The Effects of Scapulohumeral Rehabilitation on Scapula Kinematics and Upper Extremity Functionality in Individuals With Parkinson's Disease

NCT06861933 | Active Not Recruiting

• 1 other identifier: E-60116787-020-491421
• Study Type: interventional
• Target: 28
• Locations: 1 country
• Sites: 2

Brief Summary

With this study, individuals diagnosed with PD in Burdur province in Turkey will be provided with a physiotherapy and rehabilitation program for the upper extremity, and it is thought that the treatment received by both groups will have a positive effect on the functionality of the individuals. According to the results of our study, it will be determined whether the scapula kinematics and upper extremity functionality of individuals diagnosed with PD are different from healthy individuals of the same age and gender. After the intervention programs applied to the individuals, it is thought that it will contribute to the physiotherapy and rehabilitation programs of individuals with PD by determining whether the scapulohumeral rehabilitation program is superior to the upper extremity neurorehabilitation program.

Conditions

Parkinson's Disease (PD); Physiotherapy and Rehabilitation

Keywords

Parkinson's Disease; Phsyiotherapy and rehabilitation; upper extremity; neurorehabilitation; scapulahumeral rehabilitation

Outcome Measures

Primary Outcomes (6)

• Scapular Index

  It is calculated with the formula (distance between sternal notch - coracoid process / posterolateral angle of acromion - horizontal distance between thoracic spine) x 100.

  From enrollment to the end of treatment at 7 weeks

• Pectoralis Minor Index

  It is calculated with the formula Pectoralis Minor Index = (Pectoralis Minor Length / Participant's height) x 100.

  From enrollment to the end of treatment at 7 weeks

• Lateral Scapular Slide Test

  In the Lateral Scapular Slide Test, the distance to the thoracic spinous process corresponding to the inferior angle of the scapula is measured in three different positions: arms relaxed at the sides, hands on the iliac crest, and arm in 90-degree shoulder abduction and full internal rotation. The distances between the two sides are compared. A difference of more than 1.5 cm between the two sides is considered asymmetric.

  From enrollment to the end of treatment at 7 weeks

• Box and Block Test

  150 small wooden cubes are filled from the box where the patient's hand is to be tested to the box next to it. The patient is asked to throw one cube at a time into the empty box next to it. The number of cubes thrown in 60 seconds is counted. The result gives the score. The test is repeated for both hands.

  From enrollment to the end of treatment at 7 weeks

• Upper Extremity Functional Index

  It is a scale developed by Stratford et al. in 2001 and consists of twenty activity questions. The person scores between 0-4 according to the difficulty of doing the activity. The lowest score in total is 0, the highest score is 80. Low scores indicate that the person has difficulty doing the activity due to the condition of the upper extremity.

  From enrollment to the end of treatment at 7 weeks

• Ultrasound

  During the evaluation, the patient will be in a sitting position, with the arm next to the body, the forearm in supination and the elbow in full extension. Supraspinatus muscle thickness measurement will be performed by positioning the probe on the fossa supraspinata of the scapula, perpendicular to the skin, along the muscle fibers. The hyperechogenic bone cortex of the fossa supraspinata will be accepted as the landmark. When the muscle fibers are visualized, the thickness of the supraspinatus muscle will be measured from the level where the muscle is observed to be thickest. For the infraspinatus muscle thickness measurement, the hyperechogenic bone cortex of the fossa infraspinata of the scapula will be accepted as the landmark, and the probe will be placed perpendicular to the skin, along the muscle fibers. After the muscle fibers are visualized, the thickness of the infraspinatus muscle will be measured from the level where the muscle is observed to be thickest.

  From enrollment to the end of treatment at 7 weeks

Secondary Outcomes (6)

• Visual Analog Scale (VAS)

  From enrollment to the end of treatment at 7 weeks

• King's Parkinson's Pain Scale

  From enrollment to the end of treatment at 7 weeks

• Range of Motion

  From enrollment to the end of treatment at 7 weeks

• Scapula Angles

  From enrollment to the end of treatment at 7 weeks

• New York Posture Rating Chart

  From enrollment to the end of treatment at 7 weeks

Study Arms (3)

Group 1: Scapulohumeral Rehabilitation

EXPERIMENTAL

The scapulohumeral rehabilitation group will receive 20 minutes of scapulohumeral exercises in addition to the 10-minute neurorehabilitation program. Scapulohumeral Exercises: Scapular mobilization, scapular retraction, protraction, elevation in the scapular plane and Proprioceptive Neuromuscular Facilitation (PNF) exercises with the repeated contractions method. The exercises will be applied according to the functional capacities of the individuals in the supine, sitting and standing positions with 10 repetitions at the beginning, without weights, using free weights and resistance bands, and the number of repetitions and sets will be progressed every week. The intervention groups will receive a total of 21 treatment sessions, 3 days a week for 7 weeks.

