Evidence map›Paper›PMID 42656678›Full record

ArticleParkinson's disease2026

Using Loss of Balance to Understand Postural Instability Associated With Parkinson's Disease.

Ryan D Kaya, Andrew Bazyk, Colin Waltz, Eric Zimmerman, Joshua D Johnston, Benjamin L Walter, Adam Margolius, Anson B Rosenfeldt, Mandy Miller Koop, Jay L Alberts

Abstract read
In one paragraph

Article in Parkinson's disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ryan D KayaCenter for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA, clevelandclinic.org.ORCID https://orcid.org/0000-0002-6964-888X
Andrew BazykCenter for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA, clevelandclinic.org.ORCID https://orcid.org/0009-0007-3021-7605
Colin WaltzDepartment of Biomedical Engineering, Research Institute, Cleveland Clinic, Cleveland, Ohio, USA, clevelandclinic.org.ORCID https://orcid.org/0009-0000-8598-4341
Eric ZimmermanCenter for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA, clevelandclinic.org.
Joshua D JohnstonDepartment of Biomedical Engineering, Research Institute, Cleveland Clinic, Cleveland, Ohio, USA, clevelandclinic.org.
Benjamin L WalterCenter for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA, clevelandclinic.org.ORCID https://orcid.org/0000-0002-8323-6873
Adam MargoliusCenter for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA, clevelandclinic.org.ORCID https://orcid.org/0000-0002-8735-0796
Anson B RosenfeldtDepartment of Biomedical Engineering, Research Institute, Cleveland Clinic, Cleveland, Ohio, USA, clevelandclinic.org.ORCID https://orcid.org/0000-0001-5468-8208
Mandy Miller KoopDepartment of Biomedical Engineering, Research Institute, Cleveland Clinic, Cleveland, Ohio, USA, clevelandclinic.org.ORCID https://orcid.org/0000-0003-3047-8091
Jay L AlbertsCenter for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA, clevelandclinic.org.ORCID https://orcid.org/0000-0002-9379-3630

Funding

Clinical and Translational Science Collaborative of Northern Ohio, Catalyzing Linkages to Equity in Health (CLE Health)UM1TR004528 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI GRACE A MCCOMSEY · 2023 to 2026
$32.1M
Comprehensive Augmented Reality Testing (CART) Platform for Parkinson’s diseaseR01NS129115 · NINDS · CLEVELAND CLINIC LERNER COM-CWRU · PI JAY L. ALBERTS, Mandy Miller Koop · 2022 to 2026
$3.0M
NCATS NIH HHS UM1 TR004528NINDS NIH HHS R01 NS129115
6 · The paper itself

Abstract

Background/Objectives: Postural instability compromises balance, contributing to annual fall rates of 45%-68% in Parkinson's disease (PD). A fundamental gap in clinical evaluation and treatment of postural instability is the use of insufficiently challenging postural control tests and reliance on subjective scoring. Traditional 3D motion capture (Traditional-MC), while precise and objective, is not feasible for clinical utilization. Markerless motion capture (MMC) is a viable candidate for quantifying postural control, feasible with embedded cameras of augmented reality (AR) headsets. This project aimed to assess MMC accuracy in quantifying postural control and to compare PD patients and healthy controls (HCs) to develop a loss-of-balance (LOB) prediction model. Methods: Video data were acquired by a clinician wearing a Microsoft HoloLens 2 AR headset as participants completed three progressively challenging postural control stances. Depth and red-green-blue camera data were analyzed with our custom-built human pose estimation software (CART-MMC). Criterion validity between Traditional-MC and CART-MMC was completed on outcomes, 95% ellipsoid sway area (Sway area) and 95% mediolateral and anteroposterior (ML and AP) ranges in 54 (HC = 28, PD = 26) participants. Group differences were assessed, and survival analysis was conducted to quantify no LOB probabilities in 31 HCs and 68 PD patients. A relaxed LASSO model was used to predict LOB in the PD group from CART-MMC data. Results: Sway area and ML range from CART-MMC were equivalent to Traditional-MC. Furthermore, ML range from CART-MMC differentiated PD patients from HCs in the stance that had the highest completion rate. As postural task difficulty increased, fewer PD patients were able to complete compared to HCs, resulting in lower survival probabilities of the PD group in Tandem-Firm-EO and FT-Foam-EC stances. In the least challenging stance, ML range predicted the occurrence of LOB in the more challenging stance (LOO-CV AUC = 0.78). Conclusions: CART-MMC is a valid method of obtaining objective postural control outcomes, which can detect latent postural control deficits and demonstrates a scalable, objective clinical and remote monitoring approach for predicting falls.

Identifiers

PMID42656678
PMCPMC13507832

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.