PDF(Pubmed)
Abstract：
Axial postural abnormalities (APAs), characterized by their frequency, disabling nature, and resistance to pharmacological treatments, significantly impact Parkinson\'s disease and atypical Parkinsonism patients. Despite advancements in diagnosing, assessing, and understanding their pathophysiology, managing these complications remains a significant challenge. Often underestimated by healthcare professionals, these disturbances can exacerbate disability. This systematic review assesses botulinum toxin treatments\' effectiveness, alone and with rehabilitation, in addressing APAs in Parkinson\'s disease, utilizing MEDLINE (PubMed), Web of Science, and SCOPUS databases for source material. Of the 1087 records retrieved, 16 met the selection criteria. Most research has focused on botulinum toxin (BoNT) as the primary treatment for camptocormia and Pisa syndrome, utilizing mostly observational methods. Despite dose and injection site variations, a common strategy was using electromyography-guided injections, occasionally enhanced with ultrasound. Patients with Pisa syndrome notably saw consistent improvements in APAs and pain. However, studies on the combined effects of botulinum toxin and rehabilitation are limited, and antecollis is significantly under-researched. These findings recommend precise BoNT injections into hyperactive muscles in well-selected patients by skilled clinicians, avoiding compensatory muscles, and underscore the necessity of early rehabilitation. Rehabilitation is crucial in a multidisciplinary approach to managing APAs, highlighting the importance of a multidisciplinary team of experts.
摘要：
轴向姿势异常（APAs），以它们的频率为特征，致残性质，和对药物治疗的抗性，显著影响帕金森病和非典型帕金森病患者。尽管在诊断方面取得了进步，评估,了解他们的病理生理学，处理这些并发症仍然是一项重大挑战.经常被医疗保健专业人员低估，这些障碍会加剧残疾。本系统评价评估肉毒杆菌毒素治疗的有效性，单独和康复，在解决帕金森病的APA时，利用MEDLINE（PubMed），WebofScience,和SCOPUS数据库的源材料。在检索到的1087条记录中，16符合选择标准。大多数研究都集中在肉毒杆菌毒素（BoNT）作为喜树病和比萨综合征的主要治疗方法，主要利用观测方法。尽管剂量和注射部位不同，一种常见的策略是使用肌电图引导注射，偶尔用超声波增强。Pisa综合征患者在APA和疼痛方面表现出持续的改善。然而,关于肉毒杆菌毒素和康复联合作用的研究有限，并且前tecollis的研究明显不足。这些发现建议熟练的临床医生对精心挑选的患者进行精确的BoNT注射到过度活跃的肌肉中。避免代偿性肌肉，强调早期康复的必要性。康复在管理APA的多学科方法中至关重要，强调多学科专家团队的重要性。
