Visual and Verbal Posture Training in Parkinson's Disease

Type

Master of Arts thesis (Physical Therapy)

Institution

Touro College, Barry Z. Levine School of Health Sciences

Year

1990

Author

Russ L'HommeDieu, SPT

Abstract

As Parkinson's disease advances, patients develop a characteristic stooped, forward-flexed posture, marked by forward head and thoracic kyphosis, that drives many of the condition's most disabling sequelae: festinating gait, reduced lung vital capacity, difficulty swallowing and coughing, low back pain, and the loss of eye contact that feeds social isolation. This experimental study asked whether adding simultaneous visual feedback to conventional verbal posture instruction produces greater and more lasting postural improvement than verbal instruction alone.

Independently ambulatory patients at the Parkinson's Therapy Center in Smithtown, New York were assigned to a vision group (verbal plus visual training), a non-vision group (verbal training alone), and a control group, with sagittal-plane posture measured across five sessions. Because no instrument existed to make photographs metrically reliable, the study required designing and calibrating a film-plane posture grid that turned an ordinary 35mm camera into a measurement device, quantifying posture as the linear distance between the external auditory meatus and the apex of the thoracic kyphosis. Seven null hypotheses tested immediate and long-term change, both within and between groups. Beyond its clinical argument for early postural-awareness intervention in Parkinson's disease, the thesis planted a career-long question, the idea that the method of learning shapes the durability of change, that continues to run through the compassion, flourishing, and assessment strands of the current research agenda.