The Effectiveness of Telerehabilitation in Improving Upper Extremity in Parkinson's Patients

The Effectiveness of Task-Oriented Training Based Telerehabilitation in Improving Upper Extremity Motor Function in Parkinson's Patients

Parkinson's Disease (PD) is a disease that affects the functional skills of the upper extremity with clinical findings such as bradykinesia, rigidity, and hypokinesia and causes limitations in the daily life activities of the patients. Task-oriented training (TOT) is a highly individualized, client-centered, occupational therapy, functional-based intervention compatible with motor learning and motor control principles such as intensive motor training, variable practice, and intermittent feedback. Few studies have been found on the TOT of the upper extremity in PD. Telerehabilitation of Parkinson's patients shows many strengths, such as cost-related and time-dependent ease, and the possibility of telecommunication with clinicians. In addition, the refinement of digital health solutions with the goal to offer a patient-tailored intervention remains an ongoing process. There are a limited number of studies on TOT and telerehabilitation of the upper extremity in PD. In addition, no studies have been found applying TOT through telerehabilitation. For this purpose, a study including TOT-based telerehabilitation in upper extremity education in PD was planned.

Study Overview

• Status: Completed
• Conditions: Parkinson Disease
• Intervention / Treatment: Other: Exercise

Detailed Description

This study is a randomized controlled study. The patients will be randomly divided into two groups as exercise and control. Balance and walking exercises consisting of 3 days a week for 6 weeks will be given to both groups as a home program. In addition, the exercise group will receive TOT-based telerehabilitation via video conferencing 3 days a week for 6 weeks. TOT will be formed from daily life activities such as reaching out, grasping, writing, and manual skills, which are frequently used in daily life. As the outcome measures, disease severity and disability, finger and hand function, hand strength, and quality of life will be evaluated.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Ankara, Turkey
    • Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 45 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 45- 70 years of age
• Having diagnosed with "Parkinson's Disease" by a specialist physician
• Having between 1-3 stages according to the Hoehn and Yahr Scale
• Mini-Mental Test score more than or equal 24

Exclusion Criteria:

- Any orthopedic, vision, hearing, cardiovascular, or perception problems that may affect the research results

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Exercise group; The group that will receive task-oriented training via telerehabilitation	Other: Exercise; Both groups will receive exercise-based training
Placebo Comparator: Control group; The control group only will be given a home program that includes walking and balance exercises	Other: Exercise; Both groups will receive exercise-based training

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Manual dexterity performance - Baseline	Nine Hole Peg test (9-HPT)	Assessment will be conducted before the intervention
Manual dexterity performance - Post intervention	Nine Hole Peg test (9-HPT)	Assessment will be conducted immediately after the intervention
Finger and hand function - Baseline	Jebsen-Taylor Hand Function Test (JTHFT)	Assessment will be conducted before the intervention
Finger and hand function - Post intervention	Jebsen-Taylor Hand Function Test (JTHFT)	Assessment will be conducted immediately after the intervention
Upper extremity performance (coordination, dexterity and functioning) - Baseline	Action Research Arm Test (ARAT)	Assessment will be conducted before the intervention
Upper extremity performance (coordination, dexterity and functioning) - Post intervention	Action Research Arm Test (ARAT)	Assessment will be conducted immediately after the intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Isometric hand strength - Baseline	J-Tech ™	Assessment will be conducted before the intervention
Isometric hand strength - Post intervention	J-Tech ™	Assessment will be conducted immediately after the intervention
Isometric pinch strength - Baseline	Baseline® pinch meter	Assessment will be conducted before the intervention
Isometric pinch strength - Post intervention	Baseline® pinch meter	Assessment will be conducted immediately after the intervention
Disease severity and disability - Baseline	MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The MDS-UPDRS has a maximum score of 272 and is composed of four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications) (UPDRS). (0= best , 272= worst)	Assessment will be conducted before the intervention
Disease severity and disability - Post intervention	MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The MDS-UPDRS has a maximum score of 272 and is composed of four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications) (UPDRS). (0= best , 272= worst)	Assessment will be conducted immediately after the intervention
Health-related Quality of Life - Baseline	Parkinson's Disease Questionnaire 8 (PDQ-8). There are 8 questions in total and each question is scored from 0-4 points. High score indicates decreased quality of life	Assessment will be conducted before the intervention
Health-related Quality of Life - Post intervention	Parkinson's Disease Questionnaire 8 (PDQ-8). There are 8 questions in total and each question is scored from 0-4 points. High score indicates decreased quality of life	Assessment will be conducted immediately after the intervention

Collaborators and Investigators

• Sponsor: Gazi University
• Investigators: Study Chair: Sefa Eldemir, PT, MSc., Research assistant; Study Director: Arzu Güçlü-Gündüz, PT, PhD., PROFESSOR

Publications and helpful links

Helpful Links

• Related info
• Related info

Study record dates

Study Major Dates

• Study Start (Actual): April 15, 2021
• Primary Completion (Actual): May 15, 2022
• Study Completion (Actual): May 25, 2022

Study Registration Dates

• First Submitted: March 30, 2021
• First Submitted That Met QC Criteria: April 6, 2021
• First Posted (Actual): April 8, 2021

Study Record Updates

• Last Update Posted (Actual): May 27, 2022
• Last Update Submitted That Met QC Criteria: May 25, 2022
• Last Verified: May 1, 2022

More Information

Terms related to this study

• Keywords: Telerehabilitation; Parkinson Disease; upper extremity; Task-oriented
• 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: 1- PD- UE-Telerehabilitation

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No
• IPD Plan Description: There is not a plan to make IPD 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