Early and Long-Term Effects of Comprehensive Pelvic Physiotherapy on Autonomic Disorders in Parkinson's Disease: A case report

Yıl 2024, , 145 - 150, 27.06.2024

Betül Çınar , Abdullah İlktaç

https://doi.org/10.57224/jhpr.1393977

Öz

AIM: Parkinson's disease is a neurodegenerative disease characterized by both motor and non-motor symptoms. Pelvic floor dysfunction due to autonomic disorders are common in this population. The purpose of this case report is to assess the early and long-term effects of comprehensive pelvic physiotherapy on autonomic dysfunction in a woman with Parkinson's disease.
MATERIAL AND METHOD: Bladder diary, Pelvic Floor Distress Inventory-20, Overactive Bladder Questionnaire, Incontinence Severity Index, Incontinence Impact Questionnaire- short form, and PERFECT scheme were evaluated at baseline, immediately after the 12-week comprehensive pelvic physiotherapy program, and after 1-year follow-up.
RESULTS: Improvements were detected in all parameters in the short term and maintained in the long term.
CONCLUSION: We think that a comprehensive pelvic physiotherapy program is an effective method that can non-invasively improve the symptoms of pelvic floor dysfunction and quality of life seen in Parkinson's disease.

Anahtar Kelimeler

anal incontinence, overactive bladder, bladder diary, pelvic floor dysfunction, pelvic floor muscle training

Kapsamlı Pelvik Fizyoterapinin Parkinson Hastalığındaki Otonomik Bozukluklar Üzerine Erken ve Uzun Dönem Etkileri: Olgu sunumu

Öz

Amaç: Parkinson hastalığı, hem motor hem de non-motor semptomlarla karakterize nörodejeneratif bir hastalıktır. Bu hasta popülasyonunda otonomik bozukluklara bağlı gelişen pelvik taban disfonksiyonları sık görülür. Bu olgu sunumunun amacı, otonomik disfonksiyon bulguları olan Parkinson hastası bir kadına uygulanan kapsamlı pelvik fizyoterapinin kısa ve uzun vadeli etkilerini incelemektir.
Gereç ve Yöntem: Mesane günlüğü, pelvik taban distres envanteri-20, aşırı aktif mesane sorgulama formu, inkontinans şiddet indeksi, inkontinans etki sorgulaması kısa formu, pelvik taban kas değerlendirmesi 12 haftalık kapsamlı pelvik fizyoterapi programından önce, program tamamlandıktan hemen sonra ve 1 yıllık takibin ardından tekrar uygulandı.
Bulgular: Hasta, kısa dönemde tüm parametrelerde iyileşme gösterirken uzun dönemde de kazanımlarını korudu.
Sonuç: Kapsamlı pelvik fizyoterapi programının, Parkinson hastalığında görülen pelvik taban disfonksiyon semptomlarını ve yaşam kalitesini non-invaziv olarak iyileştirebilen, etkili bir yöntem olduğunu düşünmekteyiz.

Anahtar Kelimeler

anal inkontinans, aşırı aktif mesane, mesane günlüğü, pelvik taban disfonksiyonu, pelvik taban kas eğitimi

