Abstract:
Parkinson\'s disease (PD) is a progressive neurological disease characterized by muscle stiffness, tremor, slowness of movement, and difficulties with posture and walking. Muscle and joint pain are frequent non-motor symptoms of PD. Pain associated with PD is mainly caused by a combination of truncal dystonia, stooped posture, and muscle rigidity. However, PD deformities were rarely discussed in the literature. A 68-year-old Asian female with PD treated with Levodopa for six years complained of progressive neck pain, contractures, and subluxation of both hands in the last two years. A positron emission tomography (PET) scan revealed decreased rostrocaudal gradient uptake in both posterior putamen. After 9 months of multimodal chiropractic rehabilitation, the patient had significant improvement in symptoms, including pain resolution as per the numeric rating scale and physical and mental improvement as per the PD questionnaire. Radiographic measurement showed significantly improved postural alignment and stability. Measurement of joint motion and angles showed an improvement in hand deformity. Although PD is a neurodegenerative disease that is not curable, multimodal rehabilitation may improve neurological and musculoskeletal functions by inducing proprioceptive balance, motor strength, and joint movement. The current study may illustrate multimodal rehabilitation addressing orthopedic deformity associated with symptoms in a PD patient.
摘要:
帕金森病(PD)是一种以肌肉僵硬为特征的进行性神经系统疾病,震颤,运动缓慢,姿势和行走困难。肌肉和关节痛是PD的常见非运动症状。与PD相关的疼痛主要是由躯干肌张力障碍的组合引起的,弯腰的姿势,和肌肉僵硬。然而,PD畸形在文献中很少讨论。一名68岁的亚洲女性PD患者接受左旋多巴治疗六年,主诉进行性颈部疼痛,挛缩,在过去的两年里,两只手都被脱位了。正电子发射断层扫描(PET)扫描显示两个后壳核的rostrocautal梯度摄取降低。经过9个月的多模式整脊康复,病人的症状有了显著的改善,包括数字评分量表的疼痛缓解和PD问卷的身心改善。射线照相测量显示姿势对准和稳定性显着改善。关节运动和角度的测量显示手部畸形有所改善。尽管PD是一种无法治愈的神经退行性疾病,多模式康复可以通过诱导本体感觉平衡来改善神经和肌肉骨骼功能,电机强度,联合运动。当前的研究可以说明解决与PD患者症状相关的骨科畸形的多模式康复。