PMID- 29547479 OWN - NLM STAT- MEDLINE DCOM- 20190910 LR - 20190910 IS - 1557-0584 (Electronic) IS - 1557-0576 (Print) IS - 1557-0576 (Linking) VI - 42 IP - 2 DP - 2018 Apr TI - Effects of Fatigue on Balance in Individuals With Parkinson Disease: Influence of Medication and Brain-Derived Neurotrophic Factor Genotype. PG - 61-71 LID - 10.1097/NPT.0000000000000213 [doi] AB - BACKGROUND AND PURPOSE: Because falls can have deleterious consequences, it is important to understand the influence of fatigue and medications on balance in persons with Parkinson disease (PD). Thus, the purpose of this study was to investigate the effects of fatigue on balance in individuals with PD. Because brain-derived neurotrophic factor (BDNF) has been shown to be related to motor performance, we also explored its role. METHODS: A total of 27 individuals (age = 65.4 +/- 8.1 years; males = 14, females = 13) with neurologist-diagnosed PD with 13 genotyped for BDNF as Val66Val, 11 as Val66Met, 2 as Met66Met (1 refused). Participants were tested both on and off medication, 1 week apart. On both days, they completed a pre- and posttest separated by a fatiguing condition. Factorial analyses of variance were performed for the following balance domains: (1) anticipatory postural responses; (2) adaptive postural responses; (3) dynamic balance; (4) sensory orientation; and (5) gait kinematics. For BDNF, t-tests were conducted comparing genotype for the pre-post difference scores in both the on and off medication states. RESULTS: There were no interactions between time (pre- and postintervention) and medication for any of the domains (Ps >/= 0.187). Participants with BDNF Met alleles were not significantly different from Val66Val participants in balance (Ps >/= 0.111) and response to a fatiguing condition (Ps >/= 0.070). DISCUSSION AND CONCLUSIONS: Fatigue does not appear to have a detrimental effect on balance, and there was not a differential effect of medication in individuals with PD. These results also indicate that participants with a BDNF Met allele did not have a greater decay in function after a fatiguing condition.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A196). FAU - Baer, Michael AU - Baer M AD - Spring Valley Hospital, Las Vegas, Nevada (M.B.); Meier and Marsh Professional Therapies, Tooele, Utah (B.K.); Centennial Hills Hospital, Las Vegas, Nevada (D.S.); and Departments of Psychology (A.S.M., J.W.K.), Kinesiology (J.W.N.), and Physical Therapy (M.R.L.), University of Nevada, Las Vegas. FAU - Klemetson, Bradley AU - Klemetson B FAU - Scott, Diana AU - Scott D FAU - Murtishaw, Andrew S AU - Murtishaw AS FAU - Navalta, James W AU - Navalta JW FAU - Kinney, Jefferson W AU - Kinney JW FAU - Landers, Merrill R AU - Landers MR LA - eng GR - P20 GM109025/GM/NIGMS NIH HHS/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Neurol Phys Ther JT - Journal of neurologic physical therapy : JNPT JID - 101193365 RN - 0 (Antiparkinson Agents) RN - 0 (Brain-Derived Neurotrophic Factor) SB - IM MH - Aged MH - Antiparkinson Agents/*therapeutic use MH - Biomechanical Phenomena/physiology MH - Brain-Derived Neurotrophic Factor/*genetics MH - Exercise Therapy/methods MH - Fatigue/*physiopathology MH - Female MH - Gait/physiology MH - Genotype MH - Humans MH - Male MH - Middle Aged MH - Parkinson Disease/drug therapy/genetics/*physiopathology MH - Postural Balance/drug effects/*physiology MH - Reproducibility of Results PMC - PMC5858601 MID - NIHMS936513 EDAT- 2018/03/17 06:00 MHDA- 2019/09/11 06:00 PMCR- 2019/04/01 CRDT- 2018/03/17 06:00 PHST- 2018/03/17 06:00 [entrez] PHST- 2018/03/17 06:00 [pubmed] PHST- 2019/09/11 06:00 [medline] PHST- 2019/04/01 00:00 [pmc-release] AID - 01253086-201804000-00002 [pii] AID - 10.1097/NPT.0000000000000213 [doi] PST - ppublish SO - J Neurol Phys Ther. 2018 Apr;42(2):61-71. doi: 10.1097/NPT.0000000000000213.