Spinal movement and performance of a standing reach task in participants with and without Parkinson disease.
OBJECTIVE
Evidence suggests that individuals with early and mid-stage Parkinson disease (PD) have diminished range of motion (ROM). Spinal ROM influences the ability to function. In this investigation, the authors examined available spinal ROM, segmental excursions (the ROM used) during reaching, and their relationships in community-dwelling adults with and without PD.


METHODS
The subjects were 16 volunteers with PD (modified Hoehn and Yahr stages 1.5-3) and 32 participants without PD who were matched for age, body mass index, and sex.


METHODS
Range of motion of the extremities was measured using a goniometer, and ROM of the spine was measured using the functional axial rotation (FAR) test, a measure of unrestricted cervico-thoracic-lumbar rotation in the seated position. Motion during reaching was determined using 3-dimensional motion analysis. Group differences were determined using multivariable analysis of variance followed by analysis of variance. Contributions to total reaching distance of segmental excursions (eg, thoracic rotation, thoracic lateral flexion) were determined using forward stepwise regression.


RESULTS
Subjects with PD as compared with subjects without PD had less ROM (FAR of 98.2 degrees versus 110.3 degrees, shoulder flexion of 151.9 degrees versus 160.1 degrees) and less forward reaching (29.5 cm versus 34.0 cm). Lateral trunk flexion and total rotation relative to the ground contributed to reaching, with the regression model explaining 36% of the variance.


CONCLUSIONS
These results contribute to the growing body of evidence demonstrating that spinal ROM is impaired early in PD.
Schenkman
M L
ML
Physical Therapy Program, Department of Rehabilitation Medicine, University of Colorado Health Sciences Center, 4200 E Ninth Ave, C244, Denver, CO, USA. Margaret.Schenkman@UCHSC.edu
Clark
K
K
Xie
T
T
Kuchibhatla
M
M
Shinberg
M
M
Ray
L
L
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000886:Anthropometry; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000145:classification / Q000503:physiopathology*; D011187:Posture / Q000502:physiology*; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology*; D012044:Regression Analysis; D012399:Rotation; D012720:Severity of Illness Index; D013131:Spine / Q000503:physiopathology*; D013997:Time Factors