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Spinal Movement and Performance of a Standing Reach Task in Participants With and Without Parkinson Disease

ML Schenkman, PT, PhD, is Professor, Physical Therapy Program, Department of Rehabilitation Medicine, University of Colorado Health Sciences Center, 4200 E Ninth Ave, C244, Denver, CO (USA) (Margaret.Schenkman{at}UCHSC.edu).
K Clark, PT, MS, is a graduate student in the Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, NC. He was a graduate student in the Physical Therapy Program, Duke University, when this work was carried out
T Xie, PT, PhD, is Financial Consultant, MONY Group, Raleigh, NC. He was a graduate student in the Physical Therapy Program, Duke University, when this work was carried out
M Kuchibhatla, PhD, is Assistant Research Professor, Department of Bioinformatics and Biostatistics and Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
M Shinberg, PT, MS, is Physical Therapist, Shriner's Hospital for Children, Philadelphia, Pa. She was Engineer, Motion Analysis Laboratory, Duke Center on Aging, at the time this work was completed
L Ray, PT, MS, is Physical Therapist, Department of Physical Therapy, Duke University Medical Center
Dr Schenkman, Mr Clark, Dr Xie, and Dr Kuchibhatla provided concept/research design, writing, and data analysis. Ms Shinberg and Ms Ray provided data collection and recruited subjects. Dr Schenkman, Ms Shinberg, and Ms Ray provided project management. Ms Shinberg provided technical direction for data collection and reduction. Dr Schenkman provided fund procurement, facilities/equipment, and institutional liaisons. Ms Ray provided consultation (including review of manuscript before submission). The authors thank the Measurement Core staff of the Claude D Pepper Older Americans Independence Center, Duke University Medical Center, for data collection efforts

Address all correspondence to Dr Schenkman

Background and Purpose. Evidence suggests that individuals with early and mid-stage Parkinson disease (PD) have diminished range of motion (ROM). Spinal ROM influences the ability to function. In this investigation, the authors examined available spinal ROM, segmental excursions (the ROM used) during reaching, and their relationships in community-dwelling adults with and without PD. Subjects. The subjects were 16 volunteers with PD (modified Hoehn and Yahr stages 1.5–3) and 32 participants without PD who were matched for age, body mass index, and sex. Methods. Range of motion of the extremities was measured using a goniometer, and ROM of the spine was measured using the functional axial rotation (FAR) test, a measure of unrestricted cervico-thoracic-lumbar rotation in the seated position. Motion during reaching was determined using 3-dimensional motion analysis. Group differences were determined using multivariable analysis of variance followed by analysis of variance. Contributions to total reaching distance of segmental excursions (eg, thoracic rotation, thoracic lateral flexion) were determined using forward stepwise regression. Results. Subjects with PD as compared with subjects without PD had less ROM (FAR of 98.2° versus 110.3°, shoulder flexion of 151.9° versus 160.1°) and less forward reaching (29.5 cm versus 34.0 cm). Lateral trunk flexion and total rotation relative to the ground contributed to reaching, with the regression model explaining 36% of the variance. Discussion and Conclusion. These results contribute to the growing body of evidence demonstrating that spinal ROM is impaired early in PD.

Key Words: Parkinson disease • Reaching • Spinal flexibility • Spinal range of motion • Task performance

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