gain of the feedback controller was significantly larger in PD patients; however, the gain of the feedforward controller was significantly smaller in PD patients. Furthermore, the control gains were strongly correlated with the clinical scales (Functional Reach Test and Unified Parkinson's Disease Rating Scale) in certain directions. In conclusion, the new model helps to better understand and quantify some PD symptoms in voluntary lean tasks.