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

It is calculated with the formula (distance between sternal notch - coracoid process / posterolateral angle of acromion - horizontal distance between thoracic spine) x 100.

It is calculated with the formula Pectoralis Minor Index = (Pectoralis Minor Length / Participant's height) x 100.

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.

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.

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.

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.

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.

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).

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.

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.

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.

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.