Other: Physiotherapy and rehabilitation

Group 2: Upper Extremity Neurorehabilitation

EXPERIMENTAL

In addition to the 10-minute neurorehabilitation program, a 20-minute upper extremity neurorehabilitation exercises and a total of 30 minutes of physiotherapy and rehabilitation program will be applied. Scapular retraction, protraction, elevation movements will be performed in the form of Wand exercises with the help of a stick or cane. Exercises will be progressed by increasing the number of repetitions and sets in supine, sitting and standing positions according to the functional level of the participants. The intervention groups will receive a total of 21 treatment sessions, 3 days a week for 7 weeks.

Other: Physiotherapy and rehabilitation

Control Group

NO INTERVENTION

The control group will consist of healthy volunteers of the same age and gender as individuals diagnosed with Parkinson's disease (PD). The control group will not receive any physiotherapy or rehabilitation program and will only receive relevant assessments to compare with the results of individuals with PD.

Interventions

Physiotherapy and rehabilitation OTHER

It is reported in the literature that scapulohumeral rehabilitation applied in primary shoulder pathologies is effective. In neurological diseases, a study was found in which scapulohumeral rehabilitation was applied to individuals diagnosed with stroke and reported that it was effective. However, when the literature was examined, no study was found in which scapulohumeral rehabilitation was applied to individuals diagnosed with PD. Therefore, our aim is to compare the effectiveness of the scapulohumeral rehabilitation program to be applied for shoulder dysfunction, which is thought to be one of the early findings in PD and is reported to be related to other main findings in PD, with the upper extremity neurorehabilitation program.

Also known as: Physiotherapy, Rehabilitation, neurorehabilitation

Group 1: Scapulohumeral Rehabilitation; Group 2: Upper Extremity Neurorehabilitation

Eligibility Criteria

• Age: 40 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• For the intervention group:
• Having been diagnosed with Parkinson's Disease
• Being between 1-3 according to the Hoehn \& Yahr staging
• For the control group:
• Being of the same age and gender as the individuals diagnosed with Parkinson's disease included in the study

You may not qualify if:

• For the intervention group:
• Refusing to participate in the study
• Having a full-thickness rotator cuff muscle rupture
• Having a history of humerus, clavicle, scapula or shoulder surgery
• Having a history of humerus, clavicle, scapula or shoulder fracture
• Having a history of any other disease that may affect the ability to stand independently
• For the control group:
• Refusing to participate in the study
• Having a full-thickness rupture of the rotator cuff muscles
• Having a history of humerus, clavicle, scapula or shoulder surgery
• Having a history of humerus, clavicle, scapula or shoulder fracture
• Failure to complete the tests included in the study
• Failure to comply with the study schedule, failure to complete sessions
• Incomplete data
• Failure to attend 3 consecutive sessions

Sponsors & Collaborators

• Burdur Mehmet Akif Ersoy University: lead
• Pamukkale University: collaborator

Study Sites (2)

Burdur Mehmet Akif Ersoy University

Burdur, Burdur, 15030, Turkey (Türkiye)

Location

Pamukkale University

Denizli, Denizli, 20200, Turkey (Türkiye)

Location

Related Publications (14)

• Aktas I, Unlu Ozkan F. Pectoralis minor syndrome. Turk J Phys Med Rehabil. 2022 Nov 22;68(4):447-455. doi: 10.5606/tftrd.2023.12037. eCollection 2022 Dec.

  PMID: 36589355 BACKGROUND

• Yu IY, Choo YK, Kim MH, Oh JS. The effects of pressure biofeedback training on infraspinatus muscle activity and muscle thickness. J Electromyogr Kinesiol. 2018 Apr;39:81-88. doi: 10.1016/j.jelekin.2018.01.007. Epub 2018 Jan 31.

