Efficacy of osteopathic manipulative treatment on postural control in Parkinsonian patients with Pisa syndrome: A pilot randomized placebo-controlled trial

Zarucchi Alessioa | Vismara Lucab; c; e | Frazzitta Giuseppea | Mauro Alessandro c; e | Priano Lorenzo c; e | Maestri Robertof | Bergna Andread | Tarantino Andread; g

[aDepartment of Brain Injury and Parkinson’s Disease Rehabilitation, Ospedale “Moriggia-Pelascini”, Gravedona ed Uniti, Como, Italy
[bPhD Programme in Experimental Medicine and Therapy, University di Turin, Turin, Italy
[cDivision of Neurology and Neurorehabilitation – IRCCS Istituto Auxologico Italiano, Piancavallo-Verbania, Italy
[dDepartment of Clinical Research, SOMA Istituto Osteopatia, Milan, Italy
[eDepartment of Neurosciences, “Rita Levi Montalcini” University of Turin, Turin, Italy
[f] Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri Spa Società Benefit, IRCCS, Montescano, Italy
[g] MANIMA, Not-for-profit Healthcare and Assistance, Milan, Italy

NeuroRehabilitation – Volume Pre-press, issue Pre-press, Giugno 2020
DOI 10.3233/NRE-203068
LINK: https://content.iospress.com/journals/neurorehabilitation/Pre-press/Pre-press


Pisa syndrome (PS) is a clinical condition frequently associated with Parkinson’s Disease (PD). It is characterized by a trunk lateral flexion higher than 10 degrees and reversible when lying. One pathophysiological hypothesis is the altered verticality perception, due to a somatosensory impairment. Osteopathic Manipulative Treatment (OMT) manages fascial-system alterations, linked to somatic dysfunctions. Fascial system showed to be implicated in proprioceptive sensibility.

The aim of the study was to assess OMT efficacy on postural control in PD-PS patients by stabilometry.

In this single-blinded trial we studied 24 PD-PS patients, 12 of whom were

At one month, the sway area of the OMT group significantly decreased compared to placebo (mean delta OMT – 326.00±491.24 mm2 , p  = 0.01). In the experimental group TLF showed a mean inclination reduction of 3.33 degrees after treatment (p  = 0.044, mean d  = 0.54). Moreover, a significant positive association between delta ECSA and delta TLF was observed (p  = 0.04, r  = 0.46).

Among PD-PS patients, MIRT plus OMT showed preliminary evidence of postural control and TLF improvement, compared to the control group.

Keywords: Fascia, osteopathic medicine, complementary therapies, Parkinson, proprioception, ClinicalTrials.gov NCT04137848