Investigation of the Effect of Sensorimotor Training on Upper Extremity Functions, Activity and Participation in Parkinson's Patients
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Parkinson Disease
- Sponsor
- Hacettepe University
- Enrollment
- 27
- Locations
- 1
- Primary Endpoint
- Proprioception
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
There are many factors affecting the upper extremity such as tremor, bradykinesia, rigidity, and postural instability in Parkinson's patients. According to the International Classification of Functioning, Disability and Health (ICF) model, there are restrictions on people's activities and participation in life due to structural and functional disorders affecting the upper extremity in PD.
In PD, integrating and using proprioceptive feedback, sensorimotor integration and peripheral sensory functions are reported to be impaired. Numerous studies show that the main source of motor problems in PD is dysfunction of sensorimotor integration. Since the cervical region contains a dense concentration of proprioceptive organs such as muscle spindles, it plays an important role in providing afferent proprioceptive information for postural control. Therefore, sensorimotor training targeting the cervical region gains importance. In this study, we aim to reduce PD-specific upper extremity disorders and related activity and participation limitations by increasing motor control in the cervical region with sensorimotor training. Patients with Parkinson's disease will be included in the study and randomly divided into 2 groups. While the general physiotherapy program will be applied to the control group, sensorimotor training will be given in addition to the exercise group.
Investigators
Ozlem Menevse
Principal Investigator
Hacettepe University
Eligibility Criteria
Inclusion Criteria
- •Having idiopathic Parkinson's disease over the age of 40
- •Meets the diagnostic criteria of the United Kingdom Parkinson's Disease Society Brain Bank
- •Hoehn-Yahr Staging \<3
- •Mini mental test score of 24 and above
- •In the "on" period
- •Receiving oral therapy only
Exclusion Criteria
- •Patients receiving device-assisted therapy
- •Patients receiving apomorphine therapy
- •Patients with mini mental test scores below 24
- •Patients who use drugs (antidepressants, etc.) that will affect cognitive functions
- •Patients with hearing and speech problems
- •Patients with orthopedic, neurological and vestibular problems other than Parkinson's that may prevent them from completing the tests and treatment
Outcomes
Primary Outcomes
Proprioception
Time Frame: Change from baseline at 8 week
For proprioception, joint position error in the cervical region and upper extremity will be evaluated with the laser kit.
Pinch Grip Strength
Time Frame: Change from baseline at 8 week
Pinch meter will be used to measure pinch grip strength.
Posture Analysis
Time Frame: Change from baseline at 8 week
New York Posture Rating Chart
Tremor
Time Frame: Change from baseline at 8 week
Fahn; Tolosa, Marin Clinical Tremor Rating Scale will be used to evaluate tremor. Each item was scored between 0-4. A lower score is an indicator of better status.
Unified Parkinson's Disease Rating Scale
Time Frame: Change from baseline at 8 week
Unified Parkinson's Disease Rating Scale is a scale that evaluates disability and disorders related to Parkinson's and consists of 4 main subtitles and 42 questions in total . Each item was scored between 0-4 . A lower score is an indicator of better status.
Touch threshold
Time Frame: Change from baseline at 8 week
Semmes Weinstein Monofilament Test will be used to evaluate upper extremity touch threshold.
Pain intensity
Time Frame: Change from baseline at 8 week
Visual pain scale (VAS) will be used to evaluate upper extremity pain.In the evaluation, pain averages ranging from 0 to 10 cm are given. "0" indicates that there is no pain, while as the score increases, the severity of pain increases.
Hand Grip Strength
Time Frame: Change from baseline at 8 week
Hand Dynamometer will be used to measure hand grip strength.
Endurance of Cervical Muscles
Time Frame: Change from baseline at 8 week
Craniocervical Flexion (CSF) test, Evaluation of cervical flexor-extensor muscles
Dual Task Performance
Time Frame: Change from baseline at 8 week
During the Purdue Pegboard Test, the second task will be added and the completion time will be recorded.
Tactile acuity
Time Frame: Change from baseline at 8 week
For upper extremity tactile acuity, moving 2-point discrimination test (MTPD) will be performed using an esthesiometer.
Pain threshold
Time Frame: Change from baseline at 8 week
Algometer will be used to evaluate upper extremity pain threshold.
Hand functions
Time Frame: Change from baseline at 8 week
Purdue Pegboard Test (PPT)
Disabilities of the Arm, Shoulder and Hand Questionnaire
Time Frame: Change from baseline at 8 week
It will be used to determine the problems experienced in the use of the upper extremity. It consists of 3 sections. All questions are answered according to a 5-point Likert system. A score between 0-100 is obtained from each section. The higher the score, the higher the disability.
Motor speed
Time Frame: Change from baseline at 8 week
Motor speed will be evaluated using the Finger tapping test.
Fatigue
Time Frame: Change from baseline at 8 week
Parkinson's Fatigue Scale will be used to evaluate fatigue. It is consists of 16 items related to presence of fatigue. All items are scored by patients using a five-point Likert-type scale including response options ranging from '(1) strongly disagree' to '(5) strongly agree'. A higher score indicates a higher level of fatigue.
Evaluation of Environmental Factors
Time Frame: Change from baseline at 8 week
Questions structured by the researchers will be used on the issues of support and attitudes under the environmental factors heading of the ICF model. Questions are scored between 0 and 10. A high score indicates high satisfaction.
Quality of life evaluation
Time Frame: Change from baseline at 8 week
Parkinson's Disease Questionnaire (PDQ-39) will be used to evaluate quality of life. It contains 39 items in total. A score between 0 and 4 is given for each question. A high overall score indicates worsening quality of life.