The Acute Effect of Cervical Mobilization in Parkinson's Disease

Hacettepe University33 enrolled

Overview

Patients with Idiopathic Parkinson's disease have balance and gait problems due to sensory and motor impairments. In the literature, there are lots of studies including various approaches for rehabilitation of these parameters such as sensory interventions, conservative treatments, neurophysiological approaches and motor imagery. The posture of the cervical region is impaired by the findings of the disease such as rigidity, flexor posture and loss of axial rotation. Considering that the cervical region is rich in proprioceptors and one of the key points for the vestibular system, interventions to this area can be thought to contribute to postural control and gait. However, taking into account of literature, there is no study investigating the effects on balance and gait of cervical mobilization by stimulating proprioceptors and vestibular receptors. Therefore, the aim of this study is to investigate the acute effect of cervical mobilization on balance and gait in patients with idiopathic Parkinson's disease.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Interventions

cervical mobilizationOTHER

Cervical mobilization techniques were applied in the study. Within the scope of application; rotation with traction, lateral gliding, anterior-posterior gliding with traction, bridging and stroking techniques to the paravertebral muscles were used. Mobilization were performed at grade A (mobilization in painless joint range) and grade B (continuous stretching at the end of the joint range). The mobilization were applied during 10 minutes. At the end of study all patients were received home-based exercise tailored to each individual's needs which include stretching, strengthening, balance and gait exercise and posture exercise

controlOTHER

There was no intervention in the control group during study. At the end of study all patients were received home-based exercise tailored to each individual's needs which include stretching, strengthening, balance and gait exercise and posture exercise

Eligibility

Sex: ALLMin age: 50 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Having been diagnosed with Idiopathic Parkinson's disease * Being between the ages of 50-80 * Patients scoring \>24 on Standardized Mini Mental State Examination * Modified Hoehn and Yahr stage 2-3 * No medication or dose changes during treatment * Not participating in the physiotherapy and rehabilitation program in the last 6 months * Volunteering to participate in the study Exclusion Criteria: * Vertebrobasilar insufficiency * Other neurological diseases * Postural hypotension, visual problems (which can not be compensated with the correct lens) or vestibular disorders that may affect balance * Cardiopulmonary diseases that may affect gait * Orthopedic problems (such as fracture, osteomyelitis, severe osteoporosis), advanced inflammatory arthritis, knee prothesis * Uncontrolled dyskinesia or motor fluctuation * Excessive use of alcohol or substance abuse * Anticoagulant therapy, blood clotting diseases * Long-term use of corticosteroids

Outcomes

Primary Outcomes

Static Posturography Assesment (NeuroCom® Balance Master® Systems)

Posturography measures postural stability statically and dynamically. Device has lots of test parameters such as Modified Clinical Test of Sensory Integration on Balance Test, limits of stability, rhythmic weight shift, weight bearing squat, unilateral stance, sit to stand, walk across, tandem walk, step/quick turn, step up/over and forward lunge. In addition to assesment, exercise training can also be given by posturography.