None listed
Conditions
Brief summary
There is growing evidence that physiotherapy and exercise can improve mobility and balance in people with Parkinson's disease (PD). However, there is limited research on the method of service delivery to provide optimally effective and efficient physiotherapy to people with PD. The primary aim of this pilot randomised controlled trial is to investigate the feasibility of a predominantly home-based physiotherapy program compared to a predominantly group-based program. The secondary aim is to determine the effect of the programs on balance and mobility in people with PD. In addition participants will also provide feedback on their satisfaction of exercising in group environment and at home.
Interventions
All participants will complete a predominantly group-based physiotherapy exercise program conducted in conjunction with an exercise self-management program for the first 5 weeks of the intervention. Participants will perform physiotherapy exercises three times per week, with two group sessions (1 hour per session) and one home-based session (1 hour) each week. Exercises will be prescribed by a physiotherapist and will be based on each individual participant’s initial assessment results.
The gro
All participants will complete a predominantly group-based physiotherapy exercise program conducted in conjunction with an exercise self-management program for the first 5 weeks of the intervention. Participants will perform physiotherapy exercises three times per week, with two group sessions (1 hour per session) and one home-based session (1 hour) each week. Exercises will be prescribed by a physiotherapist and will be based on each individual participant’s initial assessment results. The group will have 5-8 participants per class, under the supervision of a physiotherapist and two physiotherapy students. The exercise program will consist of task-specific training of activities while targeting key motor impairments in PD (hypokinesia, bradykinesia, freezing of gait and postural instability). Examples of exercises include balance exercises (anticipatory and reactive), sit to stand, stepping and walking incorporating cueing and dual-task training strategies. Participant’s home-based physiotherapy exercise programs will be prescribed by a physiotherapist and remotely monitored using internet and app resources available at PhysioTherapy eXercises. The home-based physiotherapy exercise program will be similar to the group-based program with adjustments made for safety and availability of equipment. Participants will complete one weekly 15 minute self-management session, designed to increase self-efficacy for exercise and to promote the development of exercise self-management skills. The self-management program will be facilitated by a physiotherapist and consist of the following topics; Why is exercise important (education session provided by the physiotherapist). Goal setting (participants discuss how they like to exercise and set appropriate goals). Identifying barriers to exercise (participants identify their barriers to exercises). Solutions for barriers to exercise (participants provide solutions for each barrier identified). Developing a plan to continue exercising (participants develop a five week plan to continue exercising). Participants will be provided with worksheets to complete during the self-management sessions. At the end of week 5, participants will be randomised to the predominantly home-based (PHB) or predominantly group-based (PGB) model. Predominantly home-based physiotherapy The PHB group will be prescribed, by a physiotherapist, a home-based physiotherapy exercise program to complete independently three times per week (1 hour per session) for 5 weeks (weeks 6 – 10). This program will be based on the group-based physiotherapy exercise program with adjustments made for safety and availability of equipment. Examples of exercises include balance exercises (anticipatory and reactive), sit to stand, stepping and walking incorporating cueing and dual-task training strategies. These participants will receive two, five minute, phone calls (week 7 and week 9) from a physiotherapist. The purpose of the phone calls is to review participant’s performance, assist with any difficulties and progress the home exercise program (if indicated). The participant’s adherence and adverse events will be remotely monitored using internet and app resources available at PhysioTherapy eXercises. However, if participants prefer not to use the internet-based technology, adherence and adverse events will be monitored using paper-based log books.
Sponsors
University of Sydney
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Idiopathic Parkinson's disease Living in the community (Canberra and surrounding regions) Stable medications for at least 2 weeks prior to baseline assessment
Exclusion criteria
Mini Mental State Examination of less than 24. A medical condition which will prevent participants from completing a physiotherapy exercise program three times a week. Are currently attending the PD exercise classes at the University of Canberra Have attended the PD exercise classes at the University of Canberra in the last 12 weeks.
Outcome results
None listed