Comparison of Balance, Activity-specific Balance Confidence and Quality of Life in Parkinson's Patients

Study Overview
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Brief Summary
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Parkinson's disease is characterized by cardinal motor signs and motor freezing, gait, posture and balance disorder. About 80% of the causes of falls in Parkinson's patients are due to postural instability and motor freezing, and patients' quality of life is significantly affected. Loss of balance and falls, which are frequently experienced in Parkinson's patients, cause individuals to feel insecure during activities. It is thought that the quality of life of PD patients whose movements are restricted due to the fear of falling may also be negatively affected. The neutrophil/lymphocyte ratio is a marker of peripheral inflammation. The relationship of peripheral inflammation to balance, activity-specific balance confidence, and quality of life in individuals is unclear. The aim of this study was to compare balance, activity-specific balance confidence, quality of life, and the relationship between neutrophil/lymphocyte ratio in Parkinson's patients with and without freezing.

Detailed Description
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Parkinson's disease is characterized by cardinal motor signs and motor freezing, gait, posture and balance disorder. About 80% of the causes of falls in Parkinson's patients are due to postural instability and motor freezing, and patients' quality of life is significantly affected. Loss of balance and falls, which are frequently experienced in Parkinson's patients, cause individuals to feel insecure during activities. It is thought that the quality of life of PD patients whose movements are restricted due to the fear of falling may also be negatively affected. The neutrophil/lymphocyte ratio is a marker of peripheral inflammation. The relationship of peripheral inflammation to balance, activity-specific balance confidence, and quality of life in individuals is unclear. The aim of this study was to compare balance, activity-specific balance confidence, quality of life, and the relationship between neutrophil/lymphocyte ratio in Parkinson's patients with and without freezing. A total of 20 Parkinson's Disease age of older the 50 participate in the research. Participants were divide into two groups with and without freezing.

Official Title
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Comparison of Balance, Activity-specific Balance Confidence and Quality of Life in Parkinson's Patients With Freezing and Relationship Between Neutrophil/Lymphocyte Ratio

Conditions
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Idiopathic Parkinson's Disease

Intervention / Treatment
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* Diagnostic Test: Assessment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being diagnosed with idiopathic Parkinson's disease Healthy individuals who do not have musculoskeletal disease or any neurological disease that may affect assessments Older than 50 years old Volunteer to participate in the study Grade 1-3 on the Modified Hoehn-Yahr Scale To have a score above 24 in the Standardized Mini Mental Test To have a hemogram follow-up in the last 1 month before the date of participation in the study. Being able to walk independently on flat ground Exclusion Criteria: Having an additional or psychiatric disease other than Parkinson's disease Lack of cooperation Presence of orthopedic problems (such as fractures, osteoporosis, osteomyelitis)

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Parkinson's Patients with Motor Freezing<br>Individuals with Parkinson's Disease with motor freezing were included in this group. | Diagnostic Test: Assessment<br>* Tandem walking test, Tandem Stance test, Activity-specific Balance Confidence Parkinson's Disease Quality of Life-8 N/L ratio Tinetti Balance Test UPDRS<br>|
| Parkinson's Patients Without Motor Freezing<br>Individuals with Parkinson's Disease without motor freeze were included in this group. | Diagnostic Test: Assessment<br>* Tandem walking test, Tandem Stance test, Activity-specific Balance Confidence Parkinson's Disease Quality of Life-8 N/L ratio Tinetti Balance Test UPDRS<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Freezing of Gait Questionnaire | The scale is a scale that evaluates motor freezing in Parkinson's patients. It is questioned whether freezing occurs during activities such as walking and turning on the 6-item scale developed. In addition, in the presence of freezing, the severity, frequency and duration of freezing are recorded. The higher the score, the higher the freezing. | Baseline | 
| The Tinetti Balance and Gait Test | It provides useful information on the ability of sick individuals to comfortably perform various functional tasks. For this reason, it is an easily and inexpensively applicable scale. This test consists of two parts and a total of 16 questions. These are walking in the 7-question part and balance in the 9-question part. The total score in the first 9 questions constitutes the balance score, and the total score in the next 7 questions constitutes the walking score. The total score in balance and walking constitutes the TDYT total score. TDYT score calculation is done by observation. 2 points indicate that the movement is performed correctly, 1 point indicates that there are adaptations in the movement, and 0 points indicate that the desired movement cannot be performed. A total score of 18 or less after TDYT indicates a high fall risk, a score of 19-24 indicates a moderate fall risk, and a score above 24 indicates a low risk of falling. | Baseline | 
| Activity-Specific Balance Confidence | Individuals are asked 16 questions about daily living activities inside and outside the home. For each question, individuals are asked to rate their confidence in the activity between 0 and 100%. These values are added together and divided by 16 and the nearest decimal value is accepted as the value of the scale. The higher the score, the higher the balance confidence of individuals. | Baseline | 
| Parkinson's Disease Quality of Life-8 | One question from each of the eight domains in PHA-39, which are activities of daily living, physical discomfort, cognition, communication, emotional well-being, mobility, social support and stigma, gives the total domain score.Each question is scored between 0-4 points and points are added up. The total score is then divided by the total possible score and given as a percentage point out of 100. The lower the score, the higher the quality of life. | Baseline | 
| Hemogramme | The neutrophil/lymphocyte ratio is a marker of peripheral inflammation. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Unified Parkinson's Disease Rating Scale | This scale was created to evaluate the motor performance, mental and mental status, and activities of daily living of Parkinson's patients. It also evaluates motor fluctuations, dyskinesias, and autonomic dysfunction. The scale was prepared as 4 parts and 42 items. When the extremities are evaluated separately, it increases up to 55 items. Items are rated from 0 (no symptoms or signs) to 4 (most severe symptoms and signs). The first part evaluates the non-motor features of the disease, such as thoughts, behaviors, and emotions. The second part consists of activities of daily living. In the third part, motor examination, in the fourth part, the complications of the treatment are given. It is used to evaluate the symptoms of the disease and the complications that develop due to treatment. In this scale, which consists of 4 parts, the scoring of each item is between 0-4 points. The increase in the total score reflects the increase in the severity of the symptoms. | Baseline | 
| Tandem stance test: | During the tandem stance test, which allows the evaluation of static balance, the individual will be asked to position the heel of one of his feet to the tip of the other. While the individual maintains this position without support, the time elapsed until the individual's balance is broken will be recorded with the help of a stopwatch. For individuals without balance problems, the test takes 30 seconds. It will be continued until it is full. | Baseline | 
| Tandem walking test | The tandem walking test is a clinical assessment of dynamic balance associated with falls in many studies. It is recommended as a simple tool to identify those at risk of falling. The participant is asked to walk 10 steps in a straight line with the heel of one foot touching the toe of the other foot, with his hands folded over the chest, wearing comfortable shoes, and the time is recorded. | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Parkinson's disease, Balance, Balance confidence, Quality of life, Freezing, Neutrophil/Lymphocyte ratio