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Parkinson's Disease (PD) is a disease that affects the functional skills of the upper extremity with clinical findings such as bradykinesia, rigidity, and hypokinesia and causes limitations in the daily life activities of the patients. Task-oriented training (TOT) is a highly individualized, client-centered, occupational therapy, functional-based intervention compatible with motor learning and motor control principles such as intensive motor training, variable practice, and intermittent feedback. Few studies have been found on the TOT of the upper extremity in PD. Telerehabilitation of Parkinson's patients shows many strengths, such as cost-related and time-dependent ease, and the possibility of telecommunication with clinicians. In addition, the refinement of digital health solutions with the goal to offer a patient-tailored intervention remains an ongoing process. There are a limited number of studies on TOT and telerehabilitation of the upper extremity in PD. In addition, no studies have been found applying TOT through telerehabilitation. For this purpose, a study including TOT-based telerehabilitation in upper extremity education in PD was planned.
This study is a randomized controlled study. The patients will be randomly divided into two groups as exercise and control. Balance and walking exercises consisting of 3 days a week for 6 weeks will be given to both groups as a home program. In addition, the exercise group will receive TOT-based telerehabilitation via video conferencing 3 days a week for 6 weeks. TOT will be formed from daily life activities such as reaching out, grasping, writing, and manual skills, which are frequently used in daily life. As the outcome measures, disease severity and disability, finger and hand function, hand strength, and quality of life will be evaluated.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Exercise group | Experimental | The group that will receive task-oriented training via telerehabilitation |
|
| Control group | Placebo Comparator | The control group only will be given a home program that includes walking and balance exercises |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exercise | Other | Both groups will receive exercise-based training |
|
| Measure | Description | Time Frame |
|---|---|---|
| Manual dexterity performance - Baseline | Nine Hole Peg test (9-HPT) | Assessment will be conducted before the intervention |
| Manual dexterity performance - Post intervention | Nine Hole Peg test (9-HPT) | Assessment will be conducted immediately after the intervention |
| Finger and hand function - Baseline | Jebsen-Taylor Hand Function Test (JTHFT) | Assessment will be conducted before the intervention |
| Finger and hand function - Post intervention | Jebsen-Taylor Hand Function Test (JTHFT) | Assessment will be conducted immediately after the intervention |
| Upper extremity performance (coordination, dexterity and functioning) - Baseline | Action Research Arm Test (ARAT) | Assessment will be conducted before the intervention |
| Upper extremity performance (coordination, dexterity and functioning) - Post intervention | Action Research Arm Test (ARAT) | Assessment will be conducted immediately after the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Isometric hand strength - Baseline | J-Tech ™ | Assessment will be conducted before the intervention |
| Isometric hand strength - Post intervention | J-Tech ™ |
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Inclusion Criteria:
Exclusion Criteria:
- Any orthopedic, vision, hearing, cardiovascular, or perception problems that may affect the research results
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| Name | Affiliation | Role |
|---|---|---|
| Sefa Eldemir, PT, MSc. | Research Assistant | Study Chair |
| Arzu Güçlü-Gündüz, PT, PhD. | Professor | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation | Ankara | Turkey (Türkiye) |
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| Label | URL |
|---|---|
| Related info | View source |
| Related info | View source |
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There is not a plan to make IPD data but when the statistical analysis of all data is made, all results will be shared.
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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Two groups as exercise group and control group
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| Assessment will be conducted immediately after the intervention |
| Isometric pinch strength - Baseline | Baseline® pinch meter | Assessment will be conducted before the intervention |
| Isometric pinch strength - Post intervention | Baseline® pinch meter | Assessment will be conducted immediately after the intervention |
| Disease severity and disability - Baseline | MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The MDS-UPDRS has a maximum score of 272 and is composed of four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications) (UPDRS). (0= best , 272= worst) | Assessment will be conducted before the intervention |
| Disease severity and disability - Post intervention | MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The MDS-UPDRS has a maximum score of 272 and is composed of four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications) (UPDRS). (0= best , 272= worst) | Assessment will be conducted immediately after the intervention |
| Health-related Quality of Life - Baseline | Parkinson's Disease Questionnaire 8 (PDQ-8). There are 8 questions in total and each question is scored from 0-4 points. High score indicates decreased quality of life | Assessment will be conducted before the intervention |
| Health-related Quality of Life - Post intervention | Parkinson's Disease Questionnaire 8 (PDQ-8). There are 8 questions in total and each question is scored from 0-4 points. High score indicates decreased quality of life | Assessment will be conducted immediately after the intervention |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |