Determinants of impaired bed mobility in Parkinson's disease: Impact of hip muscle strength and motor symptoms.
Seira Taniguchi, Nicholas D'cruz, Miho Nakagoshi and 2 others
PMID 35147569WHAT IT FOUND
Arm rigidity and weak hip adductors, not general axial stiffness, drive slow bed mobility in Parkinson's.
Patients with these deficits rely on hip-hitching or lateral flexion without rotation. Targeting hip strength and managing arm rigidity may improve turning efficiency.
Key findings
01Arm rigidity on the more affected side was the only independent predictor of movement time, explaining 75% of the variability in getting out of bed.
02Slower movement time was significantly correlated with reduced hip adductor torque on the more affected side and tended to correlate with reduced hip flexor torque.
03Patients with Parkinson's predominantly used movement patterns that avoid trunk rotation, such as lateral flexion without rotation or sit and hip-hitching, unlike healthy controls who mostly rotated their trunk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small (16 patients, 10 controls) and unbalanced. The study only assessed muscle strength in the lower limbs; trunk and upper limb strength were not measured. Participants were assessed in the ON medication state, so results may not reflect nighttime mobility when medication wears off. The study design is cross-sectional, so it identifies associations but cannot prove that weakness or rigidity causes the slowness.
The easy way to misread this
Do not assume that general axial rigidity or trunk weakness is the primary cause of slow bed mobility. This study found that arm rigidity and hip adductor strength were the key correlates, while axial signs did not significantly correlate with movement time.