Relationship between Lower Limbs Performance and Spinal Alignment in Parkinson’s Disease Patients: An Observational Study with Cross Sectional Design

Abstract

Parkinson’s disease (PD) is a progressive neurodegenerative disease determining spinal deformities and muscle rigidity, weakness and dystonia that can be related to a change in muscular output during sit-to-stand tasks (STS). Purpose: The aim of this study was to determine the impacts of spinal alignment on lower limbs performance during STS tasks in Parkinson’s disease (PD) patients and healthy controls. Methods: In total, 43 consecutive PD patients (“PD” Group, 25 males and 18 females; age 73.7 ± 7.1) and 42 people not affected by any type of neurological disease (“CON” Group, 22 males, 20 females; age 69.8 ± 6.0) participated in the observational study. The clinical assessment included: IPAQ (International Physical Activity Questionnaire), Hoehn Yahr score, plumb-line distance from the spinous process of C7, kyphosis apex and the spinous process of L3 and S1. We used the Muscle Quality Index test (MQI) to assess muscle power output during STS in both groups. Results: The MQI test measurements of absolute and relative lower limb power was significantly lower in the PD group, in addition to a negative correlation with age and a positive correlation with PL-L3 in that group of patients. Conclusions: A final consideration regarding our results leads to the possibility that the preservation of lumbar lordosis may be one of the factors for maintaining efficient biomechanics of the lower limb muscles, with the preservation of the physiological contractile characteristics of these muscles being the objective for a multidisciplinary rehabilitation based on postural exercises of the spine and a program of training exercises for the lower limb muscles.

Efficacy of Specific Trunk Exercises in the Balance Dysfunction of Patients with Parkinson’s Disease: A Systematic Review and Meta-Analysis

“…Notwithstanding, most studies on physical therapy treatments for PD traditionally focus on the muscles of the lower limb, whereas those addressing the neuromuscular control of central segments are scarce [ 24 , 25 , 26 , 27 ]. It has been reported that the strength of lower limb muscles is predictive and related to independence in the activities of daily living, and the preservation of lumbar lordosis may be one of the factors necessary to maintain the efficient biomechanics of these muscles [ 28 ]. In a recent study [ 29 ], patients with early-stage PD had a deficit of about 20% in force production in lower limb muscle groups compared with age-matched neurologically normal controls.…”

Muscle Power in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis

“…Muscle power is expressed as the product of force and velocity generated during a muscle contraction and diminishes with age even more than maximal strength [6]. Moreover, muscle power showed a stronger association with functional performance than muscle strength in healthy older adults and patients with neurological diseases [7][8][9]. Similarly, cross-sectional studies have found associations between muscle power and functional performance [10,11] or physical activity [12,13] in individuals with COPD.…”