Evaluation of an individualized, tablet-based physiotherapy training programme for patients with Parkinson’s disease: the ParkProTrain study, a quasi-randomised controlled trial

Abstract

Background Regular physical activity is of great relevance in Parkinson's disease (PD). It is part of the inpatient multimodal Parkinson's complex treatment (MKP) in Germany. However, there is often a lack of human resources in outpatient settings to continue an interprofessional approach. A large proportion of PD patients live a predominantly sedentary lifestyle and do not get enough exercise. Methods The intervention group (IG) used a tablet-based physiotherapy training programme at home for a period of nine months. We conducted a quasi-randomised longitudinal study with three measurement times (at the beginning (t0) and end of MKP (t1) and at 9 months after MKP (t2)). The primary outcome measured was PD-specific quality of life using the PDQ-8. The secondary outcome focused on participation restrictions, falling anxiety, sleep disorder, anxiety and depression as well as comorbidity, pain, performance capability and physical activity. Results For n = 93 IG and n = 137 control group (CG) patients, evaluable cases were available for all measurement times. Both groups achieved significant improvements in all parameters at the end of MKP. These parameters deteriorated again at nine months after MKP for most parameters and were even below the baseline levels. However, this deterioration was less pronounced in the IG than in the CG. For general health and social participation, a significant slightly positive effect was observed in the IG nine months after MKP when compared with the baseline level. Paying attention to physical activity slightly increased in the IG for the catamnesis survey compared to baseline. Nearly all IG patients were satisfied with the intervention, especially with the consultations with the physiotherapist. Conclusions Although the expected extent of effects could not be determined for the IG, stabilisation effects could be demonstrated. These stabilisation effects shown for the IG might be attributed to the intervention. The effects might have been greater without the COVID-19 pandemic. Trial registration. German Register of Clinical Trials, drks.de. Identifier: DRKS00014952. Registered 20/06/2018. Date and version identifier 25/04/2019; version 1.

New Strategies to Improve the Quality of Life for Normal Aging versus Pathological Aging

“…Other tools, such as HHIE, IOI-AI, BRCS, and PEG evaluated different impairments and investigated issues of general activities [ 11 , 19 ]. Quality of life for patients with Parkinson’s disease was monitored through PDQ-8 [ 32 , 33 ]. Well-being and status health was assessed through PHQ-4 [ 24 , 32 ].…”

“…Quality of life for patients with Parkinson’s disease was monitored through PDQ-8 [ 32 , 33 ]. Well-being and status health was assessed through PHQ-4 [ 24 , 32 ]. The COSI tool is used to estimate the qualitative improvement of the elderly person’s life [ 19 ].…”

“…Fall risk scores are investigated by FRAT, FaB, FRM, and PROFANE [ 4 , 14 , 43 ]. Fear of falling was evaluated through FES-I and Short FES [ 10 , 13 , 14 , 28 , 31 , 32 , 40 , 41 ]. Different physical activities may be accompanied by risks of falling after several stages of training that can be assessed by: FSST and Mini BEST 28 [ 36 ].…”

“…Other tools will investigate the varying degrees of depression, such as GDS, PHQ-9, and CES-D [ 10 , 11 , 13 , 19 , 22 , 25 , 28 , 43 ]. PDSS-2 assesses by 15 items on a visual scale the quality of sleep in older adults with PD [ 32 ] and the degrees of mental disorder are assessed by CRIq and D-QOL [ 22 , 30 , 38 ]. Monitoring the impairment of cognitive function with aging through these tools justifies the concern regarding the quality-of-life conditions in the elderly either healthy or with neurodegenerative diseases.…”

A study on the effects of the Qihuang Needle therapy on patients with Parkinson's disease

“…Clinical guidelines recommend that these patients have gait rehabilitation as soon as possible (12). Some studies (13)(14)(15) also demonstrated that gait rehabilitation has immediate real-life benefits on FOG symptoms among patients with mild-to-moderate PD. Therefore, subjects were instructed to perform home-based rehabilitation training according to Parkinson's easy quintile, one time in the morning and one time at night.…”