Kaynakça

• 1. Simon DK, Tanner CM, Brundin P. Parkinson Disease Epidemiology, Pathology, Genetics, and Pathophysiology. Clin Geriatr Med. 2020; 36(1): 1-12.
• 2. Sung VW, Nicholas AP. Nonmotor symptoms in Parkinson’s disease: expanding the view of Parkinson’s disease beyond a pure motor, pure dopaminergic problem. Neurol Clin. 2013; 31(3 Suppl): 1–16.
• 3. Martignoni E, Pacchetti C, Godi L, Micieli G, Nappi G. Autonomic disorders in Parkinson's disease. J Neural Transm Suppl. 1995;45:11-9.
• 4. Martinez-Martin P, Schapira AH, Stocchi F, Sethi K, Odin P, MacPhee G, et al. Prevalence of nonmotor symptoms in Parkinson's disease in an international setting; study using nonmotor symptoms questionnaire in 545 patients. Mov Disord. 2007;22(11):1623-9.
• 5. Campos-Sousa RN, Quagliato E, da Silva BB, de Carvalho RM Jr, Ribeiro SC, de Carvalho DF. Urinary symptoms in Parkinson's disease: prevalence and associated factors. Arq Neuropsiquiatr. 2003;61(2B):359-63.
• 6. Sakakibara R, Shinotoh H, Uchiyama T, Sakuma M, Kashiwado M, Yoshiyama M, et al. Questionnaire-based assessment of pelvic organ dysfunction in Parkinson's disease. Auton Neurosci. 2001;92(1-2):76-85.
• 7. Zesiewicz TA, Sullivan KL, Arnulf I, Chaudhuri KR, Morgan JC, Gronseth GS, et al. Practice Parameter: treatment of nonmotor symptoms of Parkinson disease: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010;74(11):924-31.
• 8. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21(1):5-26.
• 9. Malaekah H, Al Medbel HS, Al Mowallad S, Al Asiri Z, Albadrani A, Abdullah H. Prevalence of pelvic floor dysfunction in women in Riyadh, Kingdom of Saudi Arabia: A cross-sectional study. Womens Health (Lond). 2022;18:17455065211072252.
• 10. Gupta A, LaFaver K, Duque KR, Lingaiah A, Meriwether KV, Gaskins J, et al. Pelvic Floor Health in Women with Parkinson's Disease. J Parkinsons Dis. 2021;11(2):857-64.
• 11. Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Neurourol Urodyn. 2017;36(2):221-44.
• 12. Stewart E. Assessment and management of urinary incontinence in women. Nurs Stand. 2018;33(2):75-81.
• 13. Toprak Celenay S, Akbayrak T, Kaya S, Ekici G, Beksac S. Validity and reliability of the Turkish version of the Pelvic Floor Distress Inventory-20. Int Urogynecol J. 2012;23(8):1123-7.
• 14. Uyar Hazar H, Şirin AA. Validity and Reliablity Study of the Incontinence Index. Meandros Med. Dental J. 2008; 9(3): 5-8.
• 15. Kucukbas M, Selçuk S, Asoglu MR, Akdemir Y, Karateke A, Cam C. Validation of the Fecal Incontinence Severity Index in a Turkish Population. Female Pelvic Med Reconstr Surg. 2016;22(4):283-6.
• 16. Cam C, Sakalli M, Ay P, Cam M, Karateke A. Validation of the short forms of the incontinence impact questionnaire (IIQ-7) and the urogenital distress inventory (UDI-6) in a Turkish population. Neurourol Urodyn. 2007;26(1):129-33.
• 17. Tarcan T, Mangır N, Özgür MÖ, Akbal C. OAB-V8 Aşırı Aktif Mesane Sorgulama Formu Validasyon Çalışması. Üroloji Bülteni. 20212;(21):113-6.
• 18. Laycock J, Jerwood D. Pelvic floor muscle assessment: the PERFECT scheme. Physiotherapy. 2001;87(12):631–42.
• 19. Sakakibara R, Uchiyama T, Yamanishi T, Shirai K, Hattori T. Bladder and bowel dysfunction in Parkinson's disease. J Neural Transm (Vienna). 2008;115(3):443-60.
• 20. Fink HA, Kuskowski MA, Taylor BC, Schousboe JT, Orwoll ES, Ensrud KE, et al. Association of Parkinson's disease with accelerated bone loss, fractures and mortality in older men: the Osteoporotic Fractures in Men (MrOS) study. Osteoporos Int. 2008 Sep;19(9):1277-82.
• 21. Sakushima K, Yamazaki S, Fukuma S, Hayashino Y, Yabe I, Fukuhara S, et al. Influence of urinary urgency and other urinary disturbances on falls in Parkinson's disease. J Neurol Sci. 2016;360:153-7.
• 22. Uchiyama T, Sakakibara R, Hattori T, Yamanishi T. Short-term effect of a single levodopa dose on micturition disturbance in Parkinson's disease patients with the wearing-off phenomenon. Mov Disord. 2003;18(5):573-8.
• 23. Zesiewicz TA, Evatt M, Vaughan CP, Jahan I, Singer C, Ordorica R, et al. Randomized, controlled pilot trial of solifenacin succinate for overactive bladder in Parkinson's disease. Parkinsonism Relat Disord. 2015 May;21(5):514-20.
• 24. Ehrt U, Broich K, Larsen JP, Ballard C, Aarsland D. Use of drugs with anticholinergic effect and impact on cognition in Parkinson's disease: a cohort study. J Neurol Neurosurg Psychiatry. 2010;81(2):160-5.
• 25. Goode PS, Burgio KL, Richter HE, Markland AD. Incontinence in older women. JAMA. 2010;303(21):2172-81.
• 26. Vaughan CP, Burgio KL, Goode PS, Juncos JL, McGwin G, Muirhead L, et al. Behavioral therapy for urinary symptoms in Parkinson's disease: A randomized clinical trial. Neurourol Urodyn. 2019;38(6):1737-44.
• 27. McDonald C, Rees J, Winge K, Newton JL, Burn DJ. Bladder training for urinary tract symptoms in Parkinson disease: A randomized controlled trial. Neurology. 2020;94(13):e1427-e1433.
• 28. Araujo TG, Schmidt AP, Sanches PRS, Silva Junior DP, Rieder CRM, Ramos JGL. Transcutaneous tibial nerve home stimulation for overactive bladder in women with Parkinson's disease: A randomized clinical trial. Neurourol Urodyn. 2021;40(1):538-48.
• 29. Coggrave M, Norton C, Cody JD. Management of faecal incontinence and constipation in adults with central neurological diseases. Cochrane Database Syst Rev. 2014;2014(1):CD002115.