•Parkinson’s
disease (PD) is the most common neurodegenerative
movement disorder, which is characterized by four
cardinal features: rest tremor, rigidity, bradykinesia and postural instability.
•Although
the pathology of postural instability is unknown, several hypotheses exist.
•According
to Karen
M Doherty:
In
patients with Parkinson’s, the reduced spinal movements cause an effort to
maintain the body gravity line within the limits of stability and are usually
compensated by increased trunk flexion.
•According
to Zhang T:
The
stooped posture in Parkinson’s may be
because of tonic hyperactivity of the
flexors due to abnormal drive from the basal ganglia.
•According to Gross
AK: stooped posture in
Parkinson’s may be compensatory strategy
to facilitate forward motion of the Center of Mass for step initiation.
•Dietz
et al. further
noted that Parkinson’s patient stoop for compensation to backward falls
and its not a cause of, primary postural
deficits in PD.
•The
clinical assessment of stopped posture is very important for evaluating the
functional and physical consequences of the disease and the risk factors for
its progression. •Therefore,
therapeutic approaches including active posture correction and proprioceptive
stimulation are thought to be effective on axial symptoms. •Mobilization
is a multiple, controlled, bidirectional, small to large amplitude, rhythmic
oscillation given within physiological range. •
Kinesio taping aims to activate the proprioceptive system by increasing sensory
stimuli with cutaneous mechanoreceptors and also helps to improve anticipatory
postural adjustments and activate trunk muscles and joints without restricting
body movements. •Studies
have shown that kinesio
taping improves postural control not only by increasing proprioceptive
sensation, but also by determining the correct joint position for a comfortable
and non-burdening posture. •In
recent years, it has been utilized in musculoskeletal and neurological diseases
with the aim of increasing or inhibiting muscle activity, providing joint
repositioning, preventing injuries and improving proprioception. •Stooped posture in Parkinson’s
patients have its negative effect on balance,
which cause
falls, resulting in extremity and spinal-compression fractures, and also detoriate
their quality of life. •Rib
cage mobilization can contribute to improve posture by addressing restrictions
and imbalances in the thoracic spine and surrounding musculature. •It
will also help patients with improved mobility of spine, improved breathing and
relaxation. •It
has been stated in recent studies that elastic taping can be used for postural
correction and can be an effective form of cutaneous proprioceptive
biofeedback. •Moreover,
previous studies have developed several invasive treatments for stooped
posture, such as deep brain stimulation and botulinum toxin injected into the primary-culprit muscles for the condition. However, the effect of these
treatments on stooped posture has remained controversial over the years. •Therefore,
non-invasive treatment for stooped posture in Parkinson’s patients needs to be
established.
•Samples
will be randomly and equally divided into 2 groups.
Group A :- will receive rib cage
mobilisation intervention
Group B :- will receive kinesio-taping
intervention
•All
the participants will be assessed pre and post treatment after 1 week using
Smart phone application ( Clinometer) and trunk mobility scale.
|