The Effect of Spinal Mobilization on Respiratory Parameters in Parkinson's Disease Patients
- Conditions
- CamptocormiaParkinson DiseaseRestrictive Lung Disease
- Interventions
- Other: Diaphragmatic stimulation treatment with PNF techniquesOther: Costal mobilizationOther: Breathing exercisesOther: Sham mobilizationOther: Spinal mobilization
- Registration Number
- NCT04941326
- Lead Sponsor
- Abant Izzet Baysal University
- Brief Summary
Parkinson's patients suffer from respiratory distress for different reasons. It is thought that physiotherapy methods that have an indirect effect on the diaphragm can improve respiratory functions. The aim of this study is to investigate the effects of spinal mobilization and diaphragmatic breathing techniques on respiratory function.
- Detailed Description
Respiratory complications are one of the most common causes of death in Parkinson's patients. Camptocormia may develop in Parkinson's disease and other pathological conditions involving the basal ganglia, which can be defined as an abnormal flexion of the thoracolumbar spine of 45° or more, which increases during walking or standing and disappears completely in the supine position. Parkinson's patients with camptocormia often complain of dyspnea, which can be attributed to reduced lung capacity due to limited chest expansion.
Restrictive changes due to respiratory muscle dysfunction in Parkinson's disease, upper airway obstruction, abnormal ventilatory control, and drug use such as levodopa have an effect on respiratory functions.
Restrictive dysfunction has been reported in 28-94% of patients with Parkinson's.
Postural disorders such as camptocormia can also lead to restriction. One study found that the lung volumes of Parkinson's disease patients with camptocormia decreased, although it was not associated with major clinical changes.
Diaphragmatic dyskinesia in Parkinson's patients may also lead to a restrictive deterioration in respiratory functions.
Studies examining the effects of chest and diaphragm mobilization on spirometric parameters in patients with cerebral palsy reported that the applied mobilization and soft tissue techniques improved FEV1 and FVC. The effect of indirect diaphragmatic treatments with vertebral mobilization in individuals with Parkinson's who are at risk of experiencing restrictive respiratory problems is unknown. The aim of this study is to examine the effects of spinal mobilization techniques for the diaphragm on respiratory function parameters and posture.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 63
- Have been diagnosed with Parkinson's disease
- Volunteering to participate in the study
- Modified Medical Research Council (MMRC) score >2
- Those with COVID-19
- Diseases that increase intra-abdominal pressure
- Diseases affecting diaphragmatic motility
- Those who had a recent thoracic or abdominal operation
- Those who have a parenchymal, pleural or chest wall mass that will cause restriction on a recent chest X-ray or CT will not be included in the study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Sham group Breathing exercises Diaphragmatic stimulation with proprioceptive neuromuscular facilitation techniques (PNF), diaphragmatic breathing techniques, costal mobilization treatments and sham mobilization will be applied to the sham group. Sham group Sham mobilization Diaphragmatic stimulation with proprioceptive neuromuscular facilitation techniques (PNF), diaphragmatic breathing techniques, costal mobilization treatments and sham mobilization will be applied to the sham group. Spinal mobilization group Costal mobilization Spinal mobilization will be applied to the application group for 4 weeks in addition to the treatments applied to the sham group Sham group Costal mobilization Diaphragmatic stimulation with proprioceptive neuromuscular facilitation techniques (PNF), diaphragmatic breathing techniques, costal mobilization treatments and sham mobilization will be applied to the sham group. Sham group Diaphragmatic stimulation treatment with PNF techniques Diaphragmatic stimulation with proprioceptive neuromuscular facilitation techniques (PNF), diaphragmatic breathing techniques, costal mobilization treatments and sham mobilization will be applied to the sham group. Spinal mobilization group Diaphragmatic stimulation treatment with PNF techniques Spinal mobilization will be applied to the application group for 4 weeks in addition to the treatments applied to the sham group Spinal mobilization group Breathing exercises Spinal mobilization will be applied to the application group for 4 weeks in addition to the treatments applied to the sham group Spinal mobilization group Spinal mobilization Spinal mobilization will be applied to the application group for 4 weeks in addition to the treatments applied to the sham group
- Primary Outcome Measures
Name Time Method Pulmonary Function Test Four weeks Respiratory function tests will be performed on all individuals with the MIR SPIROLAB II brand pulmonary function test device. In each measurement, the maneuvers will be repeated at least 3 times and the best values will be recorded. Forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) results from the test will be used to calculate the ratio of FEV1 to FVC (FEV1/FVC) will be recorded. The combined FEV1/FVC ratio will be used as primary outcome.
- Secondary Outcome Measures
Name Time Method Spinal Mouse Evaluation Four weeks The Spinal Mouse is a computer-aided, non-invasive, easy-to-use electromagnetic handheld device designed to measure the curvature of the spine in various positions. Validity-reliability studies of the Spinal Mouse were conducted. Spinal posture assessment will be performed in the sagittal position. All spinous processes will be detected by palpation, starting from the spinous process of the seventh cervical vertebra to the spinous process of the third sacral vertebra by the physiotherapist. Measurements are planned to be performed in two different positions;
* the individual is in a standing upright position.
* the individual is asked to perform maximum body flexionCamptocormia and Range of Motion Evaluations Four weeks Postural deviations of the spine will be recorded through photographs taken from the side and back in the standing position. Flexion of the individual more than 45° from the thoracolumbar spine will be recorded as the presence of camptocormia.
• Evaluation of the spine from a lateral view; The baseline is drawn perpendicular to the ground and passing behind the 5th lumbar spine. The body line is drawn to pass through the 1st thoracic vertebra and the 5th lumbar vertebra. The angle between the two lines is measured.
The flexion angle and extension angle deficit of the knee joint will be measured with a goniometer.Ultrasonography Four weeks When the patient is in the supine position, by placing a transducer on the chest wall at the level of the right 9th intercostal space, diaphragmatic movement will be monitored during inspiration, and diaphragmatic thickness will be measured at the end of expiration and inspiration.
Trial Locations
- Locations (2)
Abant Izzet Baysal University Faculty of Health Science
🇹🇷Bolu, Turkey
AIBU Physical Therapy and Rehabiltiation Department
🇹🇷Bolu, Turkey