Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT05119803 |
Other study ID # |
2021-335 |
Secondary ID |
|
Status |
Completed |
Phase |
|
First received |
|
Last updated |
|
Start date |
November 3, 2021 |
Est. completion date |
June 15, 2022 |
Study information
Verified date |
July 2022 |
Source |
Gulhane School of Medicine |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational
|
Clinical Trial Summary
The aim of this study is to investigate whether spinal alignment and spinal mobility have an
effect on upper extremity functions in Parkinson's patients. In the light of the data
obtained as a result, we think that our study will also contribute to determining the factors
that may cause upper limb dysfunctions seen in Parkinson's patients and will guide new
treatment-oriented studies to be carried out in the future.
Description:
Parkinson's disease is a neurodegenerative disease that occurs due to the influence of
dopaminergic pathways, causing progressive deficits, especially in motor functions. The four
main motor symptoms of Parkinson's are tremor, muscular rigidity, bradykinesia (slowing down
of movements) and postural instability.
One of the inadequacies of these symptoms on patients is the disruption of the functions of
the upper extremities. Since the formation of isometric force at parkinson disease is
delayed, the reaction time is disrupted. In addition, patients exhibit sensory deficits, such
as a decrease in the spatial and temporal tactile discrimination thresholds of the
fingertips. Since patients tend to have difficulty initiating movement to a goal (akinesia),
there are disorders of reaching and grasping it. There is also a lack of coordination between
the timing of the movement components. In particular, tremor and rigidity can cause serious
deficiencies during targeted activities in which the patient uses their upper limbs in their
daily life. Incidence studies conducted to date have shown that Parkinson disease, causes
various degrees of impairment in the manual skills of about 90% of individuals. In this
context, the fine manipulative skills of the hand and the identification of components
affecting the functions of the upper extremities in this group of diseases are important in
the detection and management of the problem.
In Parkinson's disease, forward oblique posture, forward tilting of the head and neck, and
scoliosis are common spinal deformities. The studies conducted have revealed that these
deformities are directly proportional to the severity of the disease. In addition, the
rigidity of the global trunk muscles may reduce the spinal mobility of the patients and may
affect the independence measures in trunk-dependent activities. In this regard, it is
important to analyze the spine sequence and mobility when monitoring patients in this group
of diseases. At the same time, postural correction and balance reactions are also reduced due
to postural changes, such as the development of flexion posture and reduced body rotation in
Parkinson's disease. This condition causes Parkinson's patients to have difficulty
maintaining their current posture and an increased risk of falling.
In a study conducted with healthy adults, upper extremity function was evaluated using the
'Jebsen Taylor Hand Function Test' in three different trunk postures (flexion, lateral
flexion, neutral posture), and the best upper limb performance was obtained in neutral trunk
posture. In another study, it was found that Pisa Syndrome (lateral flexion deformity of the
trunk) was associated with both upper extremity functions and the level of independence in
activities of daily living in Parkinson's disease. To the best of our group's knowledge,
extremity dysfunctions, spinal posture and mobility involvement in Parkinson's disease have
been well defined in the studies we have conducted in the literature, but we have not found
any study investigating the effects of spinal alignment and spinal mobility on upper
extremity functions and quality of life.
The aim of this study, which was planned accordingly, was to investigate: (A) spinal postural
changes in Parkinson's disease, (B) changes in upper extremity functions in Parkinson's
disease, (C) effects of spinal alignment and spinal mobility on upper extremity functions and
quality of life in Parkinson's disease.