Postural Abnormality in Parkinson's Disease: A Large Comparative Study With General Population

Abstract

Background Postural abnormalities in Parkinson's disease (PD) patients and unimpaired elderly are not well differentiated. Factors related to postural abnormality associated with PD are controversial. Objective We assessed differences in postural change between PD patients and unimpaired elderly and elucidated factors related to abnormal posture in PD patients. Methods We measured the dropped head angle (DHA), anterior flexion angle (AFA), and lateral flexion angle (LFA) of the thoracolumbar spine of an unprecedented 1,117 PD patients and 2,732 general population participants (GPPs) using digital photographs. Two statistical analyses were used for elucidating factors related to these angles. Results In GPPs, age was correlated with DHA, AFA, and LFA. DHAs, AFAs, and LFAs of PD patients and age‐matched GPPs were 21.70° ± 14.40° and 13.13° ± 10.79°, 5.98° ± 12.67,°and − 3.82° ± 4.04°, and 0.86° ± 4.25° and 1.33° ± 2.16°, respectively. In PD patients, factors related to DHA were age, male sex, and H & Y stage during ON time. Factors related to AFA were age, duration of disease, H & Y stage during ON and OFF times, pain, vertebral disease, and bending to the right. A factor related to LFA was AFA. Conclusions DHA and AFA of GGPs correlated with age and were larger in PD patients than those with in GPPs. Some PD patients showed angles far beyond the normal distribution. Thus, factors associated with disease aggravation affected postural abnormality in PD patients.

Subjective postural vertical in Parkinson's disease with lateral trunk flexion

“…There is a report of improvement in 34 of 138 patients with camptocormia after discontinuation of pramipexole, 25 and there has been a dopaminergic drug dose‐control study showing improvement of patients with Pisa syndrome 26 . Although no noticeable difference has been found in affinity between non‐dopamine drugs, 27 the effects of anti‐PD drug administration on abnormal posture have not been established. Although these studies have targeted severe postural abnormalities such as camptocormia at a trunk flexion angle of 45° or more and Pisa syndrome with trunk flexion of 10° or more, the LTF has ranged from 1° or more to severe bending.…”

The Effect of Medication and Deep Brain Stimulation on Posture in Parkinson's Disease

“…However, also in that study, only 37% of the variance of the stimulation effect was predicted (7). A study with a great number of PD patients found age, duration of disease, H-Y stage, pain, and vertebral disease relevant, but without further specification of their individual relevance (18).…”

Istradefylline to Treat Patients with Parkinson’s Disease Experiencing “Off” Episodes: A Comprehensive Review

“…These episodes are due in part to chronic levodopa therapy, which is one of the disease’s most common treatment methods. These episodes consist of both motor, non-motor, posture, and autonomic symptoms [ 3 , 7 ]. Patients with off-episodes also report anxiety about impending symptoms [ 3 ].…”