Parkinson hastalarına yönelik bir rehabilitasyon programının reaksiyon ve hareket zamanı üzerine etkileri: bir elektromiyografik çalışma

Yıl 2022, Cilt: 47 Sayı: 2, 504 - 510, 30.06.2022

Nurhan Kızıl Halil Öğüt Esra Okuyucu Hayal Güler Cahit Özer Ayşe Dicle Turhanoğlu

https://doi.org/10.17826/cumj.1017006

Öz

Amaç: Çalışmanın amacı Parkinson Hastalığı (PH) hastalarına özel egzersizlerden oluşan bir rehabilitasyon programının reaksiyon zamanı (RZ), hareket zamanı (HZ), yaşam kalitesi ve hastalık aktivitesi üzerindeki etkilerini araştırmaktır.
Gereç ve Yöntem: Çalışmaya toplam 26 idiyopatik PH hastası dahil edildi. Hastalara 16 hafta süresince Parkinson hastalığına özgü olan egzersizler uygulandı. Hastaların değerlendirilmesi tedavi öncesi ve sonrası olacak şekilde yapıldı. Hastalık şiddeti Birleşik Parkinson Hastalığı Derecelendirme Ölçeği (BPHDÖ) ile yapılırken, yaşam kalitesi değerlendirmesi Kısa Form-36 (KF-36) ile ölçüldü. RZ ve HZ değerlendirmesi elektromiyografik ölçümler kullanılarak yapıldı.
Bulgular: Egzersiz programı öncesi ve sonrası BPHDÖ toplam ve alt bölüm değerleri ile KF-36 yaşam kalitesi değerlendirmesinde istatistiksel olarak anlamlı sayılabilecek bir fark tespit edilmedi. 16 haftalık egzersiz programı sonrası hastaların RZ değerlerinde program öncesine göre kıyasla (sırasıyla, Deltoit RZ 370.46 ± 25’den 219.58 ± 17, Biseps RZ 370.42 ± 27’den 216.49 ± 14 ve Triseps RZ 445.21 ± 31’den 247.53 ± 23) anlamlı bir düşüş tespit edildi.
Sonuç: PH'de hastalığa özgü bir rehabilitasyon programı RZ değerlerinde belirgin bir azalmaya yol açmaktadır. Egzersizin hastalık aktivitesi, yaşam kalitesi ve HZ değerleri üzerinde istatistiksel olarak anlamlı bir etkisi olmamasına rağmen yine de düzelme sağladığı görüldü.

Anahtar Kelimeler

Egzersiz, Parkinson Hastalığı, elektromiyografi

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

Effects of a rehabilitation program for Parkinson’s patients on reaction and movement time: an electromyographic study

Öz

Purpose: The aim of the study was to investigate the effects of a rehabilitation program consisting of specific exercises for Parkinson's Disease (PD) patients on reaction time (RT), movement time (MT), quality of life and disease activity.
Materials and Methods: A total of 26 idiopathic PD patients were included in the study. The exercises specific to Parkinson’s were applied to the patients for 16 weeks. The evaluation of the patients were done before and after the treatment. The disease severity was measured with Unified Parkinson’s Disease Rating Scale (UPDRS), quality of life was measured with Short Form-36 (SF-36). RT and MT measurements were done electromyographically.
Results: There was no statistically significant difference in UPDRS total and sub-section values and SF-36 quality of life evaluation before and after the exercise program. While a significant decrease was observed in the RT values of the patients after the 16 week exercise program compared to prior to the program (Deltoid RT 370.46 ± 25 to 219.58 ± 17, biceps RT 370.42 ± 27 to 216.49 ± 14 and triceps RT 445.21 ± 31 to 247.53 ± 23, respectively).
Conclusion: In PD, the rehabilitation program specific to the disease leads to a significant decrease in RT. Although the exercise has no statistically significant effect on disease activity, quality of life and MT values, it was seen that it still led to improvement.

