Parkinson Disease
Conditions
Brief summary
Parkinson's Disease is an incurable and progressive disease. Treatment includes medication and non-pharmacological intervention such as physiotherapy. Physiotherapy is a main component of non-pharmacological interventions. It includes exercise to strengthen the muscles; improves balance and walking, and adopts the use of visual cue training. Treatment has been found to be effective in patients with mild impairment up to 6 months post-treatment. The present study will investigate the effectiveness of treatment for patients with mild to moderate impairment for short term (3-month) and long term (1 year). The hypothesis is that compared to patient education alone, physiotherapy intervention for patients with Parkinson's disease leads to improve function and quality of life.
Detailed description
Parkinson's disease (PD) is an incurable and progressive disease (Rubenis 2007). Current management include medical, neuro-surgical and non-pharmacological intervention. Physiotherapy is a major component in non-pharmacological interventions. Effective interventions including visual or auditory cues improves gait (Nieuwboer et al. 2007), exercise is effective in improving balance (Hirsch et al 2003); intense treadmill training improves motor control, quality of life and walking speed so as to sustain improvement in gait speed and motor control post 4 weeks of treatment (Herman et al 2007). Patient with PD attending physiotherapy twice weekly, one and half hour for 12 weeks showed improvement in walking speed and Activities of Daily Living (Ellis et al 2005). However, the majority of focus on patients in the Hoehn and Yahr stage of 2 to 3 and long term effect is lacking (Kwakkel et al 2007). A knowledge gap is present in the effectiveness of physiotherapy training of patients with Parkinson's disease in the more advanced stage of disease and long term effect is lacking. The aim of the study is to investigate the immediate, short-term & long-term clinical effects of physiotherapy training of patients with Parkinson's disease. The hypothesis is that compared to patient education alone, physiotherapy intervention for patients with Parkinson's disease leads to improve function and quality of life.
Interventions
OTHERPhysiotherapy Interventions
Physiotherapy interventions including strengthening exercise, balance training, gait training with visual cus and gait training with treadmill
OTHEREducation Classes
Education Classes
Sponsors
Queen Elizabeth Hospital, Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
35 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Stable medication usage * Hoehn and Yahr stage II to IV * At least 1 score of 2 or more for at least 1 limb of either the tremor, rigidity, or bradykinesia item of the Unified Parkinson's Disease Rating Scale (UPDRS) * Able to walk independently * No severe cognitive impairments (Mini-Mental State Examination - Chinese Cantonese version) score greater than 24
Exclusion criteria
* Other severe neurological, cardiopulmonary, or orthopedic disorders * Having participated in a physiotherapy or rehabilitation program in previous 2 months
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Movement Disorder Society-Unified Parkinson's Disease Rating Scale | Baseline. Immediate, 3-month, 6-month and 1 year Post-intervention |
| Levodopa equivalent daily dosage (LEDD) | Baseline. Immediate, 3-month, 6-month and 1 year Post-intervention |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Timed Up and Go Test | Baseline. Immediate, 3-month, 6-month and 1 year Post-intervention | — |
| Activities-Specific Balance Confidence Scale (Chinese version) | Baseline. Immediate, 3-month, 6-month and 1 year Post-intervention | — |
| Parkinson's Disease Questionnaire (Standard Chinese Version) | Baseline. Immediate, 3-month, 6-month and 1 year Post-intervention | Parkinson's Disease Questionnaire (Standard Chinese Version) - PDQ-39 (Chinese) |
| Number of Injurious Falls | Baseline. Immediate, 3-month, 6-month and 1 year Post-intervention | — |
Countries
Hong Kong
Outcome results
None listed