Article

Clinically, people with Parkinson's disease (PD) demonstrate a loss of
axial rotation of the spine often described as moving "enbloc", with little
dissociation between the head, trunk and lower limbs whilst turning. The purpose
of this narrative review is to explore the behaviour and relationship of the
reported deficits during whole body turning in people with PD, compared to
controls. Better understanding of the relationship and impact of the deficits
will permit the development of tailored and novel intervention strategies to
improve functional performance in turning for people with PD. METHODS: Four
electronic databases with the search terms: Parkinson* and turn* were used.
RESULTS: Seventy-seven papers were reviewed. Turning deficits in people with PD
were identified as originating from two hypothetical body segments -
perpendicular (i.e. legs) or axial (i.e. head, trunk and pelvis) segments and the
relationship between them discussed. CONCLUSION: Specific movement deficits in
turning in people with PD can be categorised into axial and perpendicular
deficits. Synthesis of the literature suggests the possibility of axial deficits
driving secondary responses in the perpendicular segments. This should be
explored when designing rehabilitation aimed at improving turning performance, as
current therapy guidelines focus on exercises emphasising perpendicular aspects.
Implications for Rehabilitation Turning performance is compromised in people with
PD, which can lead to significant disability, falls and loss of function.
Specific movement deficits can be categorised into perpendicular deficits (taking
more steps and shorter steps and an altered turn strategy) and axial deficits
(segment rigidity, altered segment co-ordination and timing, reduced segment
rotation and the effects of altered posture). Axial deficits may drive secondary
responses in the perpendicular segments during turning in people with PD.
Therefore, specific focus should be made to the rehabilitation of the axial
deficits alongside those of the perpendicular body segments in the design of
multi-modal treatment strategies to improve turning performance.

Langue : ANGLAIS