Pisa Syndrome in Parkinson's Disease: Electromyographic Aspects and Implications for Rehabilitation

Giuseppe Frazzitta, Pietro Balbi, Francesco Gotti, Roberto Maestri, Annarita Sabetta, Luca Caremani, Laura Gobbi, Marina Capobianco, Rossana Bera, Nir Giladi, Davide Ferrazzoli

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Pisa Syndrome (PS) is a real clinical enigma, and its management remains a challenge. In order to improve the knowledge about resting state and during maximal voluntary muscle contraction (MVMC) of the axial muscles, we described the electromyography results of paraspinal muscles, rectus abdominis, external oblique, and quadratus lumborum of both sides of 60 patients. Electromyography was assessed at rest, during MVMC while bending in the opposite direction of the PS and during MVMC while bending in the direction of the PS. The MVMC gave information about the interferential pattern (INT) or subinterferential pattern (sub-INT). We defined asymmetrical activation (AA) when a sub-INT was detected on the muscle on the side opposite to the PS bending and an INT of same muscle in the direction of PS bending. We observed significant AA during MVMC only in the external oblique muscles in 78% of the subjects. Our results of asymmetric ability to generate maximal voluntary force of the external oblique muscles support a central dissynchronisation of axial muscles as a significant contributor for the bending of the spine in erect position. These results could have important implication to physiotherapy and the use of botulinum toxin in the treatment of PS.

Original languageEnglish
Article number437190
JournalParkinson's Disease
Volume2015
DOIs
Publication statusPublished - 2015

Fingerprint

Parkinson Disease
Muscle Contraction
Rehabilitation
Skeletal Muscle
Muscles
Electromyography
Paraspinal Muscles
Rectus Abdominis
Botulinum Toxins
Spine
Direction compound
Abdominal Oblique Muscles

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Pisa Syndrome in Parkinson's Disease : Electromyographic Aspects and Implications for Rehabilitation. / Frazzitta, Giuseppe; Balbi, Pietro; Gotti, Francesco; Maestri, Roberto; Sabetta, Annarita; Caremani, Luca; Gobbi, Laura; Capobianco, Marina; Bera, Rossana; Giladi, Nir; Ferrazzoli, Davide.

In: Parkinson's Disease, Vol. 2015, 437190, 2015.

Research output: Contribution to journalArticle

Frazzitta, G, Balbi, P, Gotti, F, Maestri, R, Sabetta, A, Caremani, L, Gobbi, L, Capobianco, M, Bera, R, Giladi, N & Ferrazzoli, D 2015, 'Pisa Syndrome in Parkinson's Disease: Electromyographic Aspects and Implications for Rehabilitation', Parkinson's Disease, vol. 2015, 437190. https://doi.org/10.1155/2015/437190
Frazzitta, Giuseppe ; Balbi, Pietro ; Gotti, Francesco ; Maestri, Roberto ; Sabetta, Annarita ; Caremani, Luca ; Gobbi, Laura ; Capobianco, Marina ; Bera, Rossana ; Giladi, Nir ; Ferrazzoli, Davide. / Pisa Syndrome in Parkinson's Disease : Electromyographic Aspects and Implications for Rehabilitation. In: Parkinson's Disease. 2015 ; Vol. 2015.
@article{a502d410574f424e9e361fc57236012b,
title = "Pisa Syndrome in Parkinson's Disease: Electromyographic Aspects and Implications for Rehabilitation",
abstract = "Pisa Syndrome (PS) is a real clinical enigma, and its management remains a challenge. In order to improve the knowledge about resting state and during maximal voluntary muscle contraction (MVMC) of the axial muscles, we described the electromyography results of paraspinal muscles, rectus abdominis, external oblique, and quadratus lumborum of both sides of 60 patients. Electromyography was assessed at rest, during MVMC while bending in the opposite direction of the PS and during MVMC while bending in the direction of the PS. The MVMC gave information about the interferential pattern (INT) or subinterferential pattern (sub-INT). We defined asymmetrical activation (AA) when a sub-INT was detected on the muscle on the side opposite to the PS bending and an INT of same muscle in the direction of PS bending. We observed significant AA during MVMC only in the external oblique muscles in 78{\%} of the subjects. Our results of asymmetric ability to generate maximal voluntary force of the external oblique muscles support a central dissynchronisation of axial muscles as a significant contributor for the bending of the spine in erect position. These results could have important implication to physiotherapy and the use of botulinum toxin in the treatment of PS.",
author = "Giuseppe Frazzitta and Pietro Balbi and Francesco Gotti and Roberto Maestri and Annarita Sabetta and Luca Caremani and Laura Gobbi and Marina Capobianco and Rossana Bera and Nir Giladi and Davide Ferrazzoli",
year = "2015",
doi = "10.1155/2015/437190",
language = "English",
volume = "2015",
journal = "Parkinson's Disease",
issn = "2090-8083",
publisher = "Hindawi Publishing Corporation",

