Pisa syndrome: Pathophysiology, physical rehabilitation and falls risk

Abstract

BACKGROUND: Pisa syndrome (PS) is a postural disorder characterised by lateral flexion of the spine (> 10°), predisposing the affected individuals to falls, and contributing to increased mortality in neurodegenerative diseases. OBJECTIVE: An overview of currently applied therapeutic management options, primarily focused on specifically structured rehabilitation exercises, in conjunction with falls-risk assessment in the individuals affected by PS. METHODS: A narrative literature review, augmented with the authors’ own experience in physical rehabilitation management. RESULTS: As individuals affected by PS are evidenced to be intrinsically exposed to higher falls-risk through acquired postural deformities, they often fall victims of traumatic accidents, occasionally also facing relocation into 24-hour nursing facilities due to the injuries sustained/resultant disability, consequently having overall quality of their life appreciably reduced. CONCLUSIONS:s A comprehensive approach is postulated in designing optimal therapeutic management, comprised of the exercises controlling postural stability, whilst reducing lower back pain, and the ones also promoting specific skills essential for coping unassisted after an accidental fall effectively. Rehabilitation of individuals affected by PS should be a fully integrated service, eliminating all identified risk factors for falls. As clinical PS symptoms tend to recur after completion of a full course of therapeutic management, all PS patients should continue the pursuit of therapeutic exercises on an individual basis, to effectively retard their recurrence. In view of overall scarcity of clinical studies completed on the large population samples of PS patients, further in-depth research is still required to ensure higher credence to overall efficacy of the presently proposed therapeutic solutions.

Frailty Syndrome—Fall Risk and Rehabilitation Management Aided by Virtual Reality (VR) Technology Solutions: A Narrative Review of the Current Literature

“…The individuals experiencing difficulties should be offered some extra assistance, e.g., by placing a pillow under their knees to reduce any undue discomfort. The final stage involves moving on to a supported kneeling position, and finally to a lying-down position [ 67 , 68 , 69 ].…”

Análise baropodométrica de indivíduos com doença de Parkinson

“…Outra alteração importante é a síndrome de Pisa, esta é marcada por uma flexão lateral do tronco, que pode estar relacionada ao comprometimento da orientação postural, a disfunção vestibular, ao tônus postural, dentre outras causas [7,19]. Porém ainda não há um consenso sobre o seu diagnóstico e sua causa, podendo ser um efeito colateral dos medicamentos, mas sabe-se que ela está também presente nessa população [19,20]. Isso pode levar a alterações na região distal quando falamos de descarga de peso o que influencia diretamente no nosso achado.…”