Effect of intramuscular lidocaine injection with physical therapy on camptocormia in patients with Parkinson's disease who had previously had deep brain stimulation

Abstract

[Purpose] We aimed to evaluate the effects of an intervention consisting of intramuscular lidocaine injection in combination with physical therapy on the standing posture, balance ability, and walking ability in patients with Parkinson's disease who had camptocormia after deep brain stimulation. [Participants and Methods] The participants were nine patients with Parkinson's disease who had previously undergone deep brain stimulation. The intervention comprised a lidocaine injection into the abdominal external oblique muscles for five days in combination with physical therapy, including body weight-supported treadmill training for two weeks. Before and after the intervention, the total and upper camptocormia angles were used to assess the standing posture; the Berg balance scale was used to assess the balancing ability; and maximum walking speed and stride length were used to assess the walking ability. [Results] The total and upper camptocormia angles, and Berg balance scale improved significantly more after the intervention than before. Before and after the intervention, there was no significant difference in maximum walking speed, but the stride length was significantly greater after the intervention than before. [Conclusion] The intervention was effective in alleviating camptocormia and improving the balance and walking abilities of patients with Parkinson's disease with camptocormia after deep brain stimulation.

Keywords: Intramuscular lidocaine injection; Parkinson’s disease; Physical therapy.

Fig. 1.

How to measure standing posture. A: total camptocormia angle (TCCangle), B: upper camptocormia angle (UCCangle). TCCangle was defined as the angle on a sagittal image between the line from the L5 spinous process to the C7 spinous process and the line from the L5 spinous process to the lateral malleolus while standing. UCCangle was defined as the angle between the line from the C7 spinous process to the inflection point and the line from the L5 spinous process to the inflection point.