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Musculoskeletal problems in Parkinson’s disease

  • Neurology and Preclinical Neurological Studies - Review Article
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Abstract

Musculoskeletal problems are very common and are an important contributor to poor quality of life in Parkinson’s disease. However, they are under-appreciated, under-evaluated, and under-treated. This paper will address the prevalence of musculoskeletal problems in Parkinson’s disease, and review the clinical characteristics of selected musculoskeletal conditions, such as shoulder problems, low back pain, arthritis, deformity, osteoporosis and fracture. Finally, a variety of treatment modalities for musculoskeletal problems will be reviewed.

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References

  • Abou-Raya S, Helmii M, Abou-Raya A (2009) Bone and mineral metabolism in older adults with Parkinson’s disease. Age Ageing 38(6):675–680. doi:10.1093/ageing/afp137

    Article  PubMed  Google Scholar 

  • Andreadou E, Anagnostouli M, Vasdekis V, Kararizou E, Rentzos M, Kontaxis T, Evdokimidis I (2011) The impact of comorbidity and other clinical and sociodemographic factors on health-related quality of life in Greek patients with Parkinson’s disease. Aging Mental Health 15(7):913–921. doi:10.1080/13607863.2011.569477

    Article  PubMed  Google Scholar 

  • Ashour R, Jankovic J (2006) Joint and skeletal deformities in Parkinson’s disease, multiple system atrophy, and progressive supranuclear palsy. Mov Dis Off J Mov Disord Soc 21(11):1856–1863. doi:10.1002/mds.21058

    Article  Google Scholar 

  • Ashour R, Tintner R, Jankovic J (2005) Striatal deformities of the hand and foot in Parkinson’s disease. Lancet Neurol 4(7):423–431. doi:10.1016/S1474-4422(05)70119-8

    Article  PubMed  Google Scholar 

  • Beiske AG, Loge JH, Ronningen A, Svensson E (2009) Pain in Parkinson’s disease: prevalence and characteristics. Pain 141(1–2):173–177. doi:10.1016/j.pain.2008.12.004

    Article  PubMed  CAS  Google Scholar 

  • Bellomo G, Santambrogio L, Fiacconi M, Scarponi AM, Ciuffetti G (1991) Plasma profiles of adrenocorticotropic hormone, cortisol, growth hormone and prolactin in patients with untreated Parkinson’s disease. J Neurol 238(1):19–22

    Article  PubMed  CAS  Google Scholar 

  • Bezza A, Ouzzif Z, Naji H, Achemlal L, Mounach A, Nouijai M, Bourazza A, Mossadeq R, El Maghraoui A (2008) Prevalence and risk factors of osteoporosis in patients with Parkinson’s disease. Rheumatol Int 28(12):1205–1209. doi:10.1007/s00296-008-0632-6

    Article  PubMed  CAS  Google Scholar 

  • Bissonnette B (1986) Pseudorheumatoid deformity of the feet associated with parkinsonism. J Rheumatol 13(4):825–826

    PubMed  CAS  Google Scholar 

  • Broen MP, Braaksma MM, Patijn J, Weber WE (2012) Prevalence of pain in Parkinson’s disease: a systematic review using the modified QUADAS tool. Mov Dis Off J Mov Disord Soc. doi:10.1002/mds.24054

    Google Scholar 

  • Broetz D, Eichner M, Gasser T, Weller M, Steinbach JP (2007) Radicular and nonradicular back pain in Parkinson’s disease: a controlled study. Mov Dis Off J Mov Disord Soc 22(6):853–856. doi:10.1002/mds.21439

    Article  Google Scholar 

  • Chen YY, Cheng PY, Wu SL, Lai CH (2012) Parkinson’s disease and risk of hip fracture: an 8-year follow-up study in Taiwan. Park Relat Disord. doi:10.1016/j.parkreldis.2012.01.014

    Google Scholar 

  • Defazio G, Berardelli A, Fabbrini G, Martino D, Fincati E, Fiaschi A, Moretto G, Abbruzzese G, Marchese R, Bonuccelli U, Del Dotto P, Barone P, De Vivo E, Albanese A, Antonini A, Canesi M, Lopiano L, Zibetti M, Nappi G, Martignoni E, Lamberti P, Tinazzi M (2008) Pain as a nonmotor symptom of Parkinson disease: evidence from a case-control study. Arch Neurol 65(9):1191–1194. doi:10.1001/archneurol.2008.2

    Article  PubMed  Google Scholar 

  • Di Monaco M, Vallero F, Di Monaco R, Tappero R, Cavanna A (2006) Bone mineral density in hip-fracture patients with Parkinson’s disease: a case-control study. Arch Phys Med Rehabil 87(11):1459–1462. doi:10.1016/j.apmr.2006.07.265

