Objective: The primary aim was to compare the effects of a four-week trunk-specific rehabilitation program on the severity of the forward trunk flexion. The secondary aim was to compare the training effects on the motor impairments, dynamic and static balance, pain, falls, and quality of life.

Background: Pathological forward trunk flexion is a disabling and drug-refractory motor complication of Parkinson’s disease (PD) leading to imbalance, pain, and fall-related injuries [1]. Since it might be reversible [1,2], the early and multidisciplinary management is emphasised [3].

Method: 37 patients with PD (H&Y£4) and forward trunk flexion were randomised in the experimental (n=19) or control group (n=18). The former consisted of active self-correction exercises with visual and proprioceptive feedback, passive and active trunk stabilization exercises and functional tasks. The latter consisted of joint mobilization, muscle strengthening and stretching, gait and balance exercises. Protocols lasted 4 weeks (60 min/day, 5 day/week). Before, after, and at 1-month follow-up, a blinded examiner evaluated patients using primary and secondary outcomes. The primary outcome was the forward trunk flexion severity (degree).Secondary outcomes were the MDS-UPDRS III, dynamic and static balance, pain, falls, and quality of life assessment.

Results: Significant time per group interaction was measured for the forward trunk flexion severity (p<0.001), dynamic (p=0.03) and static balance (p=0.01) in favour of the experimental training. Comparable effects were reported on the other outcomes. Pre-treatment forward trunk flexion values were highly correlated to post-treatment trunk deviation changes.

Conclusion: The four-week trunk-specific rehabilitation training decreased the forward trunk flexion severity and increased postural control in patients with PD.

References: [1] K.M. Doherty, B.Pp van de Warrenburg, M.C. Peralta, L. Silveira-Moriyama, J.P. Azulay, O.S. Gershanik, B.R. Bloem. Postural deformities in Parkinson’s disease. Lancet Neurol. 10 (2011) 538-49. [2] M. Bartolo, M. Serrao, C. Tassorelli, R. Don, A. Ranavolo, F Draicchio, C. Pacchetti, S. Buscone, A. Perrotta, A. Furnari, P. Bramanti, L. Padua, F. Pierelli, G. Sandrini. Four-week trunk-specific rehabilitation treatment improves lateral trunk flexion in Parkinson’s disease. Mov Disord. 25 (2010) 325-31. [3] N. Smania, A. Picelli, S. Negrini, M. Romano. Neurophysiological basis of rehabilitation of adolescent idiopathic scoliosis. Disability and Rehabilitation, 30(10) (2008) 763 – 771.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/four-week-trunk-specific-exercise-program-decreases-forward-trunk-flexion-in-parkinsons-disease-a-single-blinded-randomized-controlled-trial/