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. 2019 Jan 25;6(3):213-221.
doi: 10.1002/mdc3.12723. eCollection 2019 Mar.

Postural Abnormality in Parkinson's Disease: A Large Comparative Study With General Population

Yoshihito Ando  1   2 , Ken-Ichi Fujimoto  3 , Ken Ikeda  4 , Hiroya Utsumi  5 , Yasuyuki Okuma  6 , Hisayoshi Oka  7 , Satoshi Kamei  8 , Akira Kurita  9   10 , Kazushi Takahashi  11 , Shigeru Nogawa  12 , Nobutaka Hattori  13 , Koichi Hirata  14 , Toshiya Fukui  15 , Kaoru Yamazaki  16 , Toshimasa Yamamoto  11 , Fumihito Yoshii  17
Affiliations

Postural Abnormality in Parkinson's Disease: A Large Comparative Study With General Population

Yoshihito Ando et al. Mov Disord Clin Pract. .

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.

Keywords: Parkinson's disease; digital camera photograph; general population; postural abnormality; related factor.

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Figures

Figure 1
Figure 1
Measurement procedure. 1: external acoustic foramen; 2: acromion; and 3: greater trochanter. A straight line A: between the external acoustic foramen and acromion; A straight line B: between the acromion and greater trochanter. The DHA is made by the straight lines A and B. The AFA is made by straight line B and a vertical line V. A straight line C: between both acromions shown in the back photographs and a straight line D crossing line C at a right angle. The LFA is made by straight line D and vertical line V. Plus sign indicates right direction and minus sign indicates left direction.
Figure 2
Figure 2
Comparison between the measured angles in the age‐matched general population participants and the angles in the PD patients. Upper section: total distribution. Lower section: extended indication to watch small distribution (n = 0–10).
Figure 3
Figure 3
Comparison between the measured angles in the age‐matched general population participants and the angles in the PD patients (540 males and 577 females). Upper section: males. Lower section: females.
See this image and copyright information in PMC

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