The effect of the Pisa syndrome on balance and gait in Parkinson’s disease: a comparative study

Abstract

INTRODUCTION. Pisa syndrome is a postural deformity that can lead to impaired posture control and balance in patients with Parkinson’s disease (PD), which increases the risk of injury and reduces the quality of life. AIM. To study the effect of the Pisa syndrome on postural control, balance and gait of patients with Parkinson’s disease. HYPOTHESIS. It is assumed that patients with PD with the Pisa syndrome will have specific features of postural control and balance, which must be taken into account when developing rehabilitation technologies for correcting postural disorders. MATERIALS AND METHODS. As part of the comparative study, 30 people of both sexes were examined, all study participants received levodopa drugs in an individual dosage selected by a neurologist-parkinsonologist. The subjects were divided into 2 groups of 15 people each according to the principle of the presence of the Pisa syndrome and its absence. Criteria for inclusion in the groups: voluntary informed consent of persons with PD for the study; age from 45–80 years, stage 2–4 of Hoehn-Yahr Parkinson’s disease, absence of other diseases and gross cognitive impairment. The diagnosis was carried out using the COBS Physiomed stabilometry system and the EQ-5D-3L questionnaire, a diary of falls and a dynamic gait index (DGI). The reliability of the differences was determined by the Mann-Whitney U-test. Data processing was carried out using the Statistica 10 program. RESULTS. Significant differences were revealed in the parameter of the coordination index of the Standing Balance test for the right leg and on the EQ-5D-3L scale at a significance level of p 0.05, in the group of people with PD without the Pisa syndrome, the quality of life was significantly higher, the number of falls was significantly higher in the group of people suffering from PD with the Pisa syndrome towers. DISCUSSION. Walking with a change of direction and multitasking is the most significant problem for people with PD with the Pisa syndrome, the differences between the groups are significant at a significance level of p 0.01. CONCLUSION. Patients with PD and Pisa syndrome have altered gait associated with body tilt forward, instability and decreased balance control.