The Effects of Scapulohumeral Rehabilitation on Scapula Kinematics and Upper Extremity Functionality in Individuals With Parkinson's Disease

September 3, 2025 updated by: Betül Söylemez, Burdur Mehmet Akif Ersoy University

The Effects of Scapulohumeral Rehabilitation on Scapula Kinematics and Upper Extremity Functionality in Individuals With Parkinson's Disease: A Single Blind Randomized Controlled Trial

With this study, individuals diagnosed with PD in Burdur province in Turkey will be provided with a physiotherapy and rehabilitation program for the upper extremity, and it is thought that the treatment received by both groups will have a positive effect on the functionality of the individuals. According to the results of our study, it will be determined whether the scapula kinematics and upper extremity functionality of individuals diagnosed with PD are different from healthy individuals of the same age and gender. After the intervention programs applied to the individuals, it is thought that it will contribute to the physiotherapy and rehabilitation programs of individuals with PD by determining whether the scapulohumeral rehabilitation program is superior to the upper extremity neurorehabilitation program.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

28

Phase

  • Not Applicable

Contacts and Locations

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

Study Locations

  • Turkey (Türkiye)
    • Burdur
      • Burdur, Burdur, Turkey (Türkiye), 15030
        • Burdur Mehmet Akif Ersoy University
    • Denizli
      • Denizli, Denizli, Turkey (Türkiye), 20200
        • Pamukkale University

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

Yes

Description

Inclusion Criteria:

  • For the intervention group:

    • Having been diagnosed with Parkinson's Disease
    • Being between 1-3 according to the Hoehn & Yahr staging

  • For the control group:

    • Being of the same age and gender as the individuals diagnosed with Parkinson's disease included in the study

Exclusion Criteria:

  • For the intervention group:

    • Refusing to participate in the study
    • Having a full-thickness rotator cuff muscle rupture
    • Having a history of humerus, clavicle, scapula or shoulder surgery
    • Having a history of humerus, clavicle, scapula or shoulder fracture
    • Having a history of any other disease that may affect the ability to stand independently

  • For the control group:

    • Refusing to participate in the study
    • Having a full-thickness rupture of the rotator cuff muscles
    • Having a history of humerus, clavicle, scapula or shoulder surgery
    • Having a history of humerus, clavicle, scapula or shoulder fracture

Study Exclusion Criteria for Volunteers:

  • Failure to complete the tests included in the study
  • Failure to comply with the study schedule, failure to complete sessions
  • Incomplete data
  • Failure to attend 3 consecutive sessions
  • Voluntary withdrawal

