The Relationship Between Upper Extremity Function and Balance and Functional Mobility in Parkinson's Disease

March 17, 2025 updated by: Kader Eldemir, Gazi University

Investigation of the Relationship Between Upper Extremity Function and Balance and Functional Mobility in Parkinson's Disease

Parkinson's Disease (PD) is the second most common neurodegenerative disease, affecting 2-3% of the population aged 65 and over, characterized by the loss of dopaminergic neurons. The basal ganglia play a significant role in the pathogenesis of PD. The lesions of the basal ganglia impair the ability of patients to perform complex, goal-oriented, and skill-requiring movements. Consequently, motor symptoms such as bradykinesia, rigidity, hypokinesia, and tremor, which are progressively worse, are added to the clinical picture of the disease.

These symptoms, which cause movement and activity limitations in individuals with PD, also affect upper extremity functions, balance, and functional mobility. Impairment of upper extremity functions, commonly seen from the early stages of the disease, can affect many basic activities of daily living, including buttoning clothes, tying shoelaces, sewing, writing, eating, and using various modern devices. Balance and mobility disorders are among the most debilitating features of the disease, as they lead to the deterioration of physical functions in PD. Balance and mobility issues in PD are identified as key determinants of the increasing fear of falling and the resulting decline in quality of life. Various factors such as rigidity, bradykinesia, impaired postural adjustments, and decreased sensory integration contribute to the negative impact on balance and mobility in individuals with PD.

Proper balance and mobility performance are achieved through synergistic control during both dynamic and static postures between proximal body segments such as the trunk, spine, and pelvis. This contributes to the mobility of distal segments and the functionality of the upper extremities. Additionally, the contribution of upper extremity functions to balance and mobility has been demonstrated in healthy populations. Current literature also reveals that treatment programs targeting the upper extremities can improve mobility and balance, especially in neurological patient populations.

In conclusion, balance and mobility disorders in Parkinson's disease can reduce proximal stability and affect hand dexterity. This study aims to examine the relationship between hand dexterity, balance, and functional mobility in individuals with PD.

Study Overview

Status

Recruiting

Conditions

Detailed Description

According to the sample size calculation, at least 26 diagnosed PD will be included. Participants' demographic characteristics will be taken initially and the stage will be recorded according to the Hoehn and Yahr Scale. Then, upper extremity functions, balance, and functional mobility will be evaluated.

Study Type

Observational

Enrollment (Estimated)

26

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Turkey
      • Sivas, Turkey
        • Recruiting
        • Sivas Cumhuriyet University
        • Contact:
          • kader eldemir

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

Patients referred with a diagnosis of Parkinson's Disease (PD) to the Department of Physiotherapy and Rehabilitation at the University by a specialist physician from the Department of Neurology at the University Medical Faculty Research and Application Hospital will be included in the study

Description

Inclusion Criteria:

  • Having accepted participation in the study after being provided with detailed information about the research
  • Having been diagnosed with only Parkinson's Disease by a specialist physician
  • Having a Standardized Mini-Mental Test score greater than 24
  • Being in stages 1 to 3 according to the Hoehn and Yahr Scale

Exclusion Criteria:

  • Having any vision, hearing, or perceptual issues that could affect the research outcomes
  • Having an orthopedic problem in the upper extremity that could impact hand dexterity, balance, or mobility
  • Having a cardiovascular, pulmonary, or hormonal disorder

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Individials with Parkinson's Disease
Parkinson's Disease patients will be included in this study. Inclusion and exclusion criteria will be considered.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The Nine-Hole Peg Test
Time Frame: Assessment will be conducted immediately after enrollment.
The Nine-Hole Peg Test (9-HPT) will be used to assess upper extremity functions. The 9-HPT evaluates hand dexterity based on performance. The test consists of nine pegs and nine holes (peg length: 32 mm, peg diameter: 7 mm, hole diameter: 7.5 mm, hole depth: 13 mm). In the test, the participant is asked to pick up the pegs one by one and place them into the holes as quickly as possible, and once all the pegs are placed, they are asked to collect them again without delay. The test begins with the command "start" and the test duration is recorded in seconds using a stopwatch. It is performed separately for both the right and left hands. The 9-HPT has been determined to be valid and reliable in individuals with Parkinson's Disease.
Assessment will be conducted immediately after enrollment.
The Berg Balance Scale
Time Frame: Assessment will be conducted immediately after enrollment.
The balance assessment will be conducted using the Berg Balance Scale (BBS). The BBS measures the ability to maintain balance during different positions, postural changes, and movements. It is widely used in Parkinson's Disease (PD) and is a highly reliable and valid scale. The scale consists of 14 tests, each rated on a 4-point scale. The highest score is 56; a score of 0-20 indicates balance impairment (high risk of falling), 21-40 suggests acceptable balance (moderate risk of falling), and 41-56 indicates good balance (low risk of falling). Lower scores point to a loss of static or dynamic balance during daily activities, indicating the presence of a higher risk of falls and functional limitations.
Assessment will be conducted immediately after enrollment.
The Timed Up and Go Test
Time Frame: Assessment will be conducted immediately after enrollment.
Functional mobility will be assessed using the Timed Up and Go Test (TUG). During the test, the individual is asked to rise from a chair, walk 3 meters, turn to the right or left, and then walk back to the chair at a brisk pace without running, and sit down again. The test begins with the command "go" and the time is recorded using a stopwatch. In our study, the TUG will be performed three times, and the best score will be used for analysis. The TUG has been found to be valid and reliable in individuals with Parkinson's Disease (PD).
Assessment will be conducted immediately after enrollment.
The timed 360° turn test
Time Frame: Assessment will be conducted immediately after enrollment.
The timed 360° turn test is an easily administered, not time-consuming, and specific measurement tool to assess turning ability. It measures the time taken for an individual to 360° turn around in a standing position. The timed 360° turn test is also correlated with balance and functional mobility.
Assessment will be conducted immediately after enrollment.
Functional Reach Test
Time Frame: Assessment will be conducted immediately after enrollment.
The Functional Reach Test assesses balance by measuring the limits while the patient reaches forwards as far as possible, having the arms in 90° flexion and without lifting the heels off the floor.
Assessment will be conducted immediately after enrollment.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Gazi University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 15, 2024

Primary Completion (Actual)

December 15, 2024

Study Completion (Estimated)

March 30, 2025

Study Registration Dates

First Submitted

September 9, 2024

First Submitted That Met QC Criteria

September 9, 2024

First Posted (Actual)

September 19, 2024

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

March 17, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PD-hand-balance-mobility

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

There is not a plan to make individual participant data but when the statistical analysis of all data is made, all results will be shared.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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