Establishment of an Evaluation Method for Postural Instability in Parkinson's Disease Using Subjective Postural Vertical

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K11321
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: St. Marianna University School of Medicine
• Principal Investigator: Shiraishi Makoto 聖マリアンナ医科大学, 医学部, 教授 (40350631)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 主観的垂直位 / 前屈姿勢 / パーキンソン病 / 垂直姿勢保持困難

Outline of Final Research Achievements

A prospective observational study was conducted to elucidate the relationship between subjective postural vertical (SPV) measurement and disease progression in early-stage Parkinson's disease (PD) cases. Postural assessment included measurements of the forward flexion of the trunk (FFT) angle, lateral flexion of the trunk angle, and the angle at the position perceived as vertical by SPV angle at initial observation, after six months, and after twelve months. The SPV angle significantly worsened after six months and one year compared to the initial observation (9.3±6.7 vs. 10.8±8.2 degrees, 10.6±7.8 degrees, P<0.05), and the FFT angle significantly worsened after one year compared to the initial observation (11.1±8.1 vs. 12.2±8.8 degrees, P=0.004). These results suggest that SPV may predict the worsening of FFT.

Free Research Field

神経変性疾患

Academic Significance and Societal Importance of the Research Achievements

パーキンソン病（PD）における垂直姿勢保持困難の要因は多岐にわたり、評価と治療に対する手法の開発は急務である。本研究では、前屈姿勢は運動機能評価を指標に薬剤調整したとしても改善が得られにくい症例が存在し、主観的垂直位による評価は薬剤調整とは異なって変動することを示し、ＰＤに対する主観的垂直位評価の有用性が証明された。こられらの成果は垂直姿勢保持困難の早期出現 が重要な指標となり、リハビリプログラムの早期導入に貢献できる。また、より早期の段階 で垂直位の認識不良への検出が可能となれば、薬剤の適切な調整や、転倒・転落防止対策等 の的確な対応もでき、予後を改善させる臨床的な意義がある。