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Postural Abnormalities in Parkinson's Disease: An Epidemiological and Clinical Multicenter Study
Author(s) -
Tinazzi Michele,
Gandolfi Marialuisa,
Ceravolo Roberto,
Capecci Marianna,
Andrenelli Elisa,
Ceravolo Maria Gabriella,
Bonanni Laura,
Onofrj Marco,
Vitale Michela,
Catalan Mauro,
Polverino Paola,
Bertolotti Claudio,
Mazzucchi Sonia,
Giani Sara,
Smania Nicola,
Tamburin Stefano,
Vacca Laura,
Stocchi Fabrizio,
Radicati Fabiana G.,
Artusi Carlo Alberto,
Zibetti Maurizio,
Lopiano Leonardo,
Fasano Alfonso,
Geroin Christian
Publication year - 2019
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.12810
Subject(s) - medicine , levodopa , parkinson's disease , confidence interval , logistic regression , disease , epidemiology , quality of life (healthcare) , physical therapy , pediatrics , nursing
The overall frequency of postural abnormalities (PA) in Parkinson's disease (PD) is unknown. We evaluated the overall prevalence of PA and assessed the association with demographic and clinical variables. Methods For this multicenter, cross‐sectional study, consecutive PD outpatients attending 7 tertiary Italian centers were enrolled. Patients were evaluated and compared for the presence of isolated PA such as camptocormia, Pisa syndrome, and anterocollis and for combined forms (ie, camptocormia + Pisa syndrome) together with demographic and clinical variables. Results Of the total 811 PD patients enrolled, 174 (21.5%; 95% confidence interval [CI], 18.6%–24.3%) presented PA, 144 of which had isolated PA and 30 had combined PA. The prevalence of camptocormia was 11.2% (95% CI, 9%–13.3%), Pisa syndrome 8% (95% CI, 6.2%–9.9%), and anterocollis 6.5% (95% CI, 4.9%–8.3%). Patients with PA were more often male and older with longer disease duration, more advanced disease stage, more severe PD symptoms, a bradykinetic/rigid phenotype, and poorer quality of life. They were initially treated with l evodopa , and more likely to be treated with a combination of l evodopa and dopamine agonist, took a higher daily l evodopa equivalent daily dose, and had more comorbidities. Falls and back pain were more frequent in PD patients with PA than in those without PA. Multiple logistic regression models confirmed an association between PA and male gender, older age, Hoehn and Yahr stage, and total Unified Parkinson's Disease Rating Scale score. Conclusions PA are frequent and disabling complications in PD, especially in the advanced disease stages.