Clinical factors associated with abnormal postures in Parkinson's disease.

<h4>Background</h4>Abnormal posture (AP) is often seen in Parkinson's disease (PD), and marked forms known as dropped head syndrome and camptocormia encumber daily living activities. Unlike other motor disabilities such as bradykinesia or muscular rigidity, AP is not always improved...

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Autores principales:	Tomoko Oeda, Atsushi Umemura, Satoshi Tomita, Ryutaro Hayashi, Masayuki Kohsaka, Hideyuki Sawada
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5a70a5ef330945daa278b5d5364df432
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spelling	oai:doaj.org-article:5a70a5ef330945daa278b5d5364df4322021-11-18T08:54:36ZClinical factors associated with abnormal postures in Parkinson's disease.1932-620310.1371/journal.pone.0073547https://doaj.org/article/5a70a5ef330945daa278b5d5364df4322013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24069205/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Abnormal posture (AP) is often seen in Parkinson's disease (PD), and marked forms known as dropped head syndrome and camptocormia encumber daily living activities. Unlike other motor disabilities such as bradykinesia or muscular rigidity, AP is not always improved but rather deteriorated by PD medication.<h4>Purpose</h4>To clarify factors associated with neck and thoracolumbar AP.<h4>Methods</h4>Neck flexion (NF) and thoracolumbar (TL) angles were measured in 216 consecutive PD patients and 175 elderly healthy controls. The differences in NF and TL angles between PD patients and controls were designated as ΔNFA and ΔTLA, respectively. The association of ΔNFA or ΔTLA and predictable factors such as age, sex, duration of PD, Hoehn Yahr (H-Y) stage, Unified Parkinson's Disease Rating Scale Part 3 (UPDRS-3), daily dose of dopamine agonists, and comorbid orthopedic spinal lesions was investigated in PD patients. Patients were divided into quartiles according to ΔNFA or ΔTLA. The association between predictable factors and ΔNFA or ΔTLA was estimated as odds ratio (OR), comparing with the lowest quartile as the reference by multivariate regression analysis.<h4>Results</h4>Compared with controls, distributions of all three posture angles were significantly shifted rightward in PD patients. Although there were no difference in UPDRS-3 scores in the quartiles of ΔNFA, the highest quartile was associated with H-Y stage ≥3 [OR 2.99, 95% confidence interval (CI) 1.33-6.70, p = 0.008] after adjustment for age, sex and comorbid orthopedic spinal lesions. The highest quartile of ΔTLA was associated with comorbid orthopedic spinal lesions [OR 5.83 (1.42-23.8), p = 0.014], and UPDRS-3 score [OR 3.04 (1.80-5.15)/10 points, p<0.0001].<h4>Conclusion</h4>Thoraco-lumbar AP was associated with UPDRS-3 scores and orthopedic spinal lesions, and in contrast, neck AP was not associated with these factors, suggesting that they had different pathomechanisms.Tomoko OedaAtsushi UmemuraSatoshi TomitaRyutaro HayashiMasayuki KohsakaHideyuki SawadaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 9, p e73547 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tomoko Oeda Atsushi Umemura Satoshi Tomita Ryutaro Hayashi Masayuki Kohsaka Hideyuki Sawada Clinical factors associated with abnormal postures in Parkinson's disease.
description	<h4>Background</h4>Abnormal posture (AP) is often seen in Parkinson's disease (PD), and marked forms known as dropped head syndrome and camptocormia encumber daily living activities. Unlike other motor disabilities such as bradykinesia or muscular rigidity, AP is not always improved but rather deteriorated by PD medication.<h4>Purpose</h4>To clarify factors associated with neck and thoracolumbar AP.<h4>Methods</h4>Neck flexion (NF) and thoracolumbar (TL) angles were measured in 216 consecutive PD patients and 175 elderly healthy controls. The differences in NF and TL angles between PD patients and controls were designated as ΔNFA and ΔTLA, respectively. The association of ΔNFA or ΔTLA and predictable factors such as age, sex, duration of PD, Hoehn Yahr (H-Y) stage, Unified Parkinson's Disease Rating Scale Part 3 (UPDRS-3), daily dose of dopamine agonists, and comorbid orthopedic spinal lesions was investigated in PD patients. Patients were divided into quartiles according to ΔNFA or ΔTLA. The association between predictable factors and ΔNFA or ΔTLA was estimated as odds ratio (OR), comparing with the lowest quartile as the reference by multivariate regression analysis.<h4>Results</h4>Compared with controls, distributions of all three posture angles were significantly shifted rightward in PD patients. Although there were no difference in UPDRS-3 scores in the quartiles of ΔNFA, the highest quartile was associated with H-Y stage ≥3 [OR 2.99, 95% confidence interval (CI) 1.33-6.70, p = 0.008] after adjustment for age, sex and comorbid orthopedic spinal lesions. The highest quartile of ΔTLA was associated with comorbid orthopedic spinal lesions [OR 5.83 (1.42-23.8), p = 0.014], and UPDRS-3 score [OR 3.04 (1.80-5.15)/10 points, p<0.0001].<h4>Conclusion</h4>Thoraco-lumbar AP was associated with UPDRS-3 scores and orthopedic spinal lesions, and in contrast, neck AP was not associated with these factors, suggesting that they had different pathomechanisms.
format	article
author	Tomoko Oeda Atsushi Umemura Satoshi Tomita Ryutaro Hayashi Masayuki Kohsaka Hideyuki Sawada
author_facet	Tomoko Oeda Atsushi Umemura Satoshi Tomita Ryutaro Hayashi Masayuki Kohsaka Hideyuki Sawada
author_sort	Tomoko Oeda
title	Clinical factors associated with abnormal postures in Parkinson's disease.
title_short	Clinical factors associated with abnormal postures in Parkinson's disease.
title_full	Clinical factors associated with abnormal postures in Parkinson's disease.
title_fullStr	Clinical factors associated with abnormal postures in Parkinson's disease.
title_full_unstemmed	Clinical factors associated with abnormal postures in Parkinson's disease.
title_sort	clinical factors associated with abnormal postures in parkinson's disease.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/5a70a5ef330945daa278b5d5364df432
work_keys_str_mv	AT tomokooeda clinicalfactorsassociatedwithabnormalposturesinparkinsonsdisease AT atsushiumemura clinicalfactorsassociatedwithabnormalposturesinparkinsonsdisease AT satoshitomita clinicalfactorsassociatedwithabnormalposturesinparkinsonsdisease AT ryutarohayashi clinicalfactorsassociatedwithabnormalposturesinparkinsonsdisease AT masayukikohsaka clinicalfactorsassociatedwithabnormalposturesinparkinsonsdisease AT hideyukisawada clinicalfactorsassociatedwithabnormalposturesinparkinsonsdisease
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Clinical factors associated with abnormal postures in Parkinson's disease.

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