    Article  PubMed  Google Scholar 

  • Di Monaco M, Vallero F, Di Monaco R, Tappero R, Cavanna A (2008) Type of hip fracture in patients with Parkinson disease is associated with femoral bone mineral density. Arch Phys Med Rehabil 89(12):2297–2301. doi:10.1016/j.apmr.2008.06.016

    Article  PubMed  Google Scholar 

  • Dias R, Cutts S, Massoud S (2005) Frozen shoulder. Br Med J 331(7530):1453–1456. doi:10.1136/bmj.331.7530.1453

    Article  Google Scholar 

  • Dural A, Atay MB, Akbostanci C, Kucukdeveci A (2003) Impairment, disability, and life satisfaction in Parkinson’s disease. Disabil Rehabil 25(7):318–323. doi:10.1080/0963828021000043761

    Article  PubMed  CAS  Google Scholar 

  • Duvoisin RC, Marsden CD (1975) Note on the scoliosis of Parkinsonism. J Neurol Neurosurg Psychiatry 38(8):787–793

    Article  PubMed  CAS  Google Scholar 

  • Eng ML, Lyons KE, Pahwa R (2006) Prevalence of bone mineral density screening in Parkinson’s disease clinic outpatients. Mov Dis Off J Mov Disord Soc 21(12):2265–2266. doi:10.1002/mds.21155

    Article  Google Scholar 

  • Etchepare F, Rozenberg S, Mirault T, Bonnet AM, Lecorre C, Agid Y, Bourgeois P, Fautrel B (2006) Back problems in Parkinson’s disease: an underestimated problem. Jt Bone Spine 73(3):298–302. doi:10.1016/j.jbspin.2005.05.006

    Article  Google Scholar 

  • Evatt ML, Delong MR, Khazai N, Rosen A, Triche S, Tangpricha V (2008) Prevalence of vitamin d insufficiency in patients with Parkinson disease and Alzheimer disease. Arch Neurol 65(10):1348–1352. doi:10.1001/archneur.65.10.1348

    Article  PubMed  Google Scholar 

  • Fink HA, Kuskowski MA, Taylor BC, Schousboe JT, Orwoll ES, Ensrud KE (2008) Association of Parkinson’s disease with accelerated bone loss, fractures and mortality in older men: the Osteoporotic Fractures in Men (MrOS) study. Osteoporos Int 19(9):1277–1282. doi:10.1007/s00198-008-0584-4

    Article  PubMed  CAS  Google Scholar 

  • Ford B (2010) Pain in Parkinson’s disease. Mov Dis Off J Mov Disord Soc 25(Suppl 1):S98–S103. doi:10.1002/mds.22716

    Article  Google Scholar 

  • Gage H, Hendricks A, Zhang S, Kazis L (2003) The relative health related quality of life of veterans with Parkinson’s disease. J Neurol Neurosurg Psychiatry 74(2):163–169

    Article  PubMed  CAS  Google Scholar 

  • Genever RW, Downes TW, Medcalf P (2005) Fracture rates in Parkinson’s disease compared with age- and gender-matched controls: a retrospective cohort study. Age Ageing 34(1):21–24. doi:10.1093/ageing/afh203

    Article  PubMed  Google Scholar 

  • Genty S, Derrey S, Pouplin S, Lefaucheur R, Chastan N, Gerardin E, Maltete D (2011) Pain due to osteoarthritis may impair the early outcome of deep brain stimulation in Parkinson’s disease. Clin Neurol Neurosurg 113(10):864–867. doi:10.1016/j.clineuro.2011.06.006

    Article  PubMed  Google Scholar 

  • Gortvai P (1963) Deformities of the hands and feet in Parkinsonism and their reversibility by operation. J Neurol Neurosurg Psychiatry 26:33–36

    Article  PubMed  CAS  Google Scholar 

  • Grimes JD, Hassan MN, Trent G, Halle D, Armstrong GW (1987) Clinical and radiographic features of scoliosis in Parkinson’s disease. Adv Neurol 45:353–355

    PubMed  CAS  Google Scholar 

  • Invernizzi M, Carda S, Viscontini GS, Cisari C (2009) Osteoporosis in Parkinson’s disease. Park Relat Disord 15(5):339–346. doi:10.1016/j.parkreldis.2009.02.009

    Article  Google Scholar 

  • Ishizaki F, Harada T, Katayama S, Abe H, Nakamura S (1993) Bone changes in Parkinson’s disease. No to Shinkei (Brain and Nerve) 45(8):719–724

