None listed
Conditions
Brief summary
Parkinson’s manifests in motor and non-motor symptoms, which have a huge impact on quality of life and disability. Rhythmic auditory stimulation (RAS) has been shown to improve motor symptoms such as gait and balance in people with Parkinson’s. More recently, research in the non-motor domains has started to explore the effects of RAS on non-motor domains, including depression and cognition, with studies reporting significant results on both motor and non-motor symptoms. However, despite its potential, access to RAS remains limited due to various barriers encountered by people with Parkinson’s. Remote delivery can enhance accessibility and patient autonomy, ensuring healthcare reaches within New Zealand’s diverse landscape. By focusing on Parkinson’s as a complex multi-system disease, this research will contribute to the continuity of care and improve the quality of life. This feasibility study will enable us to develop a fully powered RCT to investigate the potential of remote intervention in the rehabilitation of both non-motor and motor symptoms in Parkinson’s.
Interventions
Participants will engage in a set of exercises aimed at enhancing mobility, posture and balance, as well as overground walking. Each participant will engage in 30 minutes per session, 3 times per week for 6 weeks, and for the rest of the days, they will be asked to perform a subset of the same exercises and walk with rhythmic auditory stimulation (RAS).During the training session, they will be guided virtually by a physiotherapist to focus on the beats while performing activities and while walki
Participants will engage in a set of exercises aimed at enhancing mobility, posture and balance, as well as overground walking. Each participant will engage in 30 minutes per session, 3 times per week for 6 weeks, and for the rest of the days, they will be asked to perform a subset of the same exercises and walk with rhythmic auditory stimulation (RAS).During the training session, they will be guided virtually by a physiotherapist to focus on the beats while performing activities and while walking to match their heel strike with the auditory beats.Each training session will begin with seated warm-up activities followed by a set of exercises in sitting, standing and walking.• Seated warm up- heel taps, knee lifts and clapping in time with the beat. • Standing: march on spot, forward stepping, backward stepping, gradually add arm movements • Balance: tandem stance, sit to stand, stepping sideways • Overground walking: walking with RAS for about 15 minutes of the whole session. Adherence will also be encouraged through weekly calls. m-Path application The m-Path software application (www.mPath.oi) will be used to collect electronic responses from both the intervention and the control group. m-Path is a free online application that participants can download on their smartphones. Participants will be explained by the project coordinator over a phone call on how to download and use this application. Participants will create an account, which will be linked to the primary researcher, to be able to receive the questions. Participants in the RAS plus usual care group will use this application to log the prescribed training exercises and any adverse events. Participants will be carefully explained what comprises logging exercises and adverse events, so that they understand what needs to be recorded. For logging exercises, questions will be sent through the application weekly, which will include whether the whole exercise session is completed or to record the exercises missed, if any. Adverse events will be categorised as minor, such as tripping without any falls or coming to ground while walking, moderate, such as a fall without any injuries and not requiring any medical attention or severe, such as a fall causing fracture or cut, requiring immediate medical attention.
Sponsors
University of Otago
Study design
Allocation
Randomised controlled trial
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants will be included with (a) age of 18 years and above, (b) self-reported idiopathic Parkinson’s disease, (c) community-dwelling (at home), (c) mild to moderate disease severity (Modified Hoehn and Yahr stage I-III), (d) ability to walk independently without physical assistance or an assistive device for at least 30 metres and stand without support for more than a minute,(e) patients on their regular dopamine medications, (f) has access to smartphone with high speed internet and being familiar with or have a support person familiar with mobile technology.
Exclusion criteria
We will exclude (a) People with atypical Parkinson’s, (b) living in residential/nursing home care, (c) people with severe cognitive disability which will be determined using The Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) criteria for cognitive impairment evaluation (item 1.1),(d) self-reported hearing impairments preventing the correct perception of auditory cues, (e) people with Parkinson's disease having high risk of falls screened using five times sit to stand with score higher than 16 seconds, (f) presence of any musculoskeletal or other neurological co-morbidities that affect their ability to participate in the training.
Outcome results
None listed