PARKİNSON HASTALIĞINA SAHİP BİREYLERDE SERVİKAL STABİLİZASYON EGZERSİZLERİNİN VE SERVİKAL BÖLGEYE VİBRASYON UYGULAMASININ MOTOR SEMPTOMLAR VE DUYU PROFİLİ ÜZERİNDEKİ ETKİLERİNİN İNCELENMESİ

Abstract

This study was planned to investigate the effects of cervical stabilization exercises and local vibration (LV) application to the cervical region on motor symptoms and sensory profile in Parkinson's patients and the relationship between the sensory profile and motor symptoms in Parkinson's patients. 30 patients included in the study were randomly divided into 3 groups as Vibration Group (VG), Stabilization Group (SG) and Control Group (CG). CG underwent a conventional physiotherapy program under the supervision of a physiotherapist once a week for 6 weeks and a home program on the other days. VG underwent LV application 3 days a week for 6 weeks in addition to the conventional physiotherapy program. When they came once a week, they were given a traditional physiotherapy program and LV, while only LV was applied on the other 2 days. In addition to the traditional physiotherapy program, SG was given cervical stabilization exercises (SSE) under the supervision of a physiotherapist once a week for 6 weeks, with a home program on other days. The treatment programs lasted an average of 60 minutes for each group. All evaluations were made 3 times in total, before the treatment, after the treatment, and after the 1-month follow-up. In the study, disease severity [Movement Disorders Association-Unified Parkinson's Disease Rating Scale (MDRS-UPDRS)], sensory profile (joint position sense error, vibration and stereognosis sense), neck joint range of motion (ROM) (CROM3 device), muscle strength and endurance (craniocervical flexion test, respiratory muscle strength), balance and postural control (TecnoBody device and Functional Reach test), posture (New York Posture Analysis, inclinometer, scoliometer) and motor freezing (walking freezing scale), functional assessments [Timed Up and Go Test (TUG), 2 Minute Walk Test (2MWT)] were performed. The study was completed with 28 individuals. The sociodemographic characteristics and disease-related information of the groups were similar at baseline (p>0.05). After the treatment, significant improvements were observed in disease symptoms, joint position sense, activation score, postural control and balance, cervical and thoracic posture, freezing, walking, and quality of life parameters in all three groups (p<0.05). It was determined that the highest significant improvement within the group in terms of static and dynamic balance test and endurance parameters occurred in SG. LV application applied in addition to the conventional physiotherapy program was found to be more effective on ROM, vibration sense, performance index, and expiratory pressure parameters (p<0.05). When the disease symptoms, sensory profile, cervical muscle strength, functional reach test, posture, freezing, walking, and quality of life parameters of the individuals were examined, it was determined that there was no difference between the groups and the applied treatment programs had similar effects on these parameters (p>0.05). In addition, when the relationship between sensory profile and motor symptoms was examined, between proprioception sense in the extension direction and activation score, performance index, 2MWT and dual-task 2MWT; There was a positive correlation between left upper extremity vibration sense and activation score; there was a negative correlation between right upper extremity vibration sense and activation score, performance index, 2MWT and dual- task 2MWT; and there was a negative correlation between HBD-UPDRS III, TKYT duration and cadence parameters, and dual-task TKYT duration and cadence parameters (p<0.05). The results of this study showed us that all three treatment programs are applicable and reliable methods in individuals with PD in the clinic. In addition, while SSE comes to the forefront for developing motor functions; it was thought that LV application given in addition to the traditional physiotherapy program for sensory development is more effective. We contribute to the literature by revealing the different effects of these two treatment methods.