Diaphragmatic Thickness and Pulmonary Function in Parkinson's Disease

Study Overview
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Brief Summary
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Ultrasound can give important information about the morphology of the diaphragm and the amount of contraction. Our aim, with the prediction that a restrictive pathology will occur in the pulmonary function with the addition of camptocormia in Parkinson's patients; to compare respiratory functions in Parkinson's patients with and without camptocormia, to investigate the correlation between ultrasonographically measured diaphragmatic thickness and pulmonary function test values.

Detailed Description
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Respiratory complications are one of the most common causes of death in Parkinson's patients. In Parkinson's disease, abnormal flexion of the thoracolumbar spine of 45° or more, which is called camptocormia, increases during walking or standing and disappears completely in the supine position. The prevalence of camptocormia among Parkinson's patients is about 7%. Camptocormia in Parkinson's disease is associated with significant disease disability, higher daily dopaminergic drug dosage, and cognitive impairment. Parkinson's patients with camptocormia often complain of shortness of breath, attributed to reduced pulmonary capacity due to limited chest expansion. Diaphragmatic dyskinesia in Parkinson's patients may also lead to a restrictive deterioration in respiratory functions. Diaphragmatic thickness indicates diaphragmatic contraction and is correlated with PFT. Our aim; It is a comparison of respiratory functions in Parkinson's patients with and without camptocormia.

Official Title
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Correlation of Diaphragmatic Thickness With Pulmonary Function in Parkinson's Disease

Conditions
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Parkinson's Disease and Parkinsonism

Intervention / Treatment
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* Other: No intervention, observational only


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being diagnosed with Parkinson's Volunteer to participate in the study Exclusion Criteria: Being in contact with or suffering from COVID-19 Having diseases that increase intra-abdominal pressure Having diseases that affect diaphragmatic motility Have had recent thoracic or abdominal surgery Having a parenchymal, pleural, or chest wall mass that may cause restriction on a recent chest X-ray or CT
Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| camptocormia group<br>Diaphragmatic thickness will be measured by ultrasonography. Respiratory function will be evaluated by spirometric measurements. Postural deviations of the spine, knees, and hips will be recorded through photographs taken from the side and back | Other: No intervention, observational only<br>* No intervention, observational only<br>|
| no camptocormia group<br>Diaphragmatic thickness will be measured by ultrasonography. Respiratory function will be evaluated by spirometric measurements. Postural deviations of the spine, knees, and hips will be recorded through photographs taken from the side and back | Other: No intervention, observational only<br>* No intervention, observational only<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ultrasonography | When the patient is in the supine position, by placing a transducer on the chest wall at the level of the right 9th intercostal space, diaphragmatic movement will be monitored during inspiration, and diaphragmatic thickness will be measured at the end of expiration and inspiration. | December 2021- July 2022 | 
| Pulmonary function test | It will be evaluated by conventional spirometric measurements. Pulmonary function tests will be applied to all individuals in a sitting position with the Vmax Encore PFT system, Carefusion, CA USA brand test device. In each measurement, the maneuvers will be repeated at least 3 times and the best values will be recorded. Forced vital capacity (FVC), expire in the first second of forced expiration (FEV1), and the ratio of FEV1 to FVC (FEV1/FVC) will be recorded. | December 2021- July 2022 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Camptocormia measurement | Postural deviations of the spine, knees and hips will be recorded through photographs taken from the side and back in the standing position. The individual's flexion of more than 45° from the thoracolumbar spine will be recorded as the presence of camptocormia. | December 2021- July 2022 |