Parkinson Disease Clinical Trial
Official title:
Evaluation of Impaired Mobility in Chronic Illness Constitution of a Cohort
Chronic illness is a public health issue and mobility loss is frequent in this population. Among its' multiple physical and psychological consequences, increased mortality and cardiovascular morbidity seem the main concern. Therefore, the exploration of locomotor deficiencies, physical capacities and metabolism of patients with chronic illnesses constitutes a major challenge both for the treatment of causal pathologies, as well as for evaluating the impact of therapeutic interventions, the benefit of which will be an improvement in physical capacities and ultimately mobility. In view of the hypothesis of an increase in the prevalence of mobility disorders in this population, this approach is part of a logic of screening and improving the effectiveness of the care of these patients with a multidisciplinary evaluation of individual risks. The EVALMOB protocol was designed in order to try to determine a standard profile of "dysmobility" in patients with chronic illness
We propose to constitute a prospective cohort of subjects carrying chronic disease. The
objective is to explore all the different components of mobility (balance, muscle force, body
composition, walking ability, metabolism, etc.), to assess their impact on the functional
capacity of individuals and to identify their potential interactions. Processing this data
could ultimately allow the development of a model to determine a composite standard profile
of "dysmobility" in patients with chronic disease.
In the present protocol, parameters will be measured on five occasions (at inclusion, at 6
months from the inclusion day, at 1,2 and 5 year(s) from the inclusion day). All tests will
be performed on the same day. New assessments will be done on the same principle as the
initial evaluation.
Statistical analyses will be carried out using Stata software (version 13, StataCorp, College
Station, USA). Data will be described by frequencies and percentages for categorical
variables and by means and standard deviation (or median and interquartile range if data are
not normally distributed) for continuous variables. The normality of continuous data will be
assessed graphically and using the Shapiro-Wilk test. The main analysis will consist in
determining patient profiles regarding their mobility. Clustering-type approaches (supervised
or not) will be proposed: k-means, vector machine support, machine learning, factor analysis.
For example, factor analyses on mixed data will allow the main components of mobility to be
characterized. They can be followed by an ascending hierarchical classification in order to
determine homogeneous groups of patients.
These groups will be described and compared on the main criteria evaluated using standard
statistical tests: chi2 test (or Fisher's exact test if applicable) for the categorical
criteria and using an analysis of variance (or Kruskal-Wallis if data are not normally
distributed) for continuous criteria. The main analysis will be broken down more specifically
for each of the pathologies considered. In addition, the sensitivity to change will be
assessed in each pathology and for each assessment criterion. The search for factors related
to the evolution of the different criteria will be carried out using usual tests and mixed
multivariate models (logistics for categorical / linear criteria for continuous criteria)
considering the subject as a random effect, and adjusting on the time criteria (inclusion /
follow-up) and the criteria highlighted in the univariate analyses and in light of the
elements reported in the literature. A sensitivity analysis will be proposed in order to
study the statistical nature of the missing data and to propose, if necessary, the most
suitable method of imputing the data: multiple imputation, maximum bias or LOCF in the case
of longitudinal data.
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