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

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group 1: Scapulohumeral Rehabilitation
The scapulohumeral rehabilitation group will receive 20 minutes of scapulohumeral exercises in addition to the 10-minute neurorehabilitation program. Scapulohumeral Exercises: Scapular mobilization, scapular retraction, protraction, elevation in the scapular plane and Proprioceptive Neuromuscular Facilitation (PNF) exercises with the repeated contractions method. The exercises will be applied according to the functional capacities of the individuals in the supine, sitting and standing positions with 10 repetitions at the beginning, without weights, using free weights and resistance bands, and the number of repetitions and sets will be progressed every week. The intervention groups will receive a total of 21 treatment sessions, 3 days a week for 7 weeks.
Other: Physiotherapy and rehabilitation
It is reported in the literature that scapulohumeral rehabilitation applied in primary shoulder pathologies is effective. In neurological diseases, a study was found in which scapulohumeral rehabilitation was applied to individuals diagnosed with stroke and reported that it was effective. However, when the literature was examined, no study was found in which scapulohumeral rehabilitation was applied to individuals diagnosed with PD. Therefore, our aim is to compare the effectiveness of the scapulohumeral rehabilitation program to be applied for shoulder dysfunction, which is thought to be one of the early findings in PD and is reported to be related to other main findings in PD, with the upper extremity neurorehabilitation program.
Other Names:
  • Rehabilitation
  • Physiotherapy
  • neurorehabilitation
Experimental: Group 2: Upper Extremity Neurorehabilitation
In addition to the 10-minute neurorehabilitation program, a 20-minute upper extremity neurorehabilitation exercises and a total of 30 minutes of physiotherapy and rehabilitation program will be applied. Scapular retraction, protraction, elevation movements will be performed in the form of Wand exercises with the help of a stick or cane. Exercises will be progressed by increasing the number of repetitions and sets in supine, sitting and standing positions according to the functional level of the participants. The intervention groups will receive a total of 21 treatment sessions, 3 days a week for 7 weeks.
Other: Physiotherapy and rehabilitation
It is reported in the literature that scapulohumeral rehabilitation applied in primary shoulder pathologies is effective. In neurological diseases, a study was found in which scapulohumeral rehabilitation was applied to individuals diagnosed with stroke and reported that it was effective. However, when the literature was examined, no study was found in which scapulohumeral rehabilitation was applied to individuals diagnosed with PD. Therefore, our aim is to compare the effectiveness of the scapulohumeral rehabilitation program to be applied for shoulder dysfunction, which is thought to be one of the early findings in PD and is reported to be related to other main findings in PD, with the upper extremity neurorehabilitation program.
Other Names:
  • Rehabilitation
  • Physiotherapy
  • neurorehabilitation
No Intervention: Control Group
The control group will consist of healthy volunteers of the same age and gender as individuals diagnosed with Parkinson's disease (PD). The control group will not receive any physiotherapy or rehabilitation program and will only receive relevant assessments to compare with the results of individuals with PD.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Scapular Index
Time Frame: From enrollment to the end of treatment at 7 weeks
It is calculated with the formula (distance between sternal notch - coracoid process / posterolateral angle of acromion - horizontal distance between thoracic spine) x 100.
From enrollment to the end of treatment at 7 weeks
Pectoralis Minor Index
Time Frame: From enrollment to the end of treatment at 7 weeks
It is calculated with the formula Pectoralis Minor Index = (Pectoralis Minor Length / Participant's height) x 100.
From enrollment to the end of treatment at 7 weeks
Lateral Scapular Slide Test
Time Frame: From enrollment to the end of treatment at 7 weeks
In the Lateral Scapular Slide Test, the distance to the thoracic spinous process corresponding to the inferior angle of the scapula is measured in three different positions: arms relaxed at the sides, hands on the iliac crest, and arm in 90-degree shoulder abduction and full internal rotation. The distances between the two sides are compared. A difference of more than 1.5 cm between the two sides is considered asymmetric.
From enrollment to the end of treatment at 7 weeks
Box and Block Test
Time Frame: From enrollment to the end of treatment at 7 weeks
150 small wooden cubes are filled from the box where the patient's hand is to be tested to the box next to it. The patient is asked to throw one cube at a time into the empty box next to it. The number of cubes thrown in 60 seconds is counted. The result gives the score. The test is repeated for both hands.
From enrollment to the end of treatment at 7 weeks
Upper Extremity Functional Index
Time Frame: From enrollment to the end of treatment at 7 weeks
It is a scale developed by Stratford et al. in 2001 and consists of twenty activity questions. The person scores between 0-4 according to the difficulty of doing the activity. The lowest score in total is 0, the highest score is 80. Low scores indicate that the person has difficulty doing the activity due to the condition of the upper extremity.
