None listed
Conditions
Brief summary
Parkinson’s Disease (PD) leads to complex pathological characteristics demonstrated in versatile motor and cognitive profiles. The symptoms which develop over the course of the disease changes the person with Parkinson’s ability to carry out everyday activities. Functional decline in PD has a large impact on QOL, is first characterized by difficulties in ADL’s such as house work, dressing and writing and was found to decline in connection with cognition. In regard to motor function dexterity was found to be associated with ADL independence more than tasks related to lower limb function or gross upper limb (UL) function. In order to maximize the benefits of rehabilitation of PWP’s, it is essential to better understand the interaction between cognition and motor learning strategies. This will be performed by designing and comparing between two intervention programs - Motor Imager (MI) and Cross Education (CE) - focused on improvement in Upper Limb (UL) functional ability (i.e. dressing, eating, etc.). efficacy of intervention will be assessed in regard to the participant’s personal improvement, additionally cognition will be analyzed as a potential mediating factor in the efficacy of the intervention type. Our ultimate goal is to enhance knowledge translation by creating a manual for clinicians whereby a cognitive exam administered at the beginning of an intervention period, will facilitate clinical reasoning in choosing the most efficient motor learning strategy for a specific patient. Aims: 1) to compare the immediate and delayed effects of MI and CE strategies on improving perceived performance and satisfaction from UL-related meaningful activities and dexterity (e.g. touchscreen and functional tasks), and 2) to examine associations between cognitive abilities and improvement in perceived performance and satisfaction following the implementation of each strategy. We hypothesize that both strategies would enhance perceived performance and satisfaction from UL-related meaningful activities and dexterity, and that MI gains would correlate with better cognitive abilities.
Interventions
Intervention program will be administered twice a week, 45 minute sessions, for 5 weeks by a qualified Occupational Therapist with experience with Parkinson's Disease (PD). both groups (intervention and comparator group) will receive intervention in one-on-one sessions once a week face to face in the Clinic or the patient's home and once a week on zoom from the patient’s home.
intervention description: Motor Imagery intervention- practice of dexterity exercises will be performed after imagining
Intervention program will be administered twice a week, 45 minute sessions, for 5 weeks by a qualified Occupational Therapist with experience with Parkinson's Disease (PD). both groups (intervention and comparator group) will receive intervention in one-on-one sessions once a week face to face in the Clinic or the patient's home and once a week on zoom from the patient’s home. intervention description: Motor Imagery intervention- practice of dexterity exercises will be performed after imagining the exercise in the first person. After imagining the movement, the patient will perform the activity with the hand that he was instructed to imagine using. For Activities of Daily Living (ADL) which are unilateral practice will be performed only with the dominant arm – following imagery of the activity. For bilateral ADL’s practice will be performed after imagining the activity. Motor imagery will be performed with the verbal guidance of the Occupational Therapist. After 1 weeks both groups will be asked to give 2-3 dexterity based activities that are meaningful and difficult for them in daily function, those activities will be integrated into the intervention. Session attendance will be followed and reported.
Sponsors
University of Haifa
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
40 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
Inclusion criteria: PD diagnosis of at least two years, Hoehn and Yahr =>2, existence of lateralization determined by the Unified Parkinson’s Disease Rating Scale motor examination or the patient subjective report.
Exclusion criteria
Exclusion criteria: existence of other neurological diagnosis (e.g., stroke, dementia).
Outcome results
None listed