The Effect of Spinal Mobilization on Respiratory Parameters in Parkinson's Disease Patients

Abant Izzet Baysal University

Status: Enrolling

Conditions: Camptocormia; Restrictive Lung Disease; Parkinson Disease

Treatments: Other: Costal mobilization; Other: Breathing exercises; Other: Sham mobilization; Other: Diaphragmatic stimulation treatment with PNF techniques; Other: Spinal mobilization

Study type: Interventional

Funder types: Other

Identifiers

NCT04941326

AIBU-FTR-ETB-001

Details and patient eligibility

About

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.

Full 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.

Enrollment: 63 estimated patients

Sex: All

Ages: 50 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Have been diagnosed with Parkinson's disease
• Volunteering to participate in the study
• Modified Medical Research Council (MMRC) score >2

Exclusion criteria

• 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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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63 participants in 2 patient groups

Spinal mobilization group

Active Comparator group

Description:

Spinal mobilization will be applied to the application group for 4 weeks in addition to the treatments applied to the sham group

Treatment:

Other: Spinal mobilization

Other: Diaphragmatic stimulation treatment with PNF techniques

Other: Breathing exercises

Other: Costal mobilization

Sham group

Sham Comparator group

Description:

Diaphragmatic stimulation with proprioceptive neuromuscular facilitation techniques (PNF), diaphragmatic breathing techniques, costal mobilization treatments and sham mobilization will be applied to the sham group.

Treatment:

Other: Sham mobilization

Other: Diaphragmatic stimulation treatment with PNF techniques

Other: Breathing exercises

Other: Costal mobilization