Objective: To quantitatively assess posture in a large cohort of patients with PD in association with demographic features, laboratory data and life style and to evaluate the course of posture variations over a one year period.

Background: Patients with Parkinson’s disease (PD) exhibit varied degrees of stooped posture. Previous studies concentrated on the pathophysiology of severe postural deformities, such as camptocormia and Pisa syndrome. The aim of this study was to investigate risk factors associated with flexed posture in PD and their effects on the course of posture variations.

Methods: Angles of spine inclination in upright position, extension, and flexion were assessed with SpinalMouse in 190 patients with PD. Demographic data, disease type (tremor or akinetic-rigid), amount of weekly physical were recorded. Patients underwent bone mineral density measurement and vertebral fractures assessment. Motor function was evaluated with the UPDRS, and back pain, with the RMDQ. Sixty-four patients were reevaluated after 10-14 months for progression of postural changes.

Results: At baseline, there was a significant correlation between the angle of upright inclination and UPDRS motor score (p=0.005), UPDRS and posture score (item 28; p=0.0001), disease duration (p=0.03), and degree of osteoporosis (p=0.034). Findings were not significant for age at disease onset and RMDQ score. Re-evaluation at one year yielded a significant correlation of delta of angle of inclination in upright position and in extension with disease duration (p=0.017, p=0.043), UPDRS motor score (p=0.03, p=0.018), and disease type (p=0.04, p=0.005). Delta of angle of upright inclination was significantly correlated with amount of physical activity (p=0.0035); delta of angle of extension was significantly correlated with number of vertebral fractures (p=0.048).

Conclusions: Disease severity, disease duration, and osteoporosis are risk factors for postural abnormalities in PD. Physical activity might be a protective factor at least over a limited period of time.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/risk-factors-associated-with-postural-changes-in-parkinsons-disease/