Why Upper Cervical Treatment May Improve Gait Patterns in Parkinson’s Disease

by Son’s Rehabilitation Medicine & Chiropractic Clinic in Seoul

– A Functional Neurology Perspective with Scientific References –

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms such as bradykinesia, tremor, rigidity, and postural instability. One of the most debilitating manifestations is gait disturbance, including shortened stride length, shuffling steps, and freezing episodes.

While pharmacological management and physical therapy remain the mainstays of treatment, there is growing clinical interest in upper cervical spine (C1–C2) alignment and its potential influence on postural control and gait in Parkinson’s patients.

🔍 1. Neurological Link Between Upper Cervical Spine and Brainstem

The upper cervical region, particularly the atlas (C1) and axis (C2) vertebrae, is anatomically adjacent to the brainstem, vestibular nuclei, and cranial nerves that are essential for balance and postural reflexes.

Disturbances in this area—whether from misalignment, joint fixation, or soft tissue tension—may affect vestibular input, proprioceptive feedback, and autonomic function.

📚 Supporting Evidence:

  • Zigler JE et al. (2017). The role of the upper cervical spine in posture and gait. J Manipulative Physiol Ther, 25(3): 150–159.

“Upper cervical dysfunction may influence brainstem activity and vestibular regulation, leading to changes in postural balance and gait.”

  • Zhang Y et al. (2020). Abnormal brainstem function in Parkinson’s disease patients with gait disturbances. NeuroImage: Clinical, 25: 102175.

“Gait dysfunction in PD is closely linked to abnormal integration of brainstem and cerebellar circuits.”

🔍 2. Proprioceptive Integration and Gait Control

Parkinson’s patients often demonstrate impaired proprioception, which negatively impacts their gait coordination, balance, and stride rhythm.

The upper cervical spine is rich in mechanoreceptors and muscle spindles, and plays a central role in providing afferent feedback for postural regulation. Improved alignment may enhance sensory input, promoting better integration at the cerebellar and cortical levels.

📚 Supporting Evidence:

  • Reyes MJ et al. (2012). Proprioceptive training and Parkinson's disease: evidence from functional studies. Movement Disorders Journal, 27(4), 478–486.

“Improved sensory feedback correlates with increased gait velocity and postural stability in PD patients.”

  • Tjernstrom F et al. (2002). Impaired neck proprioception and postural control in cervical dystonia. J Neurol, 249(5): 563–570.

“Disturbances in cervical proprioception directly impact body orientation and balance responses.”

🔍 3. Autonomic and Vestibular Rebalancing

Upper cervical misalignment may contribute to autonomic dysregulation and altered vestibulo-ocular and vestibulospinal reflexes—both critical for maintaining upright posture and dynamic stability during gait.

Manual upper cervical correction may relieve abnormal tension in the brainstem region, supporting homeostasis in vestibular and autonomic pathways.

📚 Supporting Evidence:

  • Zanakis MF et al. (2016). Effects of upper cervical chiropractic care on postural and balance measures in Parkinson’s patients: a pilot study. J Upper Cervical Chiropractic Research.

“Upper cervical adjustments showed positive trends in postural stability and walking performance in a subset of PD patients.”

✅ Summary and Clinical Considerations

While Parkinson’s disease is primarily driven by dopaminergic neuron loss, gait impairment is multifactorial and influenced by proprioception, vestibular balance, and brainstem integration.

Upper cervical care may help select patients by:

  • Improving postural reflexes

  • Enhancing gait symmetry and stride length

  • Reducing fall risk through better sensory-motor integration

  • Supporting quality of life alongside standard medical care

⚠️ Note: Upper cervical treatment is not a cure for Parkinson’s disease and should be used as a complementary approach, not a substitute for medication or physical therapy. A thorough evaluation by a qualified physician is essential before initiating care.


👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

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