We performed physical therapy for a patient with Parkinson’s disease to improve posture and movement. The patient showed flexion of the thoracolumbar transition and lateral flexion while sitting, ...which continued even when standing, and also demonstrated pelvic posterior tilting due to poor flexion of both hip joints. In the standing position, the patient showed instability to the left and a tendency to fall because of left tilting of the trunk due to abduction of the left hip joint. These characteristics continued even during gait motion. During gait motion, left hip flexion and lateral flexion of the thoracolumbar transition caused instability to the left anterior and a tendency to fall from initial contact of the left foot to the mid-stance. The common problems of the sitting, standing, and gait motions were determined by top-down assessment, and improvement of posture and motion were achieved by intervention.
We performed physical therapy for a patient with spinal cord metastasis after malignant lymphoma one year ago. Posterior instability was observed in the buttocks while standing up; therefore, the ...patient lacked safety and stability during this action. The motions of the flexion phase in standing up were as follows: (1) spatial anterior and lateral tilting of the leg, and (2) pelvic anterior tilting with flexion of the hip. These abnormal motions were considered to have been caused by high muscle tones in the right ankle and foot muscles. Therefore, we considered that it might be difficult for the patient to perform pelvic anterior tilting with hip flexion; and this would have made standing up difficult as well. We prescribed direct stretching and strength training for the right ankle and foot muscles. However, the pelvic anterior tilting with hip flexion showed no improvement. Therefore, pelvic anterior tilting with hip flexion was not solely caused by the ankle and foot. On re-examination, abnormal motion with left hip flexion muscle weakness was observed. Physical therapy was performed to treat these hip, ankle, and foot conditions. Consequently, the patient showed improvement in spatial anterior and lateral tilting of the leg, and pelvic anterior tilting with the flexion of the hip during the flexion phase. The patient also improved with respect to safety and stability while standing up.
