An Investigation of the Cervical Region Biomechanics in Patients With Chronic Obstructive Pulmonary Disease

Hacettepe University34 enrolled

Overview

The aim of this study is to investigate cervical region biomechanics, muscle performance and respiratory muscle strength in patients with Chronic Obstructive Pulmonary Disease (COPD) compared to healthy subjects.

The secondary purposes are to investigate the correlation between cervical region biomechanics and posture, functional exercise capacity, depression \&anxiety level,neck disability, cough severity. In accordance with this purposes, 17 patients with COPD who have Global Initiative for Chronic Obstruction Lung Disease (GOLD) stage 1-2-3-4, being clinically stable for 4 weeks and 17 healthy controls will be included ages\>40. Tests and questionnaires will be used in order to determine the severity of COPD and to evaluate posture. Photographical analysis in lateral and posterior views will be used for evaluation of cranioservical region static and dynamic biomechanics. To analyze of chest wall, radiographic evaluation will be performed. Goniometry will be used for evaluation dynamic craniocervical kinematic analysis. Cranioservical region muscle strength and endurance tests will be performed. Respiratory muscle strength tests and cough evaluation test will be performed. Neck disability index, cough evaluation test questionnare, beck depression and anxiety questionnares, Nordic Musculoskeletal questionnare will be used. 6 Minute Pegboard and Ring Test, 6 Minute Walk Test will be performed. According to the results to be obtained, relationship between cranioservical region biomechanics and posture will be investigated based on the severity of disease in patients with COPD. It will guide professional working in the field.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Chronic Obstructive Pulmonary Disease Postural; Defect Cervical Pain Cough

Eligibility

Sex: ALLMin age: 40 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * • Being diagnosed with stage 1-2-3-4 according to the Classification of Airflow Limitation in COPD (GOLD) system, * Being \>40 years old, * Being cognitively competent to understand and answer evaluation questions. * Being clinically stable for the last 4 weeks, * Being under control of accompanying comorbid conditions (such as hypertension, diabetes), * Volunteering to participate in the research. Exclusion Criteria: * • Having been hospitalized due to exacerbation in the last 3 months, * Having a musculoskeletal, neurological, rheumatological or oncological disease that affects the craniocervical \& cervicothoracic joints and/or may prevent evaluation, * Having undergone any surgical intervention on the craniocervicofacial region and spine in the last six months, * Having lung malignancy, neoplasm, adenocarcinoma, * Being a lung cancer patient or having received cancer treatment (head and neck lung radiotherapy), having undergone pneumonectemia, lobectomy or resection surgery, * Being treated for anxiety and depression, * Having scoliosis, * Having a congenital anomaly of the craniocervicofacial region. * Having 3 out of 4 findings according to the diagnostic criteria for cervical radiculopathy, * Having thoracic outlet syndrome (TOS)

Locations (1)

Hacettepe University, Health Sciences Faculty

Ankara, Turkey (Türkiye)

Outcomes

Primary Outcomes

Evaluation of sagittal cobb angle

Cobb anle will measure from X-ray imagination between T2- T12 level.

Time frame: day 1

Cranial rotation angle

Tragus- eye horizontal angle will measure from lateral cervical photographs.

Time frame: day 1

evaluation of cervical region biomechanic (dynamic)

Investigation of the cervical region range of motions of cervical flexion, cervical extension, cervical lateral flexion, and cervical rotation range of motion.

Time frame: day 1

cervical inclination angle

tragus eye and C7 level horizontal angle will measure from lateral cervical photographs.

Time frame: day 1

cervical lateral flexion angle

the angle between pogonion-tragus and C7 level will measure from lateral cervical photographs.

Time frame: day 1

Shoulder elevation/depression angle

the angle between acromion- C7 level and horizontal line will measure from lateral cervical photographs.

Time frame: day 1

chest wall analysis

the distance between 3rd, 7th and 9th ribs and horizontal line will measure from X-Ray

Time frame: day 1

rib angle

Sternum and 4th,5th, 6th rib will mark and the angle between these and maximum anteroposteror dimention of the thorax will measure from X-Ray.

Time frame: day 1

Central Contacts

AYNUR DEMIREL, PhD

CONTACT

+9053123051576 aynur.demirel@hacettepe.edu.tr

Aynur Demirel

CONTACT

+9053123051576 aynur.demirel@hacettepe.edu.tr

Data from ClinicalTrials.gov

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Secondary Outcomes

postural analysis

investigation of posture by photographic analysis in patients with COPD upward rotation/ anterior tilt/internal rotation of scapula, scapular elevation, and scapular abduction evaluations will measure from photographic analysis.

Time frame: day 1

respiratory muscle strength

respiratory muscle strength by mouth pressure device, mean inspiratory pressure and mean expiratory pressure will be tested.

Time frame: day 1

cervical region muscle strength and endurance

investigation of cervical region muscle strength and endurance with stabilizer biofeedback pressure method

Time frame: day 1

airway flow limitation

severity of disease by Global İnitiative for Chronic Obstructive Pulmonary Disease scale, GOLD 1: FEV1 (predicted%) ≥%80 GOLD 2: %50 ≤ FEV1 (predicted% ) \< %79 GOLD 3: %30 ≤ FEV1 (predicted%) \< %49 GOLD 4 : FEV1 (predicted%) \< %30

Time frame: day 1

management of cough

cough severity will be tested by the Cough evaluation Test.(1-5 scaling of items, 5-25 score range) The minimal important difference was 2.

Time frame: day 1

Upper Extremity Functional Capacity

evaluation of upper extremity functional capacity with 6-minute pegboard ring test

Time frame: day 1

functional exercise capacity

functional exercise capacity by 6 minute walking test.

Time frame: day 1

anxiety level

investigation of anxiety level with the Beck Anxiety Questionnaire (A total score of 0-7 is considered minimal range, 8-15 is mild, 16-25 is moderate, and 26-63 is severe)

Time frame: day 1

general musculoskeletal pain level

general musculoskeletal pain level is evaluated by Nordic Musculoskeletal Questionnare, cut off point is 'one yes answer'

Time frame: day 1

evaluation of cervical radiculopathy

1. Spurling test 2. cervical distraction test 3. cervical rotation test (if + spurling and cervical distraction test side is same with this test and is lower than 60 degree) 4. upper extremity stretching test If there are 3 positive answer to 4 tests, cervical radiculopathy existence will be detected.

Time frame: day 1

investigation of neck disability severity

evaluation of neck disability level by neck disability index,10-point change should be used as the minimum clinically important difference for patients with upper extremity referred sypmtoms

Time frame: day 1

investigation of the disease severity

evaluation of the disease severity with chronic obstructive pulmonary disease severity with Chronic Respiratory Questionnaire MCID( minimal clinically important difference) = a change of 0.5 per item A change in the score of 0.5 on the 7 point scale reflects a clinically significant small change A change of 1.0 reflects a moderate change A difference of 1.5 represents a large change

Time frame: day 1

investigation of the Pulmonary Function

evaluation of pulmonary functions with Lung function test FEV %,FEV1 %, FVC %, FEV1/FVC % , FEF 25-75%, PEF %

Time frame: day 1

cough sufficiency in patients with COPD

evaluation of cough sufficiency with peak expiratory flow meter device, A peak expiratory flow of \< 80% predicted was the best cut-off to detect airflow limitation.

Time frame: day 1

depression level

investigation of depression level with Beck Depression Inventory (cut off point is 17 point) Conventional cutoffs are 0-9 for normal range, 10-18 for mild to moderate depression, 19-29 for moderate to severe depression, and 30-63 for severe depression.

Time frame: day 1