Objective: APA involves distinct modes plus sequence patterns and proven predictors for every APA remains mystery. The goal is to probe the progress of APA and reveal its links to see clinical in PD.

Background: Axial postural abnormality(APA) is a key motor symptom in Parkinson disease(PD) which leads to mental agony, pain patients. APA involves different flexions (trunk in sagittal coronal planes, SC/SP). Sagittal comprises anterior neck trunk flexion(ANF,ATF) and coronal contains lateral trunk flexion(LTF). Contrary to standard theory, APA is normal in PD. Yet there is no corrective cure for APA, thus it is worth finding the progression patterns of APAs and linked factors.

Method: 150patients with PD underwent ANF, ATF at thoracic and lumbar fulcrum, LTF evaluations(3yrs). Subjects’ clinical characteristics (i.e. enrolled PD patients) given in Table1. APA was measured with linear mixed-effects models. Collective rate of APA progress was shown by Kaplan-Meier curves through log-rank test to assess variances. Uni and multi variant Cox relative hazards testing was done to examine risk-factors for distinct sorts of APA increase. As per specialized-SW, ANF,ATF, L5,FC,LTF,AP,C7,VL derived as shown in Fig`s1-D.

Results: Upon follow-up, 50.38%,13.74%,27.48%,9.16% PD patients had ANF, ATF(thoracic fulcrum, tf),ATF(lumbar fulcrum, lf),LTF progress. ANF and ATF-tf began to raise much at 1yr follow-up. ATF-lf and LTF began rising at 2yr and 3yr sequels. Collective risks improve for 4APAs – distinct, with ANF having a significantly higher risk than tf-ATF, lf-ATF, next LTF(Table2). We labeled predictors for ANF-improve were disease duration, akinesia signs. The greater axial symptom (HR=1.11,95% CI 1.03-1.18,P=0.004), akinesia(HR=1.04,95% CI 1.01-1.08,P=0.004), HAMA scores(HR=1.04, 95% CI 1.01-1.07, P=0.024) were also seen by a high risk-of ANF improve(Table2). Workout level, akinesia signs were linked via progress of ATF-tf, and H andY stage was linked with progress of ATF-lf. LTF-improve was linked by L-dopa daily dose UPDRS-Ⅲ-posture sub item.

Conclusion: An improved APA was largely seen with motoric-symptoms plus systematic real activity can reduce fall of APAs in PD p/t`s. APA is linked by motoric-signs. Regular physical activity may slow APA drop in PDs.

Table 1

Table 2

Figures 1 -4

Legends

References: 1.M.Tinazzi, M.Gandolfi, R.Ceravolo,Postural.,Abnormalities in Parkinson’s Disease:An Epidemiological – Clinical Multicenter Study. Movement disorders clinical practice.2019;6(7):576-585.
2.M.Al-Wardat, C.Geroin, T.Schirinzi.,Axial postural abnormalities and pain in Parkinson’s disease.Journal of neural transmission 2023;130(2):77-85.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-study-of-axial-postural-abnormality-in-parkinsons/