Objective: We analyzed the motion of PD patients using the Markerless Motion Capture System (MLS) and examined the quantification of motion and its usefulness.

Background: Although the MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) has been established as an evaluation scale for Parkinson’s disease (PD), little is known about the quantitative indicators of physical movement.

Method: Twenty-nine PD patients with Hoern & Yahr classification II to IV and a history of outpatient visits or hospitalization between July 2020 and March 2021 were included. Their mean age was 67.79 ± 9.22 years old, duration of illness was 10.2 ± 5.87 years, and 69.0% (20) were male. Each item of the MDS-UPDRS was evaluated. The movements from sitting to standing up and sitting at a fixed point were defined as standing movement, and the maximum values of the forward bending and lateral bending angles of the neck and trunk during each movement were measured using MLS.

Results: The subjective rise of the MDS-UPDRS Part II score of the 29 patients was 1.38 ± 1.24 points, the Part III score was 30.9 ± 18.2 points, and the maximum value of the cervical anteflexion angle during the standing motion was 42.1 ± 27.5 degrees. The subjective rise of the MDS-UPDRS Part II score correlated with the lateral flexion angle of the neck (r = 0.69, p = 0.001), the forward flexion angle of the neck (r = 0.62, p = 0.003), during the standing motion. It also correlated significantly with trunk lateral flexion angle (r = 0.64, p = 0.002) and trunk forward flexion angle (r = 0.44, p = 0.048). The cervical forward flexion angle during the standing motion correlated with the cervical lateral flexion angle (r = 0.76, p = 0.0001), trunk lateral flexion angle (r = 0.61, p = 0.003), and trunk forward flexion angle (r = 0.69, p = 0.0001), as well as the total score of MDS-UPDRS (r = 0.69, p = 0.001), Part I (r = 0.64, p = 0.003), Part II (r = 0.71, p = 0.0001), Part III (r = 0.46, p = 0.031), and Part IV (r = 0.64, p = 0.003).

Conclusion: MLS-based motion analysis in PD patients suggests a relationship with each item of the MDS-UPDRS and the measurement of the forward bending angles of the neck may be useful as an objective index.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/quantification-of-neck-and-trunk-tilt-during-standing-in-parkinsons-disease/