Investigation of acute effect of cervical mobilization on balance and gait in patients with idiopathic parkinson's disease

The study was conducted to examine the acute effect of cervical mobilization on balance and gait in patients with idiopathic Parkinson's disease. 33 patients with idiopathic Parkinson's disease (Modified Hoehn-Yahr Staging Scale: Stage 2-3) were randomly assigned to study and control groups. While there was no intervention in the control group, a single session (10 minutes) of cervical mobilization was applied to the study group. Disease severity was determined with the Unified Parkinson's Disease Rating Scale (UPDRS). Balance and gait were evaluated by the Functional Reach Test (FRT), Tandem Stance Test (TST), Clinical Test of Sensory Integration and Balance (CTSIB), Dynamic Gait Index (DGI), Dynamic Gait Index-Head score (DGI-Head score), and static posturography. Patients were evaluated twice with a one-week break. The second evaluation of the patients in the study group was made just after cervical mobilization. At the end of the study, both groups showed progress in FRT and DGI (p<0.05). The DGI-Head score, CTSIB sway, and CTSIB duration improved only in the study group (p<0.05). At the same time, the intergroup analysis of the second evaluation results, it was found a difference in favor of the study group in DGI-Head score and CTSIB sway (p<0.05). When the static posturography results were compared, a significant improvement was observed in the reaction time, maximum excursion, and endpoint excursion parameters of the LOS (Limits of Stability) in the study group (p<0.05). In addition, a significant difference was found in favor of the study group in the speed of the Walk Across Test, the endpoint sway of the Tandem Walk Test, and the turn sway of the Step/ Quick Turn Test (p<0.05). As a result, it was concluded that cervical mobilization positively affects balance and gait by stimulating vestibular structures and proprioceptors and regulating tone. Keywords: Idiopathic Parkinson's disease, cervical mobilization, balance, gait.