Using a portable gait rhythmogram to objectively evaluate acupuncture-mediated improvements in gait disturbance caused by Parkinson's disease:a case report / 全日本鍼灸学会雑誌

ABSTRACT

[Objective]We report herein the use of acupuncture to counteract gait disturbance in a patient with Parkinson's disease (PD). A portable gait rhythmogram was used to objectively demonstrate gait improvements. <BR>[Case]CaseA 72-year-old woman, who a 64 experienced a tremor of the right hand and was diagnosed with PD. Symptoms improved with anti-PD medication, but at 71 years old, she experienced heaviness of the neck and shoulders and stiffness of the anterior thighs, and her step length decreased. Acupuncture therapy was initiated to relieve these symptoms. <BR>Present illnessOn examination, she presented a wobbly gait, cold feet, and reported frequent falling. Heaviness in the neck and shoulders extended from the neck to the suprascapular region, and increasing heaviness resulted in a forward-flexed posture and decreased step length. Muscle hypertonia of the quadriceps muscles was bilaterally observed, explaining the perceived stiffness in the thighs. She was at stage III on the Hoehn and Yahr Scale. <BR>Acupuncture therapyAcupuncture therapy was performed weekly for 12 weeks to alleviate the muscle hypertonia associated with muscular rigidity. Acupuncture points comprised the points in the muscle hypertonia where tenderness was observed, including BL 10, DU 16, ST 32, SP 10 and ST 34. <BR>EvaluationA portable gait rhythmogram was used to measure the ground reaction force (GRF), velocity and step length. Dynamic balance functions and PD symptoms, were respectively evaluated using the Timed Up and Go Test (TUGT) and Unified Parkinson's Disease Rating Scale (UPDRS). Evaluations were conducted on initial examination and after the 12th therapy session.<BR>[Results]After the fourth session, perceived stiffness in the neck, shoulder region and thighs decreased. all frequency decreased from 5 times/day to 3times/day (4th session) and then once/day (7th session). There were no falls after the 8th session. Reduction in gait disturbance was objectively observed as followsIncreases were observed in GRF (0.15 to 0.17 m/s 2), gait velocity (49 to 53m/min), and step length (47 to 49 cm), while TUGT time decreased (11.8 to 9.5 s). Improvements in PD symptoms were also observed with decreased UPDRS score (41 to 28 points).<BR>[Discussion and Conclusion]The use of acupuncture therapy achieved improvements in Parkinson-related gait disturbance (objectively demonstrated using a portable gait rhythmogram). Acupuncture improved not only gait disorder but also other PD symptoms.