Trunk muscle activation pattern in parkinsonian camptocormia as revealed with surface electromyography |
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| Affiliation: | 1. Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany;2. Institute of Physiology, Christian-Albrechts-University of Kiel, Germany;1. Stanford Multidimensional Program for Innovation and Research in the Esophagus (S-MPIRE), Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, 94305, USA;2. The Parkinson''s Institute and Clinical Center, Sunnyvale, CA, USA;1. Department of Physical Therapy, The Graduate School, Inje University, Republic of Korea;2. Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, 607 Obangdong, Gimhae, Gyeongsangnamdo 621-749, Republic of Korea;1. Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan;2. Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Japan;3. Laboratory of Neuromuscular Biomechanics, School of International Liberal Studies, Chukyo University, Japan;4. Department of Rehabilitation Medicine, Hiroshima University Hospital, Japan;5. Japan Community Health Care Organization, Hoshigaoka Medical Center, Japan;1. Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China;2. Institute of Neuroscience, Soochow University, Suzhou 215123, China |
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| Abstract: | IntroductionCamptocormia is frequently seen in Parkinson's disease (PD) and multiple system atrophy. It is characterized by a pathological forward bending of the trunk during standing, often combined with a lateral trunk deviation. The etiology of camptocormia in PD is still unknown. Muscle MRI studies show abnormalities mainly of the erector spinae confirmed by muscle biopsies. Quantitative electromyographic examination of trunk muscle activity is missing.MethodsVentral (rectus and obliquus externus abdominis) and dorsal (iliocostalis lumborum, longissimus, multifidus) trunk muscles and the rectus femoris were recorded bilaterally with surface electromyography in standing PD patients with camptocormia (n = 10) and matched healthy controls (n = 10) who mimicked the patients' posture. EMG amplitudes were compared quantitatively. In controls, the relation between varying degrees of trunk flexion and EMG was established systematically.ResultsIncreasing forward trunk flexion was associated with increasing back muscle activity in controls, while abdominal muscle activity was negligible. During anterolateral trunk flexion, back muscle activity increased particularly on the contralateral side. The patients showed a similar pattern. However, normalized EMG activity of their trunk extensors was significantly higher than in controls, often reaching half-maximal amplitudes. Their rectus femoris and oblique abdominal muscles were overactive, but to a lesser extent.ConclusionsPD patients with camptocormia must use the functional reserve of their lumbar trunk muscles to counteract gravity. We interpret this as a weakness of the paravertebral muscles. Compared to the other examined muscles the paravertebral muscles are most affected. The increased EMG activity of the rectus femoris warrants further research. |
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| Keywords: | Idiopathic Parkinson's disease Camptocormia Bent spine syndrome EMG |
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