Parkinson's Disease Clinical Trial
Official title:
Home-Based Telesurveillance and Rehabilitation Program in Parkinson's Disease: Pilot Randomized Trial
Parkinson's disease (PD) is a chronic neurodegenerative disease due to the loss of
dopaminergic neurons in the substantia nigra, leading to motor symptoms of tremor, rigidity,
and bradykinesia, as well as an array of non-motor symptoms that affect cognition, sleep,
behaviour, and the autonomic nervous system.
Lifelong rehabilitation measures, along with medication treatment, are the major components
of patient management. Physical exercises positively affect patients' quality of life (QOL)
and their functional capacities. Poor adherence to rehabilitation, limited patient
education, and access to specialized care can be barriers to treatment. A number of papers
in fact report that telemedicine is an acceptable means of care delivery reduces travel
burdens and may improve patient outcomes. However, most of these studies were not randomized
or controlled and did not include nursing home patients, who may benefit the most from
specialty care.
Moreover, there is no evidence supporting the use of telerehabilitation for physical
assessments of people with PD. For this reason investigators hypothesize that a home
telerehabilitation system guiding patients in following their exercise program combined with
a computerized decision-support tool monitoring patient performance, would be feasible for
and acceptable to patients with PD and would improve functional status.
Aim of the study:
1. Demonstrate the feasibility of at home telesurveillance and rehabilitation program
2. Demonstrate the effectiveness of the program in improving quality of life and
functional aspects in patients affected by Parkinson's disease
30 patients affected by Parkinson's disease (PD), will be consecutively screened. The method
of sequence generation relied on a computerized random number generator. The person who
allocated patients to the two groups was not involved either in treatment or in evaluation
of the patients.
The study was submitted for approval of the Central Ethics Review Board. Participants will
be randomly assigned to two different groups of training using a random number table to
receive either telemedicine care (PTE) or their usual care (PUC).
All the patients will receive in our Institute a comprehensive baseline evaluation conducted
by both the neurologist and the physical therapist specialized in the treatment of PD.
During the baseline evaluation (T0), both PTE and PUC will perform two supervised
familiarization sessions using the same training protocol to be used once at home.
Caregivers are an essential part in the PD patients' home management and rehabilitation and
they therefore will be involved in all educational stages.
Each patient of both groups will receive two types of physical intervention:
1. A traditional custom-tailored rehabilitative exercise program; he will be trained by
the therapist on how to perform the exercises. These exercises will include functional
strengthening, stretching, postural changes and balance activities
2. An aerobic training All patients will be asked to perform these exercises for 60
minutes 3 days/week for three months.
The training phase will last 20 minutes during the first month and 30 minutes over the
second and third month; Training intensity could be progressively increased over the three
months of intervention, Aerobic training familiarization sessions will be performed on the
same ergometer they will receive for home-based training.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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