    CAS  Google Scholar 

  • Johnell O, Melton LJ 3rd, Atkinson EJ, O’Fallon WM, Kurland LT (1992) Fracture risk in patients with parkinsonism: a population-based study in Olmsted County, Minnesota. Age Ageing 21(1):32–38

    Article  PubMed  CAS  Google Scholar 

  • Kamanli A, Ardicoglu O, Ozgocmen S, Yoldas TK (2008) Bone mineral density in patients with Parkinson’s disease. Aging Clin Exp Res 20(3):277–279

    PubMed  Google Scholar 

  • Kao CH, Chen CC, Wang SJ, Chia LG, Yeh SH (1994) Bone mineral density in patients with Parkinson’s disease measured by dual photon absorptiometry. Nucl Med Commun 15(3):173–177

    Article  PubMed  CAS  Google Scholar 

  • Koh SB, Roh JH, Kim JH, Oh K, Kim BJ, Kim GS, Park BK, Kim SJ, Yoon JS (2008) Ultrasonographic findings of shoulder disorders in patients with Parkinson’s disease. Mov Dis Off J Mov Disord Soc 23(12):1772–1776. doi:10.1002/mds.22191

    Article  Google Scholar 

  • Koller WC, Glatt S, Vetere-Overfield B, Hassanein R (1989) Falls and Parkinson’s disease. Clin Neuropharmacol 12(2):98–105

    Article  PubMed  CAS  Google Scholar 

  • Kryzak TJ, Sperling JW, Schleck CD, Cofield RH (2009) Total shoulder arthroplasty in patients with Parkinson’s disease. J Should Elb Surg/American Shoulder and Elbow Surgeons [et al.] 18(1):96–99. doi:10.1016/j.jse.2008.07.010

    Google Scholar 

  • Kryzak TJ, Sperling JW, Schleck CD, Cofield RH (2010) Hemiarthroplasty for proximal humerus fractures in patients with Parkinson’s disease. Clin Orthop Relat Res 468(7):1817–1821. doi:10.1007/s11999-010-1353-1

    Article  PubMed  Google Scholar 

  • Lee SH, Kim MJ, Kim BJ, Kim SR, Chun S, Kim HK, Ryu JS, Kim GS, Lee MC, Chung SJ, Koh JM (2010) Hyperhomocysteinemia due to levodopa treatment as a risk factor for osteoporosis in patients with Parkinson’s disease. Calcif Tissue Int 86(2):132–141. doi:10.1007/s00223-009-9327-6

    Article  PubMed  Google Scholar 

  • Leibson CL, Maraganore DM, Bower JH, Ransom JE, O’Brien PC, Rocca WA (2006) Comorbid conditions associated with Parkinson’s disease: a population-based study. Mov Dis Off J Mov Disord Soc 21(4):446–455. doi:10.1002/mds.20685

    Article  Google Scholar 

  • Lorefalt B, Ganowiak W, Palhagen S, Toss G, Unosson M, Granerus AK (2004) Factors of importance for weight loss in elderly patients with Parkinson’s disease. Acta Neurol Scand 110(3):180–187. doi:10.1111/j.1600-0404.2004.00307.x

    Article  PubMed  CAS  Google Scholar 

  • Lorefalt B, Toss G, Granerus AK (2007) Bone mass in elderly patients with Parkinson’s disease. Acta Neurol Scand 116(4):248–254. doi:10.1111/j.1600-0404.2007.00875.x

    Article  PubMed  CAS  Google Scholar 

  • Madden MB, Hall DA (2010) Shoulder pain in Parkinson’s disease: a case–control study. Mov Dis Off J Mov Disord Soc 25(8):1105–1106. doi:10.1002/mds.23048

    Article  Google Scholar 

  • Melikoglu MA, Sezer I, Kacar C (2007) Rheumatoid-like hand deformities in Parkinson disease. J Clin Rheumatol Pract Rep Rheum Musculoskelet Dis 13(4):236–237. doi:10.1097/RHU.0b013e31812e00ca

    Google Scholar 

  • Moon SH, Lee HM, Chun HJ, Kang KT, Kim HS, Park JO, Moon ES, Chong HS, Sohn JS, Kim HJ (2011) Surgical outcome of lumbar fusion surgery in patients with Parkinson disease. J Spinal Disord Tech. doi:10.1097/BSD.0b013e318224a625

