Ann Rehabil Med.  2015 Feb;39(1):128-132. 10.5535/arm.2015.39.1.128.

Correction of Camptocormia Using a Cruciform Anterior Spinal Hyperextension Brace and Back Extensor Strengthening Exercise in a Patient With Parkinson Disease

• Ye BK
• Kim HS
• Kim YW

• KMID: 2273029
• DOI: http://doi.org/10.5535/arm.2015.39.1.128

Abstract

Parkinson disease, one of the most common neurodegenerative diseases, is characterized by cardinal motor features including bradykinesia, rigidity, resting tremor, postural instability, freezing gait, and fatigue. Of these, postural instability in the form of hyperflexion of the thoracolumbar spine upon standing and walking that disappears on recumbent positioning is called camptocormia. Many different trials have been conducted on the treatment of camptocormia, including physiotherapy, corsets, medications, and deep brain stimulation. However, there is insufficient evidence as to which treatment modality is the most valid in terms of effectiveness, cost, safety, and patient satisfaction. In this study, we present a patient whose symptom of camptocormia was effectively resolved using a cruciform anterior spinal hyperextension (CASH) brace and back extensor strengthening exercise which was modified through follow-ups based on a short-term outpatient setting for proper application with minimal discomfort. The patient was satisfied with the amount of correction provided by the brace and exercise.

Keyword

Camptocormia; Parkinson disease; Posturean

MeSH Terms

Braces*
Cost-Benefit Analysis
Deep Brain Stimulation
Fatigue
Follow-Up Studies
Freezing
Gait
Humans
Hypokinesia
Neurodegenerative Diseases
Outpatients
Parkinson Disease*
Patient Satisfaction
Spine
Tremor
Walking

Figure

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  Fig. 1 (A) Hyperflexion of the thoracolumbar spine observed on the initial outpatient visit. (B) Hyperflexion of the thoracolumbar spine resolved by recumbent positioning. (C) No evidence of compression fracture seen on plain X-ray (whole spine lateral view, supine position).

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  Fig. 2 Extension of the thoracolumbar spine partially achieved with application of a heavily loaded backpack, but the weight was intolerable to the patient.

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  Fig. 3 Camptocormia was still observed after the initial application of the cruciform anterior spinal hyperextension brace.

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  Fig. 4 (A, B) Correction of camptocormia after a serial of outpatient-based follow-ups and modifications.

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