The Acute Effect of Cervical Mobilization in Parkinson's Disease

NCT04524143 | Completed

• 1 other identifier: KA-180099
• Study Type: interventional
• Target: 33
• Locations: 1 country
• Sites: 1

Brief Summary

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. 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.

Conditions

Idiopathic Parkinson's Disease

Keywords

Parkinson's disease; Cervical Spine; Postural Balance; Gait; Manual Therapies

Outcome Measures

Primary Outcomes (2)

• 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.

  Baseline and immediately after cervical mobilization

• Dynamic Gait Index

  It is a measurement tool that can be used to assess dynamic balance, gait, and risk for falls. Balance and walking pattern changes are scored during tasks such as changing gait speed, gait with vertical and horizontal head turns, pivot turn, step over obstacle, step around obstacles and climbing stairs. A four-point ordinal scale, ranging from 0-3. "0" indicates the lowest level of function and "3" the highest level of function.Total score is 24 for this scale.

  Baseline and immediately after cervical mobilization

Secondary Outcomes (3)

• Clinical Test of Sensory Integration on Balance

  Baseline and immediately after cervical mobilization

• Functional Reach Test

  Baseline and immediately after cervical mobilization

• Tandem Stance Balance Test

  Baseline and immediately after cervical mobilization

Other Outcomes (3)

• Mini-Mental State Examination

  Baseline

• The Modified Hoehn and Yahr Scale

  Baseline

• Unified Parkinson's Disease Rating Scale

  Baseline

Study Arms (2)

control group

OTHER

There was no intervention in the control group during the study (At the end of study all patients were received home-based exercise)

Other: control

mobilization group

EXPERIMENTAL

Cervical mobilization was applied to the mobilization group. Cervical mobilization techniques were applied for 10 minutes in the supine position. (At the end of study all patients were received home- based exercise)

Other: cervical mobilization; Other: control

Interventions

cervical mobilization OTHER

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

mobilization group

control OTHER

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

control group; mobilization group

Eligibility Criteria

• Age: 50 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Hacettepe University: lead

Study Sites (1)

Hacettepe University

Ankara, 06100, Turkey (Türkiye)

Location

Related Publications (8)

• Noll DR. Management of falls and balance disorders in the elderly. J Am Osteopath Assoc. 2013 Jan;113(1):17-22.

  PMID: 23329802 BACKGROUND

• Lopez D, King HH, Knebl JA, Kosmopoulos V, Collins D, Patterson RM. Effects of comprehensive osteopathic manipulative treatment on balance in elderly patients: a pilot study. J Am Osteopath Assoc. 2011 Jun;111(6):382-8. doi: 10.7556/jaoa.2011.111.6.382.

  PMID: 21771924 BACKGROUND

• Wells MR, Giantinoto S, D'Agate D, Areman RD, Fazzini EA, Dowling D, Bosak A. Standard osteopathic manipulative treatment acutely improves gait performance in patients with Parkinson's disease. J Am Osteopath Assoc. 1999 Feb;99(2):92-8. doi: 10.7556/jaoa.1999.99.2.92.

  PMID: 10079641 BACKGROUND

• Brink EE, Jinnai K, Hirai N, Wilson VJ. Cervical input to vestibulocollic neurons. Brain Res. 1981 Jul 27;217(1):13-21. doi: 10.1016/0006-8993(81)90181-5.

  PMID: 6266589 BACKGROUND

• Mergner T, Siebold C, Schweigart G, Becker W. Human perception of horizontal trunk and head rotation in space during vestibular and neck stimulation. Exp Brain Res. 1991;85(2):389-404. doi: 10.1007/BF00229416.

  PMID: 1893987 BACKGROUND

• Haavik-Taylor H, Murphy B. Cervical spine manipulation alters sensorimotor integration: a somatosensory evoked potential study. Clin Neurophysiol. 2007 Feb;118(2):391-402. doi: 10.1016/j.clinph.2006.09.014. Epub 2006 Nov 29.

  PMID: 17137836 BACKGROUND

• Haavik H, Murphy B. The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. J Electromyogr Kinesiol. 2012 Oct;22(5):768-76. doi: 10.1016/j.jelekin.2012.02.012. Epub 2012 Apr 6.

  PMID: 22483612 BACKGROUND

• Holt KR, Haavik H, Elley CR. The effects of manual therapy on balance and falls: a systematic review. J Manipulative Physiol Ther. 2012 Mar-Apr;35(3):227-34. doi: 10.1016/j.jmpt.2012.01.007. Epub 2012 Feb 17.

  PMID: 22343006 BACKGROUND

MeSH Terms

Conditions

Parkinson Disease

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases

Study Officials

• Ayşenur Özcan, MSc

  Çankırı Karatekin University

  PRINCIPAL INVESTIGATOR

• Gül Yalçın Çakmaklı, Assoc. Prof

  Hacettepe University

  STUDY DIRECTOR

• Ayla Fil Balkan, Assoc. Prof

  Hacettepe University

  STUDY CHAIR

• Bülent Elibol, Prof. Dr.

  Hacettepe University

  STUDY CHAIR

• Songül Aksoy, Prof. Dr.

  Hacettepe University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assoc. Prof.

Model Details: randomized controlled

Study Record Dates

• First Submitted: August 18, 2020
• First Posted: August 24, 2020
• Study Start: September 2, 2020
• Primary Completion: December 28, 2020
• Study Completion: December 28, 2020
• Last Updated: October 21, 2021

Record last verified: 2021-10

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)