Objective: To clarify the clinical relationship between lifelong daily workload and postural abnormalities of patients with Parkinson’s disease (PD).

Background: Recent clinical researches revealed postural abnormalities including drop head syndrome, camptocormia and Pisa syndrome in PD as a factor deteriorating QOL because conventional medications are usually ineffective. Vertebral problems are noticed as risk factors of them. Vertebral deformities can occur asymptomatically with aging or lifelong daily workload as well as symptomatically by traumatic mechanism. In this study, we investigated the clinical relationship between the workload and postural abnormalities in PD.

Methods: PD patients and healthy controls (HC) were consecutively recruited. Their levels of workloads was evaluated using with a simple questionnaire recommended by the Ministry of Health, Labour and Welfare in Japan, which is established based on calorie requirement per kg of body weight per day (class 1; less than 25 kcal/kg, class 2; 25-30 kcal/kg, class 3; 30-35 kcal/kg, class 4; 35-40 kcal/kg, class 5; more than 40 kcal/kg). Their postural abnormalities were evaluated with the original grading scale based on severities of angle of the neck or trunk as summery score and scores of each abnormal posture, from 0 as normal to 4 as the severest angle. The correlation between the workload and postural deformities, and the factors that impact them were statistically analyzed.

Results: From October 2010 to September 2011, we could recruit 120 PD patients (mean age; 70.8 years, female; 55.8%, mean disease duration; 10.9 years, mean UPDRS; 34.8) and 49 HC (mean age; 70.7, female; 51.0%). The numbers of them were none of both in class 1 workload, 1 (0.8%) and none in class 2, 59 (49.2%) and 23 (46.9%) in class 3, 54 (45.0%) and 25 (51.0%) in class 4 and 2 (1.7%) and 1 (2.0%) in class 5. Their mean summery scores of postural abnormalities were 1.7 in PD and 0.1 in HC. There is no significant correlation between the workload and postural abnormalities in PD (p=0.0617, Spearman’s rank correlation). Multiple regression analysis also could not show a significant relationship between the workload and postural abnormalities, which detected female sex (p=0.0014), age (p=0.0256) and UPDRS (p=0.0125) as predictive factors of camptocormia.

Conclusions: Lifelong daily workload is not a definite deteriorating factor of postural abnormalities.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/lifelong-daily-workload-and-postural-abnormalities-in-patients-with-parkinsons-disease/