  PMID: 29454230 BACKGROUND

• Boehm TD, Kirschner S, Mueller T, Sauer U, Gohlke FE. Dynamic ultrasonography of rotator cuff muscles. J Clin Ultrasound. 2005 Jun;33(5):207-13. doi: 10.1002/jcu.20124.

  PMID: 16047388 BACKGROUND

• Kretic D, Turk T, Rotim T, Saric G. Reliability of Ultrasound Measurement of Muscle Thickness in Patients with Supraspinatus Tendon Pathology. Acta Clin Croat. 2018 Jun;57(2):335-341. doi: 10.20471/acc.2018.57.02.15.

  PMID: 30431728 BACKGROUND

• Moreira R, Teles A, Fialho R et al. Mobile Applications for Assessing Human Posture: A Systematic Literature Review. Electronics. 2020; (8):1196. https://doi.org/10.3390/electronics9081196

  BACKGROUND

• McRoberts LB, Cloud RM, Black CM. Evaluation of the New York Posture Rating Chart for assessing changes in postural alignment in a garment study. Cloth Text Res J 2013;31:81-96. DOI: 10.1177/0887302X13480558

  BACKGROUND

• Aytar A, Yuruk ZO, Tuzun EH, Baltaci G, Karatas M, Eker L. The Upper Extremity Functional Index (UEFI): cross-cultural adaptation, reliability, and validity of the Turkish version. J Back Musculoskelet Rehabil. 2015;28(3):489-95. doi: 10.3233/BMR-140545.

  PMID: 25322741 BACKGROUND

• Mathiowetz V, Volland G, Kashman N, Weber K. Adult norms for the Box and Block Test of manual dexterity. Am J Occup Ther. 1985 Jun;39(6):386-91. doi: 10.5014/ajot.39.6.386.

  PMID: 3160243 BACKGROUND

• Shadmehr A, Azarsa MH, Jalaie S. Inter- and intrarater reliability of modified lateral scapular slide test in healthy athletic men. Biomed Res Int. 2014;2014:384149. doi: 10.1155/2014/384149. Epub 2014 May 13.

  PMID: 24900963 BACKGROUND

• Borstad JD, Ludewig PM. The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. J Orthop Sports Phys Ther. 2005 Apr;35(4):227-38. doi: 10.2519/jospt.2005.35.4.227.

  PMID: 15901124 BACKGROUND

• Borstad JD. Resting position variables at the shoulder: evidence to support a posture-impairment association. Phys Ther. 2006 Apr;86(4):549-57.

  PMID: 16579671 BACKGROUND

• Chaudhuri KR, Rizos A, Trenkwalder C, Rascol O, Pal S, Martino D, Carroll C, Paviour D, Falup-Pecurariu C, Kessel B, Silverdale M, Todorova A, Sauerbier A, Odin P, Antonini A, Martinez-Martin P; EUROPAR and the IPMDS Non Motor PD Study Group. King's Parkinson's disease pain scale, the first scale for pain in PD: An international validation. Mov Disord. 2015 Oct;30(12):1623-31. doi: 10.1002/mds.26270. Epub 2015 Jun 11.

  PMID: 26096067 BACKGROUND

• Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain. 2014 Dec;155(12):2545-2550. doi: 10.1016/j.pain.2014.09.014. Epub 2014 Sep 17.

  PMID: 25239073 BACKGROUND

• Boonstra AM, Schiphorst Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008 Jun;31(2):165-9. doi: 10.1097/MRR.0b013e3282fc0f93.

  PMID: 18467932 BACKGROUND

MeSH Terms

Interventions

Physical Therapy Modalities; Rehabilitation; Neurological Rehabilitation

Intervention Hierarchy (Ancestors)

Therapeutics; Aftercare; Continuity of Patient Care; Patient Care; Health Services; Health Care Facilities Workforce and Services

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer, PT.MSc.

Study Record Dates

• First Submitted: February 26, 2025
• First Posted: March 6, 2025
• Study Start: April 1, 2025
• Primary Completion: January 1, 2026
• Study Completion (Estimated): June 1, 2026
• Last Updated: September 10, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

TU (2)