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Flexed Truncal Posture in Parkinson Disease: Measurement Reliability and Relationship With Physical and Cognitive Impairments, Mobility, and Balance.
J Neurol Phys Ther. 2017 04; 41(2):107-113.JN

Abstract

BACKGROUND AND PURPOSE

Flexed truncal posture is common in people with Parkinson disease (PD); however, little is known about the mechanisms responsible or its effect on physical performance. This cross-sectional study aimed to establish the reliability of a truncal posture measurement and explore relationships between PD impairments and truncal posture, as well as truncal posture and balance and mobility.

METHODS

A total of 82 people with PD participated. Truncal posture was measured in standing as the distance between vertebra C7 and a wall. Univariate and multivariate regression analyses were performed with truncal posture and impairments, including global axial symptoms, tremor, bradykinesia, rigidity, freezing of gait (FOG), reactive stepping and executive function, as well as truncal posture with balance and mobility measures.

RESULTS

The truncal posture measure had excellent test-retest reliability (ICC3,1 0.79, 95% CI 0.60-0.89, P < 0.001). Global axial symptoms had the strongest association with truncal posture (adjusted R = 0.08, P = 0.01), although the majority of the variance remains unexplained. Post hoc analysis revealed that several impairments were associated with truncal posture only in those who did not report FOG. Flexed truncal posture was associated with poorer performance of most balance and mobility tasks after adjustment for age, gender, disease severity, and duration (adjusted R = 0.24-0.33, P < 0.001-0.03).

DISCUSSION AND CONCLUSIONS

The C7 to wall measurement is highly reliable in people with PD. Global axial symptoms were independently associated with truncal posture. Greater flexed truncal posture was associated with poorer balance and mobility. Further studies are required to elucidate the mechanisms responsible for flexed truncal posture and the impact on activity.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A164).

Authors+Show Affiliations

Faculty of Health Sciences, The University of Sydney, Sydney, Australia (A.L.F., S.S.P., N.E.A., C.G.C.); Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia (S.S.P., C.S.); Movement Disorders Unit, Department of Neurology, Westmead Hospital, Sydney, Australia (V.S.C.F.); Sydney Medical School, The University of Sydney, Sydney, Australia (V.S.C.F.); and Department of Physical Therapy, University of Utah, Salt Lake City, United States of America (S.S.P.).No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28263252

Citation

Forsyth, Aimi L., et al. "Flexed Truncal Posture in Parkinson Disease: Measurement Reliability and Relationship With Physical and Cognitive Impairments, Mobility, and Balance." Journal of Neurologic Physical Therapy : JNPT, vol. 41, no. 2, 2017, pp. 107-113.
Forsyth AL, Paul SS, Allen NE, et al. Flexed Truncal Posture in Parkinson Disease: Measurement Reliability and Relationship With Physical and Cognitive Impairments, Mobility, and Balance. J Neurol Phys Ther. 2017;41(2):107-113.
Forsyth, A. L., Paul, S. S., Allen, N. E., Sherrington, C., Fung, V. S., & Canning, C. G. (2017). Flexed Truncal Posture in Parkinson Disease: Measurement Reliability and Relationship With Physical and Cognitive Impairments, Mobility, and Balance. Journal of Neurologic Physical Therapy : JNPT, 41(2), 107-113. https://doi.org/10.1097/NPT.0000000000000171
Forsyth AL, et al. Flexed Truncal Posture in Parkinson Disease: Measurement Reliability and Relationship With Physical and Cognitive Impairments, Mobility, and Balance. J Neurol Phys Ther. 2017;41(2):107-113. PubMed PMID: 28263252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Flexed Truncal Posture in Parkinson Disease: Measurement Reliability and Relationship With Physical and Cognitive Impairments, Mobility, and Balance. AU - Forsyth,Aimi L, AU - Paul,Serene S, AU - Allen,Natalie E, AU - Sherrington,Catherine, AU - Fung,Victor S C, AU - Canning,Colleen G, PY - 2017/3/7/pubmed PY - 2017/6/6/medline PY - 2017/3/7/entrez SP - 107 EP - 113 JF - Journal of neurologic physical therapy : JNPT JO - J Neurol Phys Ther VL - 41 IS - 2 N2 - BACKGROUND AND PURPOSE: Flexed truncal posture is common in people with Parkinson disease (PD); however, little is known about the mechanisms responsible or its effect on physical performance. This cross-sectional study aimed to establish the reliability of a truncal posture measurement and explore relationships between PD impairments and truncal posture, as well as truncal posture and balance and mobility. METHODS: A total of 82 people with PD participated. Truncal posture was measured in standing as the distance between vertebra C7 and a wall. Univariate and multivariate regression analyses were performed with truncal posture and impairments, including global axial symptoms, tremor, bradykinesia, rigidity, freezing of gait (FOG), reactive stepping and executive function, as well as truncal posture with balance and mobility measures. RESULTS: The truncal posture measure had excellent test-retest reliability (ICC3,1 0.79, 95% CI 0.60-0.89, P < 0.001). Global axial symptoms had the strongest association with truncal posture (adjusted R = 0.08, P = 0.01), although the majority of the variance remains unexplained. Post hoc analysis revealed that several impairments were associated with truncal posture only in those who did not report FOG. Flexed truncal posture was associated with poorer performance of most balance and mobility tasks after adjustment for age, gender, disease severity, and duration (adjusted R = 0.24-0.33, P < 0.001-0.03). DISCUSSION AND CONCLUSIONS: The C7 to wall measurement is highly reliable in people with PD. Global axial symptoms were independently associated with truncal posture. Greater flexed truncal posture was associated with poorer balance and mobility. Further studies are required to elucidate the mechanisms responsible for flexed truncal posture and the impact on activity.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A164). SN - 1557-0584 UR - https://www.unboundmedicine.com/medline/citation/28263252/Flexed_Truncal_Posture_in_Parkinson_Disease:_Measurement_Reliability_and_Relationship_With_Physical_and_Cognitive_Impairments_Mobility_and_Balance_ L2 - https://doi.org/10.1097/NPT.0000000000000171 DB - PRIME DP - Unbound Medicine ER -