# Integrative Postural Rehabilitation for Kyphotic Deformity in a Patient with Parkinson’s Disease: A Case Report and Literature Review

## TL;DR

A 76-year-old Parkinson’s patient with severe spinal curvature improved after an integrative rehabilitation program combining therapies like acupuncture and exercise.

## Contribution

This case report introduces integrative postural rehabilitation as a novel, non-invasive treatment for kyphotic deformity in Parkinson’s disease.

## Key findings

- Spinal alignment improved significantly after 4 weeks of integrative rehabilitation.
- Functional outcomes and pain levels decreased with no adverse effects observed.
- Proprioceptive stimulation and exercise may enhance postural stability and gait in Parkinson’s patients.

## Abstract

Spinal deformities, particularly thoracolumbar kyphosis, affect approximately one-third of patients with Parkinson’s disease (PD) and significantly impair their quality of life and mobility. Conventional treatments, including levodopa and surgical interventions, have limited efficacy, necessitating alternative therapies. In this report, a 76-year-old woman with PD and severe thoracolumbar kyphosis (TK: 77.7°; sagittal vertical axis [SVA]: 95.55 mm) experienced postural instability and gait impairment. She underwent integrative postural rehabilitation (acupuncture, pharmacopuncture, Chuna spinal manual therapy, thermotherapy, and bodyweight exercises). A 4-week inpatient treatment improved spinal alignment (TK: 61.1°; SVA: 77.84 mm), gait, postural stability (MDS-UPDRS score improved by 3 points), and functional outcomes, with reductions in the Oswestry Disability Index (70 to 31) and pain severity (Numeric Rating Scale: 50 to 40). No adverse events were observed. Integrative postural rehabilitation can mitigate paraspinal muscle atrophy and fatty infiltration by promoting protein synthesis, neurotrophic factor expression, and proprioceptive neuromodulation. Our literature review suggests that proprioceptive stimulation and exercise enhances postural stability and gait, aligning with the outcomes of this case. This report suggests that integrative rehabilitation may improve kyphotic deformities and related motor dysfunctions in patients with PD. Further research is warranted to validate the treatment’s efficacy and long-term benefits.