Abstract
Pisa syndrome is one of the possible postural deformities associated with Parkinson’s disease and it is clinically defined as a sustained lateral bending of the trunk. Some previous studies proposed clinical and biomechanical investigation to understand the pathophysiological mechanisms that occur, mainly focusing on EMG patterns and clinics. The current research deals with the assessment of a standardized biomechanical analysis to investigate the Pisa syndrome postural effects. Eight patients participated in the experimental test. Both static posture and gait trials were performed. An optoelectronic system and two force plates were used for data acquisition, while a custom multi-segments kinematic model of the human spine was used to evaluate the 3D angles. All subjects showed an important flexion of the trunk superior segment with respect to the inferior one, with a strong variability among patients (range values between 4.3° and 41.0°). Kinematics, ground reaction forces and spatio-temporal parameters are influenced by the asymmetrical trunk posture. Moreover, different proprioception, compensation and abilities of correction were depicted among subjects. Considering the forces exchanged by the feet with the floor during standing, results highlighted a significant asymmetry (p-value = 0.02) between the omo and contralateral side in a normal static posture, with greater load distribution on the same side of lateral deviation. When asked to self-correct the posture, all patients demonstrated a reduction of asymmetry, but without stressing any statistical significance. All these aspects might be crucial for the definition of a PS patients’ classification and for the assessment of the efficacy of treatments and rehabilitation.
Highlights
Parkinson’s disease (PD) is a chronic and developing neurodegenerative pathology characterized by several motor and non-motor symptoms
Previous literature reported a prevalence from 2% to 90%, but a recent experimental analysis made in a multicenter Italian study has estimated a prevalence of 8.8% [7]
This postural alteration is often mismatched with scoliosis due to the similarity on plane and body segment involved in the deformity
Summary
Parkinson’s disease (PD) is a chronic and developing neurodegenerative pathology characterized by several motor and non-motor symptoms. Severe abnormities of posture and spinal alignment might lead to important disability and difficulty in conducting daily activities. These spinal deformities were classified and defined based on their main characteristics and the most common are camptocormia, antecollis, scoliosis and Pisa syndrome [3,4]. Previous literature reported a prevalence from 2% to 90%, but a recent experimental analysis made in a multicenter Italian study has estimated a prevalence of 8.8% [7] This postural alteration is often mismatched with scoliosis due to the similarity on plane and body segment involved in the deformity. The combination of lateral trunk deviation and vertebral rotation in PS is reversible, a physiological lateral flexion can be achieved by a passive mobilization or supine posture; while in scoliosis it is fixed [4,8,9]
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