Parkinson Hastalarında Yutma Performansı ile Baş Boyun Artrokinematik Özelliklerinin İlişkisi

Abstract

ALKOY, S. The Relationship Between Swallowing Performance and Head and Neck Arthrokinematic Features in People with Parkinson’s Disease, Hacettepe University Graduate School of Health Sciences Neurology Physiotherapy Program, Master Thesis, Ankara, 2024. This study was planned to examine the relationship between swallowing performance and head and neck arthrokinematic features in people with Parkinson’s disease (PD). 38 people diagnosed with Parkinson’s disease were included in the study. Evaluation of the patients' mental status was determined by the Standardized Mini Mental Test, and the PH stage was determined by the Hoehn and Yahr Scale. The Movement Disorders Association Unified Parkinson's Disease Rating Scale (HBD-BPDRS) was used to evaluate the severity of PD. For arthrokinematic evaluations; Posture analysis, head-neck joint range of motion evaluation, head-neck muscle strength evaluation, cranio-vertebral angle (CVA) and cranio-cervical angle (CSA) measurements were performed. For swallowing performance evaluation; kinematic analysis, penetration-aspiration scale (PAS) and bolus residue scale (BRS) recorded over videofluoroscopic swallowing study (VFSS), Turkish version of Eating assesment tool (T-EAT-10), Swallowing Ability and Function Evaluation (SAFE), Drooling Severity and Frequency Scale (DSFS) and Functional Oral Intake Scale were recorded. Swallowing related quality of life was evaluated with Turkish version of Swallowing Quality of Life (T-Swal- QoL). Patients were divided into two groups as; patients with swallowing disorder (Group 1) (PAS ≥ 2) and patients without swallowing disorder (Group 2) (PAS < 2). As a result of the study it was found there was no difference between groups in hyolaryngeal displacement, CVA and CSA (p>0.05). It was observed that there were no relationship among KVA, KSA and hyolaryngeal displacement (p>0.05). It was observed that there were no relationship between KVA, KSA and swallowing performance, which are head and neck arthrokinematic features (p>0.05). It was found that there was a significant difference between the groups in body balance, presence of kyphosis, ROM in flexion and left lateral flexion directions, and flexion, right and left lateral flexion muscle strengths (p<0.05). As a result, our study revealed that swallowing disorder can be seen in the early stages in Parkinson's patients, but since arthrokinematic changes are not evident in the early stages, it does not affect swallowing performance. In the PD group with swallowing disorder, limitation in left lateral flexion and decrease in muscle strength in flexion are thought to affect swallowing.