Anahtar Kelimeler

Exercise, Parkinson’s Disease, electromyography

Proje Numarası

Yok

Kaynakça

• 1. Tysnes OB, Storstein A. Epidemiology of Parkinson's disease. J Neural Transm (Vienna) 2017;124:901-905.
• 2. Cholewa J, Gorzkowska A, Nawrocka A, Cholewa J. [Quality of life of people with Parkinson's disease in the context of professional work and physiotherapy]. Med Pr 2017;68:725-734.
• 3. Xu X, Fu Z, Le W. Exercise and Parkinson's disease. Int Rev Neurobiol 2019;147:45-74.
• 4. Gauntlett-Gilbert J, Brown VJ. Reaction time deficits and Parkinson's disease. Neurosci Biobehav Rev 1998;22:865-881.
• 5. Jahanshahi M, Brown RG, Marsden CD. Simple and choice reaction time and the use of advance information for motor preparation in Parkinson's disease. Brain 1992;115 ( Pt 2):539-564.
• 6. Nakashima K, Shimoyama R, Takahashi K. Paired choice reaction tasks in patients with Parkinson's disease. Acta Neurol Scand 1993;87:178-183.
• 7. Zappia M, Montesanti R, Colao R, Quattrone A. Usefulness of movement time in the assessment of Parkinson's disease. Journal of Neurology 1994;241:543-550.
• 8. Hornby B, McClellan R, Buckley L, Carson K, Gooding T, Vernon HJ. Functional exercise capacity, strength, balance and motion reaction time in Barth syndrome. Orphanet J Rare Dis 2019;14:37.
• 9. Morrison S, Colberg SR, Parson HK, Vinik AI. Exercise improves gait, reaction time and postural stability in older adults with type 2 diabetes and neuropathy. J Diabetes Complications 2014;28:715-722.
• 10. Okubo Y, Schoene D, Lord SR. Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis. Br J Sports Med 2017;51:586-593.
• 11. Opara J, Małecki A, Małecka E, Socha T. Motor assessment in Parkinson`s disease. Annals of Agricultural and Environmental Medicine 2017;24:411-415.
• 12. The Unified Parkinson's Disease Rating Scale (UPDRS): status and recommendations. Mov Disord 2003;18:738-750.
• 13. Koçyiğit H, Aydemir Ö, Fişek G. Kısa Form-36’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi Dergisi 1999;12:102-106.
• 14. Taylor ME, Lord SR, Delbaere K, Kurrle SE, Mikolaizak AS, Close JCT. Reaction Time and Postural Sway Modify the Effect of Executive Function on Risk of Falls in Older People with Mild to Moderate Cognitive Impairment. Am J Geriatr Psychiatry 2017;25:397-406.
• 15. Kutukcu Y, Marks WJ, Jr., Goodin DS, Aminoff MJ. Simple and choice reaction time in Parkinson's disease. Brain Res 1999;815:367-372.
• 16. Ebersbach G, Ebersbach A, Edler D, Kaufhold O, Kusch M, Kupsch A, et al. Comparing exercise in Parkinson's disease--the Berlin LSVT®BIG study. Mov Disord 2010;25:1902-1908.
• 17. Uygur M, Bellumori M, Knight CA. Effects of a low-resistance, interval bicycling intervention in Parkinson's Disease. Physiother Theory Pract 2017;33:897-904.
• 18. Morris ME, Menz HB, McGinley JL, Watts JJ, Huxham FE, Murphy AT, et al. A Randomized Controlled Trial to Reduce Falls in People With Parkinson's Disease. Neurorehabil Neural Repair 2015;29:777-785.
• 19. Song J, Paul SS, Caetano MJD, Smith S, Dibble LE, Love R, et al. Home-based step training using videogame technology in people with Parkinson's disease: a single-blinded randomised controlled trial. Clin Rehabil 2018;32:299-311.
• 20. Mak MK, Wong-Yu IS, Shen X, Chung CL. Long-term effects of exercise and physical therapy in people with Parkinson disease. Nat Rev Neurol 2017;13:689-703.
• 21. Ni M, Signorile JF, Mooney K, Balachandran A, Potiaumpai M, Luca C, et al. Comparative Effect of Power Training and High-Speed Yoga on Motor Function in Older Patients With Parkinson Disease. Arch Phys Med Rehabil 2016;97:345-354.e315.
• 22. Rodrigues de Paula F, Teixeira-Salmela LF, Coelho de Morais Faria CD, Rocha de Brito P, Cardoso F. Impact of an exercise program on physical, emotional, and social aspects of quality of life of individuals with Parkinson's disease. Mov Disord 2006;21:1073-1077.
• 23. Petzinger GM, Walsh JP, Akopian G, Hogg E, Abernathy A, Arevalo P, et al. Effects of treadmill exercise on dopaminergic transmission in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned mouse model of basal ganglia injury. J Neurosci 2007;27:5291-5300.
• 24. Vučković MG, Li Q, Fisher B, Nacca A, Leahy RM, Walsh JP, et al. Exercise elevates dopamine D2 receptor in a mouse model of Parkinson's disease: in vivo imaging with [¹⁸F]fallypride. Mov Disord 2010;25:2777-2784.
• 25. Petzinger GM, Fisher BE, Van Leeuwen JE, Vukovic M, Akopian G, Meshul CK, et al. Enhancing neuroplasticity in the basal ganglia: the role of exercise in Parkinson's disease. Mov Disord 2010;25 Suppl 1:S141-145.
• 26. Ellis T, de Goede CJ, Feldman RG, Wolters EC, Kwakkel G, Wagenaar RC. Efficacy of a physical therapy program in patients with Parkinson's disease: a randomized controlled trial. Arch Phys Med Rehabil 2005;86:626-632.
• 27. Lun V, Pullan N, Labelle N, Adams C, Suchowersky O. Comparison of the effects of a self-supervised home exercise program with a physiotherapist-supervised exercise program on the motor symptoms of Parkinson's disease. Mov Disord 2005;20:971-975.