Yoshihito Ando1,2, Ken-Ichi Fujimoto3, Ken Ikeda4, Hiroya Utsumi5, Yasuyuki Okuma6, Hisayoshi Oka7, Satoshi Kamei8, Akira Kurita9,10, Kazushi Takahashi11, Shigeru Nogawa12, Nobutaka Hattori13, Koichi Hirata14, Toshiya Fukui15, Kaoru Yamazaki16, Toshimasa Yamamoto11, Fumihito Yoshii17. 1. Department of Internal Medicine Josai Hospital. 2. Division of Neurology, Department of Internal Medicine Jichi Medical University. 3. Jichiidai Station Brain Clinic. 4. Department of Neurology Toho University Omori Medical Center. 5. Department of Neurology International University of Health and Welfare, Shioya Hospital. 6. Department of Neurology Juntendo University Shizuoka Hospital. 7. Department of Neurology Daisan Hospital, The Jikei University School of Medicine. 8. Department of Medicine, Division of Neurology Nihon University School of Medicine. 9. Department of Neurology The Jikei University Kashiwa Hospital. 10. Department of Neurology Teikyo University Medical Center. 11. Department of Neurology Saitama Medical University. 12. Department of Neurology Tokai University Hachioji Hospital. 13. Department of Neurology Juntendo University Hospital. 14. Department of Neurology Dokkyo Medical University Hospital. 15. Kawasaki Memorial Hospital. 16. Department of Neurology Tokyo Medical University Ibaraki Medical Center. 17. Department of Neurology Saiseikai Shonan Hiratsuka Hospital.
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.
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.
Entities:
Keywords:
Parkinson's disease; digital camera photograph; general population; postural abnormality; related factor
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