Telerehabilitation Dual-Task Training for Parkinson's: A Multidimensional Evaluation

Official title

Multidimensional Evaluation of the Effectiveness of Telerehabilitation-Based Dual-Task Training in Parkinson's Patients

Overview

In this clinical study, the aim is to assess the effectiveness of telerehabilitation-based dual-task training in improving balance and gait function among individuals diagnosed with Parkinson's Disease. Parkinson's Disease is characterized by motor symptoms such as tremors and slowness of movement, as well as cognitive impairments. While medical treatments help manage symptoms, exercise programs are vital for enhancing physical and cognitive functions. Dual-task training involves combining motor and cognitive activities to enhance gait and balance control, and recent studies have shown its effectiveness in Parkinson's Disease rehabilitation. However, there's limited research on delivering dual-task training through telerehabilitation and determining the optimal content for maximum benefits. This project involves 30 Parkinson's Disease patients who will be randomly assigned to three groups receiving different dual-task exercise programs via telerehabilitation. Each program focuses on combining balance and functional exercises with either cognitive or motor secondary activities. The exercises will be performed three times a week for four weeks under the guidance of a physiotherapist via Zoom. Before and after the intervention, participants will be evaluated for feasibility, gait, balance, cognition, and activity levels. Researchers of this study hypothesize that telerehabilitation-based dual-task training will significantly improve balance and gait function in Parkinson's Disease patients, offering a convenient and effective treatment option to enhance their quality of life.

Interventions

• Other Cognitive-Motor Dual Task Activities
  Patients included in this group will be given additional cognitive tasks (e.g. counting months, subtracting 5 from 100) in accordance with the physiotherapist's commands simultaneously with balance and large amplitude functional activities (such as stepping forward-sideways-backwards, sitting and standing).
• Other Motor-Motor Dual Task Activities
  Patients included in this group will be given additional motor tasks (e.g. passing the ball from the right hand to the left hand while standing on a soft surface, clapping) in accordance with the physiotherapist's commands simultaneously with balance and large amplitude functional activities (such as stepping forward-sideways-backwards, sitting and standing).
• Other Cognitive-Motor & Motor-Motor Dual Task Activities
  Simultaneously with balance and large amplitude functional activities (such as stepping forwards-sideways-backwards, sitting and standing), patients included in this group will be given additional cognitive (e.g. counting while standing with feet closed) and motor (e.g. passing the ball from the right hand to the left hand while standing on a soft surface) tasks in accordance with the physiotherapist's commands.

Primary outcome measures

• Feasibility Assessment [Time frame: Baseline and after the interventions (4th week)]
• Digit Span Test [Time frame: Baseline and after the interventions (4th week)]
• Mental Flexibility [Time frame: Baseline and after the interventions (4th week)]
• Word Fluency Test [Time frame: Baseline and after the interventions (4th week)]
• Gait Assessment [Time frame: Baseline and after the interventions (4th week)]
• Mini-BEST Test [Time frame: Baseline and after the interventions (4th week)]
• Four-step square test [Time frame: Baseline and after the interventions (4th week)]
• Postural Stability Assessment [Time frame: Baseline and after the interventions (4th week)]
• Parkinson's Activity Scale [Time frame: Baseline and after the interventions (4th week)]
• Dual Task Questionnaire [Time frame: Baseline and after the interventions (4th week)]

Eligibility criteria

Inclusion criteria

• Diagnosed with idiopathic Parkinson's Disease
• Stage 1-3 on the Hoehn-Yahr scale
• A minimum score of 21 on the Montreal Cognitive Assessment Scale test
• Stable drug treatment within the last 1 month
• Patients are in the "On" period
• Ability to walk independently on level ground (3 and above according to Functional Ambulation Classification)

Exclusion criteria

• Serious hearing or vision problems
• Having other neurological, cardiovascular or orthopaedic disorders that may prevent walking
• Any other neurological disorder (e.g. dementia, cerebrovascular disease)
• less than 5 years of education
• To have vascular lower extremity pathologies
• Not having internet access via smartphone or computer

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Double blind

Primary purpose

Treatment

Study locations

Turkey (Türkiye) · 1 center

• Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hast — Istanbul

Identifiers

NCT: NCT06416722 · 28.03.2024/ 59

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