    Google Scholar 

  • Pickering RM, Grimbergen YA, Rigney U, Ashburn A, Mazibrada G, Wood B, Gray P, Kerr G, Bloem BR (2007) A meta-analysis of six prospective studies of falling in Parkinson’s disease. Mov Dis Off J Mov Disord Soc 22(13):1892–1900. doi:10.1002/mds.21598

    Article  Google Scholar 

  • Reynolds FW, Petropoulous GC (1965) Hand deformities in parkinsonism. J Chron Dis 18:593–595

    Article  PubMed  Google Scholar 

  • Riley D, Lang AE, Blair RD, Birnbaum A, Reid B (1989) Frozen shoulder and other shoulder disturbances in Parkinson’s disease. J Neurol Neurosurg Psychiatry 52(1):63–66

    Article  PubMed  CAS  Google Scholar 

  • Rugbjerg K, Friis S, Jorgensen TL, Ritz B, Korbo L, Olsen JH (2010) Risk for Parkinson’s disease among patients with osteoarthritis: a Danish cohort study. Mov Dis Off J Mov Disord Soc 25(14):2355–2360. doi:10.1002/mds.23274

    Article  Google Scholar 

  • Saarni SI, Harkanen T, Sintonen H, Suvisaari J, Koskinen S, Aromaa A, Lonnqvist J (2006) The impact of 29 chronic conditions on health-related quality of life: a general population survey in Finland using 15D and EQ-5D. Qual Life Res Int J Qual Life Asp Treat Care Rehabil 15(8):1403–1414. doi:10.1007/s11136-006-0020-1

    Article  Google Scholar 

  • Sato Y, Kikuyama M, Oizumi K (1997) High prevalence of vitamin D deficiency and reduced bone mass in Parkinson’s disease. Neurology 49(5):1273–1278

    Article  PubMed  CAS  Google Scholar 

  • Sato Y, Manabe S, Kuno H, Oizumi K (1999) Amelioration of osteopenia and hypovitaminosis D by 1alpha-hydroxyvitamin D3 in elderly patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 66(1):64–68

    Article  PubMed  CAS  Google Scholar 

  • Sato Y, Kaji M, Tsuru T, Oizumi K (2001) Risk factors for hip fracture among elderly patients with Parkinson’s disease. J Neurol Sci 182(2):89–93

    Article  PubMed  CAS  Google Scholar 

  • Sato Y, Honda Y, Kaji M, Asoh T, Hosokawa K, Kondo I, Satoh K (2002a) Amelioration of osteoporosis by menatetrenone in elderly female Parkinson’s disease patients with vitamin D deficiency. Bone 31(1):114–118

    Article  PubMed  CAS  Google Scholar 

  • Sato Y, Kaji M, Tsuru T, Satoh K, Kondo I (2002b) Vitamin K deficiency and osteopenia in vitamin D-deficient elderly women with Parkinson’s disease. Arch Phys Med Rehabil 83(1):86–91

    Article  PubMed  Google Scholar 

  • Sato Y, Iwamoto J, Kanoko T, Satoh K (2006) Alendronate and vitamin D2 for prevention of hip fracture in Parkinson’s disease: a randomized controlled trial. Mov Dis Off J Mov Disord Soc 21(7):924–929. doi:10.1002/mds.20825

    Article  Google Scholar 

  • Sato Y, Honda Y, Iwamoto J (2007) Risedronate and ergocalciferol prevent hip fracture in elderly men with Parkinson disease. Neurology 68(12):911–915. doi:10.1212/01.wnl.0000257089.50476.92

    Article  PubMed  CAS  Google Scholar 

  • Sato Y, Iwamoto J, Honda Y (2011) Amelioration of osteoporosis and hypovitaminosis D by sunlight exposure in Parkinson’s disease. Park Relat Disord 17(1):22–26. doi:10.1016/j.parkreldis.2010.10.008

    Article  Google Scholar 

  • Schabitz WR, Glatz K, Schuhan C, Sommer C, Berger C, Schwaninger M, Hartmann M, Hilmar Goebel H, Meinck HM (2003) Severe forward flexion of the trunk in Parkinson’s disease: focal myopathy of the paraspinal muscles mimicking camptocormia. Mov Dis Off J Mov Disord Soc 18(4):408–414. doi:10.1002/mds.10385

    Article  Google Scholar 

  • Schneider JL, Fink HA, Ewing SK, Ensrud KE, Cummings SR (2008) The association of Parkinson’s disease with bone mineral density and fracture in older women. Osteoporos Int 19(7):1093–1097. doi:10.1007/s00198-008-0583-5

    Article  PubMed  CAS  Google Scholar 

  • Scott B, Borgman A, Engler H, Johnels B, Aquilonius SM (2000) Gender differences in Parkinson’s disease symptom profile. Acta Neurol Scand 102(1):37–43

