Parkinson Hastalarında Duyu Bütünlüğü Eğitiminin Postüral Instabilite Üzerine Etkisinin Araştırılması

Abstract

This study was carried out to determine the effects of sensory integration training that is shaped by the needs of patient and use of multisensory stimulus. For this purpose, 20 Parkinson disease patients who were the stage 2-3 according to Modified Hoehn & Yahr Rating Scale divided into two groups as control and study. The control group received general physical therapy; the study group received sensory integration training combined with general physical therapy 2 times per week for 6 weeks. Patient’s symptom severity and treatment complications assessed with Unified Parkinson Disease Rating Scale (UPDRS), cognitive status assessed with Lowenstein Occupational Therapy Cognitive Assessment (LOTCA), functional activities with Parkinson Activity Scale (PAS), and also balance assessed by staying in tandem position (STP), Functional Reach Test (FRT) Time Up and Go Test (TUG), Berg Balance Scale (BBS), Computerized Dynamic Posturography (CDP). The assessments were performed before and after treatment, also were repeated both in “off” and “on” phase. At the end of the study pre-treatment scales and tests values were compared with post-treatment values. When intra-group changes were examined, similar improvements were seen in all scales, and significant differences were found. (p<0,05). However, when the results of the scale and tests were compared, no difference was found between the two groups and when CDP results was examined it was found that the treatments caused different changes in the groups. It was detected the developments in "position 6" scores assessed vestibular system and in composite balance scores provide information about general balance in control group, in addition these "position 5" scores, the other position for assessment of vestibular system, also improved in study group. Furthermore the developments in the selection of the appropriate balance strategy during positions used vestibular system in the study group were found and these developments were different between the two groups. In the control group, there were no changes in sensory analyses part and the adaptation part of CDP, but in the study group significant improvements were found in these parts scores. (p<0,05). At the end of the study, the two treatment methods improved postural control by reducing postural instability in Parkinson's disease. However, it is concluded that combined treatment tend to be more effective. In this context, it was thought that sensory integration training had an important contribution to the development of the postural control. A wide patient population is necessary to obtain a statistically more powerful and accurate answers for the study was concluded. Keywords: Parkinson disease, postural instability, physical therapy-rehabilitation.