Ann Rehabil Med.  2017 Aug;41(4):677-685. 10.5535/arm.2017.41.4.677.

Back Extensor Strengthening Exercise and Backpack Wearing Treatment for Camptocormia in Parkinson's Disease: A Retrospective Pilot Study

• Lee KH
• Kim JM
• Kim HS

• KMID: 2389414
• DOI: http://doi.org/10.5535/arm.2017.41.4.677

Abstract

OBJECTIVE
To investigate the effect of a conservative treatment regime in Parkinson's disease patients with camptocormia.
METHODS
Nine patients with Parkinson's disease were included in a retrospective pilot study of the value of back extensor strengthening exercise. Six inpatients received a 30-minute treatment, twice daily for 5 weeks, being treated on average for 34 days; while three outpatients visited the clinic and were educated for home exercise and backpack wearing treatment. Outpatients should be scheduled to visit the outpatient department to check physical status every 2-4 weeks for an average of 3 months.
RESULTS
All patients except one showed statistically significant improvements in activities of daily living (ADL) and motor symptoms, as measured by flexion angle at standing posture, Unified Parkinson's Disease Rating Scale (UPDRS) II and III, and modified Hoehn-Yahr staging.
CONCLUSION
Conservative treatment is effective in postural correction of camptocormia in Parkinson's disease, as well as improvement in ADL and motor symptoms.

Keyword

Camptocormia; Parkinson disease; Rehabilitation; Physical therapy modalities

MeSH Terms

Activities of Daily Living
Humans
Inpatients
Outpatients
Parkinson Disease*
Physical Therapy Modalities
Pilot Projects*
Posture
Rehabilitation
Retrospective Studies*

Figure

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  Fig. 1 Patient #7 before and after treatment. (A) She had an operative treatment for kyphosis and lower back pain but showed camptocormia afterwards. (B) Lateral image before rehabilitation treatment. (C) Lateral image after rehabilitation treatment.

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  Fig. 2 Various modalities of conservative management for camptocormia. (A) Core muscle strengthening exercise. (B) Pelvic tilting exercise. (C) Back extensor strengthening exercise. (D) Low-slung backpack. (E) Anterior spinal hyperflexion brace.

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  Fig. 3 Patient #4 before and after treatment. She was educated for home exercise at the outpatient clinic. After 4 weeks of home exercise and low-slung backpack treatment, she showed improvement of camptocormia. (A) Lateral image before rehabilitation treatment. (B) Lateral image after rehabilitation treatment.

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  Fig. 4 Lumbar spine magnetic resonance imaging of patient #1. The arrows indicate atrophic change of paraspinal muscle in magnetic resonance imaging T2 image of patient #1.

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  Fig. 5 Increased angle of camptocormia during ambulation of patient #9. (A) At the beginning, angle of camptocormia is smaller. (B) After 10 minutes of gait, angle of camptocormia increased.

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