Sensory Stimulation Effect on Movement Speed in Patients With Parkinson Disease

Aponeurotic Stimulation Effect on Parkinson Bradykinesia

Movement slowness (bradykinesia) is one of the main motor symptoms in Parkinson Disease (PD). Several studies have shown that patients with PD exhibit slowness because they are unable to modulate, in an optimal way, the velocity of voluntary motor acts not induced by external stimulation. Indeed, these patients have difficulties to integrate multi-sensorial information, mainly proprioception.

The investigators investigated changes in shoulder velocity during pointing movements by patients with PD after stimulation of soft tissues (aponeurosis) of upper limb muscles. The stimulation consisted of manipulating, with a hook (the diacutaneous fibrolysis method), the aponeurotic tissues enrobing the heads of the upper limb muscles. This technique has previously been shown to decrease passive tension and the tendon reflex response of the manipulated muscle group. The investigators hypothesis is that aponeurotic manipulation of shoulder muscles therefore creates a modification in the proprioceptive information, which in return temporarily decreases the bradykinesia of shoulder movements.

Study Overview

• Status: Completed
• Conditions: Parkinson Disease
• Intervention / Treatment: Other: Aponeurotic stimulation (the diacutaneous fibrolysis method); Other: Placebo stimulation

• Study Type: Interventional
• Enrollment (Actual): 11
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Belgium
  • Brussels, Belgium, 1070
    • ULB-FSM Laboratory of neurophysiology and movement biomechanics

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Clinical diagnosis of Parkinson Disease

Exclusion Criteria:

• Patients with a limitation in the shoulder range of motion necessary to perform pointing movements

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Aponeurotic stimulation group; The stimulation consisted of manipulating, with a hook (the diacutaneous fibrolysis method), the aponeurotic tissues enrobing the heads of the trunk and upper limb muscles.	Other: Aponeurotic stimulation (the diacutaneous fibrolysis method); Treatment consisted of manipulating, with a hook, the aponeurotic tissues enrobing the heads of the upper-limb muscles. The manipulation consisted of back and forth mobilization, applied perpendicularly to the axis of the muscular fibers. The mobilization is performed with both hands; the therapist's non-dominant hand performs a manual mobilization whereas the dominant hand follows the movement with the hook. The hook allows the therapist to be very precise about the location of the tissues that are stretched. This stretch is realized at the level of the aponeurotic fibers presenting the greatest resistance to perpendicular movement. The shape of the hook is chosen to avoid discomfort or pain during manipulation. To spread the pressure exerted by the spatula on a very local point, it is important to fill completely the curved part of the hook with the adjacent soft tissues. We manipulated muscle from the proximal insertion towards the distal, giving special attention to the tendons.
Active Comparator: Placebo stimulation group; Placebo stimulation (PS) consisted of manipulating the skin along the same paths over the trunk, shoulder and arm muscles that were the targets for treatment in the Aponeurotic stimulation group.	Other: Placebo stimulation; Placebo stimulation (PS) consisted of manipulating the skin along the same paths over the trunk, shoulder and arm muscles that were the targets for treatment in the AS group

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
3D kinematic movement parameters and upper limb muscles electromyographic activation	Participants will be followed for the duration of the clinical test (2 weeks)

Secondary Outcome Measures

Outcome Measure	Time Frame
Unified Parkinson's Disease Rating Scale (UPDRS)	Participants will be followed for the duration of the clinical test (2 weeks)

Collaborators and Investigators

• Sponsor: Université Libre de Bruxelles
• Collaborators: Fonds National de la Recherche Scientifique; Belgium: Belgian Federal Science Policy Office (BELSPO)
• Investigators: Principal Investigator: Ana Bengoetxea, PhD, Université libre de Bruxelles; Study Chair: Françoise Leurs, PhD Student, Université libre de Bruxelles; Study Chair: Leslie Rigal, Master Student, Université libre de Bruxelles; Study Director: Guy Cheron, PhD, Université libre de Bruxelles

Study record dates

Study Major Dates

• Study Start: November 1, 2008
• Primary Completion (Actual): May 1, 2009

Study Registration Dates

• First Submitted: February 23, 2012
• First Submitted That Met QC Criteria: March 5, 2012
• First Posted (Estimate): March 6, 2012

Study Record Updates

• Last Update Posted (Estimate): March 6, 2012
• Last Update Submitted That Met QC Criteria: March 5, 2012
• Last Verified: February 1, 2012

More Information

Terms related to this study

• Keywords: Parkinson Disease; Bradykinesia; sensory stimulation
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Parkinsonian Disorders; Basal Ganglia Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Parkinson Disease
• Other Study ID Numbers: LMNB-01