Clinical trial NCT03854747: The Effect of Cervical Spinal Stabilization Exercises in Patients With Parkinson's Disease
Official title: Investigation of the Effect of Cervical Spinal Stabilization Exercises on Spinal Posture, Cervical Proprioception and Postural Instability in Patients With Parkinson's Disease
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Parkinson Disease
Lead sponsor: Hacettepe University
Sponsor class: OTHER
Collaborators: name: BElibol
name: NKöse
name: GYÇakmaklı
name: SAksoy
name: RGöçmen
First posted: 2019-02-26
Enrollment: 18
Sex: ALL
Minimum age (years): 40
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Parkinson's disease (PH); it occurs due to dopamine deficiency due to the loss of dopaminergic neurons in a degenerative process in the substantia nigra found in the middle brain; resting tremor, bradykinesia, trunk and extremities rigidity, mask facial and postural instability characterized by a neurodegenerative disease. These findings are basic and also motor symptoms of Parkinson's Disease. Non-motor symptoms include many problems ranging from autonomic dysfunction to sensory symptoms.

Treatment of Parkinson's disease requires a multidisciplinary approach such as medical treatment, physiotherapy and rehabilitation, surgical treatment.

Physiotherapy programs applied to patients with Parkinson's disease include classical physiotherapy methods and neurophysiological based methods.

Spinal stabilization is an important concept for proper control of body balance and extremity movements. Spinal stabilization training was based on biomechanics, neurophysiology and physiotherapy research. Stabilization exercises, which form the basis of spinal stabilization training, increase the strength and endurance of the postural and stabilizing muscles using the basic principles of motor learning and improve stability control in stable and unstable positions, provides postural smoothness.

The cervical region is one of the most affected regions of the musculoskeletal system due to the intensive proprioceptors.

Although studies have been carried out to investigate the effect of spinal stabilization exercises in Parkinson's patients, there is no study on the effect of cervical region stabilization exercises in the literature despite these important connections of the cervical region.

For these reasons, this study is planned to investigate the effects of cervical spinal stabilization exercises on spinal posture, cervical proprioception and postural instability in Parkinson's patients.

Hypothesis 1: When cervical spinal stabilization exercises are added to the traditional physiotherapy program in Parkinson's patients, it will be more effective in correcting spinal posture.

Hypothesis 2: When cervical spinal stabilization exercises are added to the traditional physiotherapy program in Parkinson's patients, cervical proprioception will develop better.

Hypothesis 3: In the case of Parkinson's patients, when the cervical spinal stabilization exercises are added to the traditional physiotherapy program, postural stability may be more pronounced.


Eligibility criteria: Inclusion Criteria:

* Diagnosis of idiopathic Parkinson's disease,
* Having planned a traditional physiotherapy program for Parkinson's disease and referring to Hacettepe University Faculty of Health Sciences Physiotherapy and Rehabilitation Department,
* 40 to 80 years old,
* According to Hoehn-Yahr scale to be in stage 2 or 3,
* Having scored 30 points above the posture evaluation
* Postural disorder in the femoral region, but the absence of structural disorder (congenital spinal deformities in medical evaluations prior to the study, structural disorders caused by other diseases should be determined that the spine does not have problems),
* 26 points higher than the mini-mental test,
* Disease duration is 3 years and above,
* The absence of any other neurological disease other than vestibular and / or Parkinson's, which may affect muscle strength, balance and coordination,
* Spinal colon and lower extremity musculoskeletal system, which may affect the stabilization of any surgery has been identified as.

Exclusion Criteria:

* Volunteers who do not comply with the inclusion criteria will not be included in the study.

Primary outcomes:
measure: Static Posturography
timeFrame: baseline to 8 week after
measure: X-Ray Measure
timeFrame: baseline to 8 week after
measure: Bubble Inclinometer
timeFrame: baseline to 8 week after
measure: Scoliometer
timeFrame: baseline to 8 week after
measure: UPDRS
timeFrame: baseline to 8 week after
measure: Berg Balance Scale
timeFrame: baseline to 8 week after
measure: Posture Analyse
timeFrame: baseline to 8 week after
measure: Cervical Proprioception
timeFrame: baseline to 8 week after
measure: Visual Analog Scale
timeFrame: baseline to 8 week after
measure: 10 meter walk test
timeFrame: baseline to 8 week after
measure: Timed Get up and Walk Test
timeFrame: baseline to 8 week after
measure: Cervical Ventral Endurance Evaluation
timeFrame: baseline to 8 week after
measure: Muscle Strength Assessment
timeFrame: baseline to 8 week after
measure: Evaluation of Muscle Shortness
timeFrame: baseline to 8 week after
measure: Normal Joint Movement Assessment
timeFrame: baseline to 8 week after
measure: Short Form-36
timeFrame: baseline to 8 week after
Secondary outcomes:
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Hacettepe University
Study officials:
References:
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citation: Park A, Stacy M. Non-motor symptoms in Parkinson's disease. J Neurol. 2009 Aug;256 Suppl 3:293-8. doi: 10.1007/s00415-009-5240-1.
citation: Shujaat F, Soomro N, Khan M. The effectiveness of Kayaking exercises as compared to general mobility exercises in reducing axial rigidity and improve bed mobility in early to mid stage of Parkinson's disease. Pak J Med Sci. 2014 Sep;30(5):1094-8. doi: 10.12669/pjms.305.5231.
citation: Carter JM, Beam WC, McMahan SG, Barr ML, Brown LE. The effects of stability ball training on spinal stability in sedentary individuals. J Strength Cond Res. 2006 May;20(2):429-35. doi: 10.1519/R-18125.1.
citation: Kaya DO, Ergun N, Hayran M. Effects of different segmental spinal stabilization exercise protocols on postural stability in asymptomatic subjects: randomized controlled trial. J Back Musculoskelet Rehabil. 2012;25(2):109-16. doi: 10.3233/BMR-2012-0318.