From enrollment to the end of treatment at 7 weeks
Ultrasound
Time Frame: From enrollment to the end of treatment at 7 weeks
During the evaluation, the patient will be in a sitting position, with the arm next to the body, the forearm in supination and the elbow in full extension. Supraspinatus muscle thickness measurement will be performed by positioning the probe on the fossa supraspinata of the scapula, perpendicular to the skin, along the muscle fibers. The hyperechogenic bone cortex of the fossa supraspinata will be accepted as the landmark. When the muscle fibers are visualized, the thickness of the supraspinatus muscle will be measured from the level where the muscle is observed to be thickest. For the infraspinatus muscle thickness measurement, the hyperechogenic bone cortex of the fossa infraspinata of the scapula will be accepted as the landmark, and the probe will be placed perpendicular to the skin, along the muscle fibers. After the muscle fibers are visualized, the thickness of the infraspinatus muscle will be measured from the level where the muscle is observed to be thickest.
From enrollment to the end of treatment at 7 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual Analog Scale (VAS)
Time Frame: From enrollment to the end of treatment at 7 weeks
VAS is a 10-centimeter (cm) scale where 0 is defined as "no pain" and 10 is defined as "unbearable pain". It is a valid and reliable method for assessing the severity of musculoskeletal pain and is frequently used in clinical studies. In a study conducted on patients with chronic musculoskeletal pain, VAS values less than 3.4 cm were classified as mild pain, VAS values between 3.5 and 7.4 cm were classified as moderate pain, and VAS values greater than 7.5 cm were classified as severe pain. The participants' pain severity will be assessed with VAS for resting and activity conditions.
From enrollment to the end of treatment at 7 weeks
King's Parkinson's Pain Scale
Time Frame: From enrollment to the end of treatment at 7 weeks
Consists of 14 items divided into seven different areas. Each item is scored by multiplying the severity (0 [no pain] 3 [very severe pain]) (0 [never] 4 [always]). The areas and score ranges are: musculoskeletal pain (0-12 points); chronic pain (0-24 points); pain associated with fluctuation (0-36 points); night pain (0-24 points); orofacial pain (0-36 points); color change, edema (0-24 points); radicular pain (0-12 points).
From enrollment to the end of treatment at 7 weeks
Range of Motion
Time Frame: From enrollment to the end of treatment at 7 weeks
Participants' shoulder flexion, abduction, internal and external rotation movements will be evaluated with a manual goniometer. The angle at which shoulder pain develops in active and passive movements will be recorded.
From enrollment to the end of treatment at 7 weeks
Scapula Angles
Time Frame: From enrollment to the end of treatment at 7 weeks
The scapula will be evaluated with the inclinometer in three different positions: at rest, with the shoulder at 45 degrees of flexion and 90 degrees of flexion. The difference between the right and left sides will be compared.
From enrollment to the end of treatment at 7 weeks
New York Posture Rating Chart
Time Frame: From enrollment to the end of treatment at 7 weeks
Postural changes in 13 different body segments based on observation are scored as 1 point (marked deviation), 3 points (slight deviation), or 5 points (correct posture). The total score ranges from 13 to 65 points, with higher scores indicating correct/normal postural alignment.
From enrollment to the end of treatment at 7 weeks
PostureScreen Mobile Smartphone Application
Time Frame: From enrollment to the end of treatment at 7 weeks
It is an image-based method that takes photographs of individuals in the sagittal and frontal planes. The application calculates postural variables using the individual's anatomical points that are digitally marked depending on the number of variables of interest. This process of digitally marking the points consists of drawing the boundaries of anatomical reference points (pelvic iliac crests, greater trochanter, femoral condyle, and ear lobule) directly on the mobile device screen. Body angles are then calculated. As a result, it provides an output file containing the values of the postural variables and images showing the digitized points and their positions relative to a neutral posture.
From enrollment to the end of treatment at 7 weeks

Collaborators and Investigators

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

Sponsor

Burdur Mehmet Akif Ersoy University

Collaborators

Pamukkale 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)

April 1, 2025

Primary Completion (Estimated)

January 1, 2026

Study Completion (Estimated)

June 1, 2026

Study Registration Dates

First Submitted

February 26, 2025

First Submitted That Met QC Criteria

March 5, 2025

First Posted (Actual)

March 6, 2025

Study Record Updates

Last Update Posted (Estimated)

September 10, 2025

Last Update Submitted That Met QC Criteria

September 3, 2025

Last Verified

September 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • E-60116787-020-491421

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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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