}

TY - JOUR

T1 - Pisa Syndrome in Parkinson's Disease

T2 - Electromyographic Aspects and Implications for Rehabilitation

AU - Frazzitta, Giuseppe

AU - Balbi, Pietro

AU - Gotti, Francesco

AU - Maestri, Roberto

AU - Sabetta, Annarita

AU - Caremani, Luca

AU - Gobbi, Laura

AU - Capobianco, Marina

AU - Bera, Rossana

AU - Giladi, Nir

AU - Ferrazzoli, Davide

PY - 2015

Y1 - 2015

N2 - Pisa Syndrome (PS) is a real clinical enigma, and its management remains a challenge. In order to improve the knowledge about resting state and during maximal voluntary muscle contraction (MVMC) of the axial muscles, we described the electromyography results of paraspinal muscles, rectus abdominis, external oblique, and quadratus lumborum of both sides of 60 patients. Electromyography was assessed at rest, during MVMC while bending in the opposite direction of the PS and during MVMC while bending in the direction of the PS. The MVMC gave information about the interferential pattern (INT) or subinterferential pattern (sub-INT). We defined asymmetrical activation (AA) when a sub-INT was detected on the muscle on the side opposite to the PS bending and an INT of same muscle in the direction of PS bending. We observed significant AA during MVMC only in the external oblique muscles in 78% of the subjects. Our results of asymmetric ability to generate maximal voluntary force of the external oblique muscles support a central dissynchronisation of axial muscles as a significant contributor for the bending of the spine in erect position. These results could have important implication to physiotherapy and the use of botulinum toxin in the treatment of PS.

AB - Pisa Syndrome (PS) is a real clinical enigma, and its management remains a challenge. In order to improve the knowledge about resting state and during maximal voluntary muscle contraction (MVMC) of the axial muscles, we described the electromyography results of paraspinal muscles, rectus abdominis, external oblique, and quadratus lumborum of both sides of 60 patients. Electromyography was assessed at rest, during MVMC while bending in the opposite direction of the PS and during MVMC while bending in the direction of the PS. The MVMC gave information about the interferential pattern (INT) or subinterferential pattern (sub-INT). We defined asymmetrical activation (AA) when a sub-INT was detected on the muscle on the side opposite to the PS bending and an INT of same muscle in the direction of PS bending. We observed significant AA during MVMC only in the external oblique muscles in 78% of the subjects. Our results of asymmetric ability to generate maximal voluntary force of the external oblique muscles support a central dissynchronisation of axial muscles as a significant contributor for the bending of the spine in erect position. These results could have important implication to physiotherapy and the use of botulinum toxin in the treatment of PS.

UR - http://www.scopus.com/inward/record.url?scp=84949255846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84949255846&partnerID=8YFLogxK

U2 - 10.1155/2015/437190

DO - 10.1155/2015/437190

M3 - Article

AN - SCOPUS:84949255846

VL - 2015

JO - Parkinson's Disease

JF - Parkinson's Disease

SN - 2090-8083

M1 - 437190

ER -