The effect of comprehensive physiotherapy-based rehabilitation on stooped posture in Parkinson’s disease

Abstract

[Purpose] The effect of physiotherapy on stooped posture in Parkinson’s disease patients remains to be clarified. Therefore, the purpose of this study was to investigate whether comprehensive physiotherapy-based rehabilitation can improve stooped posture in Parkinson’s disease patients. [Participants and Methods] The participants were Parkinson’s disease patients with stooped posture. Outpatients were assigned to the control group and inpatients to the postural rehabilitation group. The outcomes measured were trunk bending angle, lumbar lordosis, and thoracic kyphosis. Each group was assessed at baseline and 1 month later. [Results] Of 22 participants identified, 20 were included, with 10 participants in the postural rehabilitation group and 10 in the control group. The age in the postural rehabilitation group was significantly greater than that in the control group, while other parameters were comparable in both groups. After the month-long intervention, the trunk bending angle and lumbar lordosis were significantly improved in the postural rehabilitation group compared to the control group. [Conclusion] The results showed improvement in stooped posture in the postural rehabilitation group as compared to the control group. Furthermore, improvement of lumbar lordosis accompanied improvement of stooped posture. These findings suggest that comprehensive physiotherapy-based rehabilitation may improve stooped posture in Parkinson’s disease patients.

Treatment of axial postural abnormalities in parkinsonism disorders: A systematic review of pharmacological, rehabilitative and surgical interventions

“…GA reported significant improvement on back pain, while not significant changes in GB n.a. Fair −4 Kawami et al 2018 [108] Intervention Studies EG, n = 0, [MMSE = 27.1 ± 1.7]CG, n = 10 [MMSE = 28.1 ± 1.9] Patients’ exclusion criteria MMSE < 24 CG = 2-4EG = 2–4 EG = 10.1 ± 2.8CG = 10.8 ± 6.3 Stooped Posture n.a. Trunk bending angles, lumbar lordosis, thoracic kyphosis (Spinal Mouse) in comfortable and upright standing position.Pain and cognitive status n.r.…”

“…We found 18 studies on the effect of rehabilitative interventions on PA in PD, including 326 patients. 44 % (n = 8) were RCT [41] , [94] , [95] , [96] , [97] , [98] , [99] , [100] , 11 % (n = 2) were Case Reports [45] , [101] , 28 % (n = 5) were Prospective Interventional Before After [102] , [103] , [104] , [105] , [106] , 11 % (n = 2) were Case Series [43] , [107] , and one controlled intervention study [108] . In most studies (n = 13), a follow-up assessment was performed (from 1 to 26 months).…”

“…44 % (n = 8) investigated the effects of rehabilitative approaches as standalone treatments [94] , [95] , [96] , [97] , [102] , [103] , [107] , [108] Half of that were RCTs [94] , [95] , [96] , [97] . Rehabilitation combined with botulinum toxin [41] , [45] or lidocaine [43] , [105] , [106] was explored in five studies.…”

Climb up! Head up! Climbing improves posture in Parkinson's disease. A secondary analysis from a randomized controlled trial

“…46 The strengthening effect sport climbing has on the back and shoulder girdle muscles 31,33,[47][48][49][50][51] may enable the patient to yield a more upright posture. 17,21 Another explanation for the effectiveness of sport climbing for Parkinson's disease could be found in the fact that sport climbing improves flexibility in the trunk and spine. 31,48 With its high demands on movement planning and execution, climbing also trains spatial body awareness, a crucial component of maintaining and correcting posture.…”

“…16 Four randomized trials, one controlled trial and two case series have already demonstrated that targeted physical exercise significantly corrects forward postural abnormalities in Parkinson's disease. [17][18][19][20][21] Previous research observed an average improvement of 8°-23°of the forward trunk flexion after 3 or 4 weeks of intervention, respectively. One study reported that eight weeks of aquatic physiotherapy reduced forward neck flexion by 65°.…”