The effect of postural deformities on back function and pain in patients with Parkinson’s disease

Abstract

BACKGROUND: Postural deformities, such as Pisa syndrome (PS), and camptocormia and antecollis (C&A) are common in patient with Parkinson's disease (PwPD). These deformities can lead to back disability and pain with different mechanisms, including abnormal loading or stress on soft tissues as muscles, lumbar discs and ligaments. OBJECTIVES: To evaluate the effect of different postural deformities including PS and C&A on back function and pain in PwPD. METHODS: The function, disability and pain were assessed by Oswestry disability index (ODI) and brief pain inventory (BPI). All participants completed clinical assessments by the Unified Parkinson's Disease Rating Scale (UPDRS), Modified Hoenh & Yahr (mH&Y) staging and the Levodopa Equivalent Daily Dose (LEDD).RESULTS: PS and C&A groups significantly showed worse disability ODI and pain BPI, and higher LEDD and mH&Y stage compared with PD groups. However, no differences were found in PD duration and UPDRS in the same groups. Moreover, no differences were observed between PS and C&A groups in the mentioned scales. CONCLUSION: These results demonstrated that PS and C&A are associated with severe impairment of back functions and pain. Rehabilitation programs for PwPD and PS, and C&A should include spine alignment and postural training.

A summary index derived from Kinect to evaluate postural abnormalities severity in Parkinson’s Disease patients

“…ROC curves showed that patients with LTB of 10.5°might have moderate/severe motor impairment 16 . Another two studies demonstrated that camptocormia, antecollis, and Pisa syndrome were associated with severe impairment of neck and back functions, as well as pain in PD patients 41,42 . In our study, weak to moderate correlations were identified between IPA with common PD clinical scales, which indicates that IPA can reflect the clinical severity of postural abnormalities in PD to some extent.…”

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

“…Among the postural changes, a forward-stooped posture with flexion of the cervical and thoracic spine is common. 1 , 2 Forward stooped posture can cause significant discomfort, 3 contributes to an increased risk of falls 4 , 5 and reduces the quality of life. 3 , 6 – 10 Treatment options are limited as postural changes (like other axial symptoms such as postural instability and gait disorders) do not respond well to pharmacological therapy.…”

“… 1 , 2 Forward stooped posture can cause significant discomfort, 3 contributes to an increased risk of falls 4 , 5 and reduces the quality of life. 3 , 6 – 10 Treatment options are limited as postural changes (like other axial symptoms such as postural instability and gait disorders) do not respond well to pharmacological therapy. 1 , 6 , 11 – 13 Deep brain stimulation appears to have some efficacy in stooped posture in small studies, 14 , 15 but the lack of randomized controlled trials of deep brain stimulation for stooped posture, strict selection criteria, its invasive nature, and its limited availability at specialized centres limit its use for the general patient population.…”

Sagittal alignment changes and postoperative complications following surgery for adult spinal deformity in patients with Parkinson’s disease: a multi-institutional retrospective cohort study

“…With population aging, the number of patients with this age-related disorder is increasing [1]. In severe cases, PD causes postural disorder, such as anterocollis, Pisa syndrome, and camptocormia [2][3][4][5]. Reports have shown that these postural abnormalities increase susceptibility to rigid spinal deformities [2,3] and that patients with PD develop adult spinal deformity (ASD) more frequently than the general population in the same age groups [6].…”