Objective: To investigate i) whether non-motor impairments are associated with flexed truncal posture in people with Parkinson’s disease (PD), and ii) the relationship between flexed truncal posture and performance of upper body activities after adjusting for factors known to influence these activities.

Background: Flexed posture is common in people with PD and is associated with severity of axial motor impairments. Non-motor impairments may also influence posture. Flexed posture adversely affects gait and balance, however, its influence on everyday activities involving the upper body is unknown.

Methods: 70 people (43 males, mean age 75 (SD 8.5) years) with PD had flexed posture measured as the distance between the C7 vertebra and wall when standing in their usual posture. Non-motor impairments including spinal proprioception, cognition, overall fatigue, postural fatigue, pain and depression were obtained from questionnaires or physical assessment. Activities assessed included getting in and out of bed, upper limb activities, respiratory function and speech volume. Univariate and multivariate regression were used to determine associations between non-motor impairments and flexed posture, and between flexed posture and activity performance.

Results: People with PD had greater flexed posture than healthy older adults (mean 10.4 cm, SD 3.9 vs mean 5.2 [1], respectively). Spinal proprioception and postural fatigue were significantly associated with flexed posture in univariate analysis (adjusted R2 .05-.07, p=.02-.04), but did not make an independent contribution to flexed posture in a multivariate model when adjusted for age, sex and axial motor impairments (p=.07-.13). Flexed posture was associated with upper limb activities (standardized β=0.26, p=.02) and restrictive lung function (standardized β=-0.41, p=.001) but not with bed transfers (standardized β=0.14, p=.26) when age and disease severity were adjusted for. Flexed posture was not associated with speech volume (p=.90).

Conclusions: Spinal proprioception and postural fatigue are associated with flexed posture in PD but not as strongly as axial motor impairments. Flexed posture adversely influences upper limb activities and respiratory function. Interventions to improve spinal proprioception and posture may improve activity performance in people with PD.

References: [1] Ryan & Fried, J Am Geriatr Soc 1997;45:1479.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/flexed-posture-relationships-with-non-motor-impairments-and-upper-body-activities-in-people-with-parkinsons-disease/