    Article  PubMed  CAS  Google Scholar 

  • Silva EG, Viana MA, Quagliato EM (2008) Pain in Parkinson’s disease: analysis of 50 cases in a clinic of movement disorders. Arq Neuropsiquiatr 66(1):26–29

    Article  PubMed  Google Scholar 

  • Slawek J, Derejko M, Lass P (2003) Camptocormia as a form of dystonia in Parkinson’s disease. Eur J Neurol Off J Eur Fed Neurol Soc 10(1):107–108

    CAS  Google Scholar 

  • Song IU, Kim JS, Lee SB, Ryu SY, An JY, Jeong DS, Kim YI, Lee KS (2009) The relationship between low bone mineral density and Parkinson’s disease in a Korean population. J Clin Neurosci 16(6):807–809. doi:10.1016/j.jocn.2008.08.027

    Article  PubMed  Google Scholar 

  • Stamey W, Davidson A, Jankovic J (2008) Shoulder pain: a presenting symptom of Parkinson disease. J Clin Rheumatol Pract Rep Rheum Musculoskelet Dis 14(4):253–254. doi:10.1097/RHU.0b013e3181826d43

    Google Scholar 

  • Taggart H, Crawford V (1995) Reduced bone density of the hip in elderly patients with Parkinson’s disease. Age Ageing 24(4):326–328

    Article  PubMed  CAS  Google Scholar 

  • Tinazzi M, Del Vesco C, Fincati E, Ottaviani S, Smania N, Moretto G, Fiaschi A, Martino D, Defazio G (2006) Pain and motor complications in Parkinson’s disease. J Neurol Neurosurg Psychiatry 77(7):822–825. doi:10.1136/jnnp.2005.079053

    Article  PubMed  CAS  Google Scholar 

  • Vaserman N (2005) Parkinson’s disease and osteoporosis. Jt Bone Spine 72(6):484–488. doi:10.1016/j.jbspin.2004.04.012

    Article  Google Scholar 

  • Vestergaard P, Rejnmark L, Mosekilde L (2007) Fracture risk associated with parkinsonism and anti-Parkinson drugs. Calcif Tissue Int 81(3):153–161. doi:10.1007/s00223-007-9065-6

    Article  PubMed  CAS  Google Scholar 

  • Waxman MJ, Durfee D, Moore M, Morantz RA, Koller W (1990) Nutritional aspects and swallowing function of patients with Parkinson’s disease. Nutr Clin Pract Off Publ Am Soc Parenter Enter Nutr 5(5):196–199

    Article  CAS  Google Scholar 

  • Wood B, Walker R (2005) Osteoporosis in Parkinson’s disease. Mov Dis Off J Mov Disord Soc 20(12):1636–1640. doi:10.1002/mds.20643

    Article  Google Scholar 

  • Woolf AD (2003) How to assess musculoskeletal conditions. History and physical examination. Best Pract Res Clin Rheumatol 17(3):381–402

    Article  PubMed  Google Scholar 

  • Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81(9):646–656

    PubMed  Google Scholar 

  • Wunderlich S, Csoti I, Reiners K, Gunthner-Lengsfeld T, Schneider C, Becker G, Naumann M (2002) Camptocormia in Parkinson’s disease mimicked by focal myositis of the paraspinal muscles. Mov Dis Off J Mov Disord Soc 17(3):598–600. doi:10.1002/mds.10110

    Article  Google Scholar 

  • Yamada T, Kachi T, Ando K (1995) Osteoporosis and fractures in Parkinson’s disease. Nihon Ronen Igakkai zasshi Jpn J Geriatr 32(10):637–640

    Article  CAS  Google Scholar 

  • Yucel A, Kusbeci OY (2010) Magnetic resonance imaging findings of shoulders in Parkinson’s disease. Mov Dis Off J Mov Disord Soc 25(15):2524–2530. doi:10.1002/mds.23310

    Article  Google Scholar 

  • Yun JY, Jeon BS, Kim HJ, Kim YE, Lee JY, Paek SH (2012) Musculoskeletal problems need more attention in deep brain stimulation for Parkinson’s disease. Neurol Asia (accepted)

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Acknowledgments

J.B.S. is supported by a grant of the Korea Health technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A101273).

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The authors declare that they have no conflict of interest.

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Correspondence to Beom S. Jeon.

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Kim, Y.E., Jeon, B.S. Musculoskeletal problems in Parkinson’s disease. J Neural Transm 120, 537–542 (2013). https://doi.org/10.1007/s00702-012-0960-2

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