Gait dynamics in Pisa syndrome and Camptocormia: The role of stride length and hip kinematics

Tramonti, Caterina; Martino, Siria Di; Unti, Elisa; Frosini, Daniela; Bonuccelli, Ubaldo; Rossi, Bruno; Ceravolo, Roberto; Chisari, Carmelo

doi:10.1016/j.gaitpost.2017.05.029

Cited by 24 publications

(22 citation statements)

References 25 publications

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“…In terms of subjective relief of symptoms, cases 4 and 5 did not perceive the attenuation of the CA; therefore, CA alone may be an insufficient marker to evaluate amelioration of camptocormia. As case 3 achieved the ability to walk faster and with a larger stride, similar to a recent report that showed a relationship between camptocormia and gait [ 17 ], marginal symptoms/signs associated with camptocormia (i.e. painful contraction of abdominal muscles in cases 1 and 2, and dysbasia in case 3) might need intensive examination for the correct evaluation of therapeutic efficacy.…”

Section: Discussionsupporting

confidence: 77%

Injection of Onabotulinum Toxin A into the Bilateral External Oblique Muscle Attenuated Camptocormia: A Prospective Open-Label Study in Six Patients with Parkinson’s Disease

et al. 2018

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Section: Discussionsupporting

confidence: 77%

Injection of Onabotulinum Toxin A into the Bilateral External Oblique Muscle Attenuated Camptocormia: A Prospective Open-Label Study in Six Patients with Parkinson’s Disease

et al. 2018

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“…First, we did not recruit patients who were too severely affected to complete the assessment protocol, unable to stand unsupported for example, which may be the reason why there was no difference in the total score of PDQ-39 between patients with and without PS. Second, other potential factors such as gait, which has contradictory findings among studies (27, 31), were not specifically analyzed in this study. Finally, we did not identify the risk factors of PS in different medication states (“OFF” or “ON”), so the role of drug therapy in the pathophysiology of PS was difficult to explain.…”

Section: Discussionmentioning

confidence: 99%

Pisa Syndrome in Chinese Patients With Parkinson's Disease

Liu

Wei

et al. 2019

Front. Neurol.

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Objective: To investigate the prevalence and the clinical factors related to Pisa syndrome (PS) in Chinese Parkinson's disease (PD) patients. Methods: A total of 2,167 PD patients were continuously included in this observational study. Patients with PS were identified as presented with a lateral trunk flexion of at least 10° that can be completely alleviated by passive mobilization or supine positioning. The data of the motor and non-motor symptoms including depression, anxiety and cognitive dysfunction was collected and analyzed. Results: We found seventy-seven (3.6%) PD patients presenting with PS. The following variables including age, disease duration, levodopa equivalent daily doses (LEDD), the proportion of males, the proportion of participants using levodopa, dopaminergic agonist, amantadine and entacapone, the proportion of motor fluctuations, scores of Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Unified PD Rating Scale (UPDRS) part III, and Hoehn and Yahr (H&Y) stage were significantly higher in patients with PS compared with patients without PS ( P < 0.05). Scores of the Frontal Assessment Battery (FAB) and the Montreal Cognitive Assessment (MoCA) were not different between the two groups. The binary logistic regression model indicated that the presence of PS was associated with older age (OR = 1.027, P = 0.030), higher LEDD (OR = 1.002, P < 0.001) and a higher UPDRS III score (OR = 1.060, P < 0.001), but had no relationship with HAMD and HAMA scores. Conclusion: PS is relatively rare (3.6%) in Chinese PD patients. It is likely associated with older age, higher LEDD and more severe motor disabilities. However, non-motor symptoms such as depression, anxiety, and cognitive dysfunction have no association with PS in PD. These findings provided important complementary information for identifying the underlying mechanisms of PS.

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“…So far, only two studies have explored the influence of postural abnormalities in gait dynamics and postural control [8, 9]. Geroin et al reported for the first time that patients with Pisa syndrome (PS) showed higher (worse) postural instability than age-matched patients with PD but without PS and healthy controls (irrespective of side and severity).…”

Section: Introductionmentioning

confidence: 99%

“…Kinematic data revealed a marked reduction in the lower-extremity range of motion (ROM) in the patients with PS. However, the CC group showed a more noticeable reduction in hip and knee joints range of motion suggesting an increased hip flexion pattern during gait [9]. The main study limitation is the lack of distinction between upper and lower CC.…”

Section: Introductionmentioning

confidence: 99%

Do Upper and Lower Camptocormias Affect Gait and Postural Control in Patients with Parkinson’s Disease? An Observational Cross-Sectional Study

Geroin

Gandolfi

Maddalena

et al. 2019

Parkinson's Disease

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Gait impairments and camptocormia (CC) are common and debilitating in patients with Parkinson’s disease (PD). Two types of CC affect patients with PD, but no studies investigated their relative contribution in worsening gait and postural control. Therefore, we investigated spatiotemporal gait parameters, gait variability, and asymmetry and postural control in PD patients (Hoehn & Yahr ≤4) with upper CC and lower CC and patients without CC. This observational cross-sectional study involving patients with PD and upper CC (n=16) and lower CC (n=14) and without CC (n=16). The primary outcome measure was gait speed assessed by the GAITRite System. The secondary outcome measures were other spatiotemporal parameters, gait variability, and asymmetry. Postural control and balance were assessed with posturography and the Mini-BESTest. Patients with lower CC showed a higher H&Y stage (p=0.003), a worse PDQ8 (p=0.042), and a lower Mini-BESTest score (p=0.006) than patients with PD without CC. Patients with lower CC showed a reduced gait speed (p=0.012), stride length, and velocity than patients with PD without CC. Upper CC patients showed a higher stride length than lower CC ones (p=0.007). In the eyes open and closed condition, patients with lower CC showed a higher (worse) velocity of CoP displacement in mediolateral direction and length of CoP than patients with PD without CC. No significant between-group differences were measured in gait variability and asymmetry. In conclusion, lower CC was associated with more severe gait and postural control impairment than patients with upper CC and without CC. Categorizing CC based on the bending fulcrum is compulsory to identify patients with the worst performance and to implement specific rehabilitation programs.

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Gait dynamics in Pisa syndrome and Camptocormia: The role of stride length and hip kinematics

Cited by 24 publications

References 25 publications

Injection of Onabotulinum Toxin A into the Bilateral External Oblique Muscle Attenuated Camptocormia: A Prospective Open-Label Study in Six Patients with Parkinson’s Disease

Injection of Onabotulinum Toxin A into the Bilateral External Oblique Muscle Attenuated Camptocormia: A Prospective Open-Label Study in Six Patients with Parkinson’s Disease

Pisa Syndrome in Chinese Patients With Parkinson's Disease

Do Upper and Lower Camptocormias Affect Gait and Postural Control in Patients with Parkinson’s Disease? An Observational Cross-Sectional Study

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