Short-term Effect of Rib Cage Mobilisation versus Kinesio-taping on Thoracic Spine Alignment in Patients with Parkinsons Disease

•Parkinson’s disease (PD) is the most common neurodegenerative movement disorder, which is characterized by four cardinal features: rest tremor, rigidity, bradykinesia and postural instability.

•Although the pathology of postural instability is unknown, several hypotheses exist.

•According to Karen M Doherty: In patients with Parkinson’s, the reduced spinal movements cause an effort to maintain the body gravity line within the limits of stability and are usually compensated by increased trunk flexion.

•According to Zhang T: The stooped posture in Parkinson’s  may be because of  tonic hyperactivity of the flexors due to abnormal drive from the basal ganglia.

•According to Gross AK: stooped posture in Parkinson’s  may be compensatory strategy to facilitate forward motion of the Center of Mass for step initiation.

•Dietz et al. further noted that Parkinson’s patient stoop for compensation to backward falls and  its not a cause of, primary postural deficits in PD.

•The clinical assessment of stopped posture is very important for evaluating the functional and physical consequences of the disease and the risk factors for its progression.

•Therefore, therapeutic approaches including active posture correction and proprioceptive stimulation are thought to be effective on axial symptoms.

•Mobilization is a multiple, controlled, bidirectional, small to large amplitude, rhythmic oscillation given within physiological range.

• Kinesio taping aims to activate the proprioceptive system by increasing sensory stimuli with cutaneous mechanoreceptors and also helps to improve anticipatory postural

adjustments and activate trunk muscles and joints without restricting body movements.

•Studies have shown that kinesio taping improves postural control not only by increasing proprioceptive sensation, but also by determining the correct joint position for a

comfortable and non-burdening posture.

•In recent years, it has been utilized in musculoskeletal and neurological diseases with the aim of increasing or inhibiting muscle activity, providing joint repositioning,

preventing injuries and improving proprioception.

•Stooped posture in Parkinson’s patients have its negative effect on balance, which cause falls, resulting in extremity and spinal-compression fractures, and also

detoriate  their quality of life.

•Rib cage mobilization can contribute to improve posture by addressing restrictions and imbalances in the thoracic spine and surrounding musculature.

•It will also help patients with improved mobility of spine, improved breathing and relaxation.

•It has been stated in recent studies that elastic taping can be used for postural correction and can be an effective form of cutaneous proprioceptive biofeedback.

•Moreover, previous studies have developed several invasive treatments for stooped posture, such as deep brain stimulation and botulinum toxin injected into the

primary-culprit muscles for the condition. However, the effect of these treatments on stooped posture has remained controversial over the years.

•Therefore, non-invasive treatment for stooped posture in Parkinson’s patients needs to be established.

•Samples will be randomly and equally divided into 2 groups.

Group A :- will receive rib cage mobilisation intervention

Group B :- will receive kinesio-taping intervention

•All the participants will be assessed pre and post treatment after 1 week using Smart phone application ( Clinometer) and trunk mobility scale.