Abstract

Background: The association between the immediate effects of physical therapy on motor symptoms and frontal lobe dysfunction has not been clarified in patients with Parkinson’s disease. This study examined the immediate effects of physical therapy on postural instability in patients with Parkinson’s disease and whether the improvement in postural instability was associated with Frontal Assessment Battery (FAB) score, as an indicator of frontal lobe dysfunction.

Methods: Twelve patients with idiopathic Parkinson’s disease (Hoehn–Yahr classification range 3–4), independent ambulation, and no dementia were divided into FAB high-score (score ≥ 13, n = 6) and lowscore (score ≤12, n=6) groups. Postural parameter data was acquired using a three-dimensional motion analysis system and a three-dimensional inclination and horizontal stimulation system before and after a 30-min physical therapy program. Measurements were obtained for total displacement of the center of gravity (COG), total anterior-posterior (AP) displacement of the spinous process of the 7th cervical vertebra (C7) marker, maximum AP displacement of the C7 marker, maximum anterior speed of the C7 marker, and maximum posterior speed of the C7 marker.

Results: The high-score group showed significant decreases in total displacement of the COG and total AP displacement, maximum AP displacement, maximum anterior speed, and maximum posterior speed of the C7 marker. The low-score group showed no significant changes. FAB score was significantly correlated with change in maximum AP displacement of the C7 marker. Multivariate logistic regression analysis showed FAB score was the only predictor of improvement in total AP displacement and maximum AP displacement of the C7 marker.

Conclusions: There may be an association between the immediate effects of physical therapy on PI and FAB score in Parkinson’s disease. Thus, FAB score could be useful for predicting which the patients with Parkinson’s disease would be more likely to show the immediate effects of physical therapy on postural instability.

Keywords: Frontal Assessment Battery, immediate effects, Parkinson’s disease, physical therapy, threedimensional motion analysis, three-dimensional inclination and horizontal stimulation system, postural instability