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

Abstract

BACKGROUND
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.

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

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

RESULTS
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).

DISCUSSION
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