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The aim of this study is to examine the benefits that individuals with Parkinson's disease will gain from the rehabilitation program by enabling them to manage their exercise times independently using telerehabilitation method.
The main research questions examined in this study are as follows:
Parkinson's Disease (PD) is a movement disorder characterized by motor and non-motor symptoms, changes in the patient's balance and gait patterns, and a significant impact on daily living activities. Physical therapy and rehabilitation play a crucial role in managing the symptoms resulting from PD. It is known that early participation in a rehabilitation program significantly improves patients' quality of life.
Patients need to incorporate exercise prescriptions designed specifically for them into their lives and participate in a lifelong exercise program. While integrating these exercises into their lives, patients encounter certain barriers and lose their motivation to exercise. These barriers can include transportation, economic problems, time management, and motor and non-motor symptoms.
Home-based exercises and telerehabilitation methods emerge as solutions for dealing with transportation, economic problems, and time management. These methods can be seen as important aids in helping patients develop the habit of exercising.
Patients diagnosed with Idiopathic Parkinson's Disease who meet the inclusion criteria and agree to participate in the study will be included. The demographic information (age, occupation, height, body weight, etc.) and clinical status (duration of diagnosis, medication dosage, etc.) of all participants will be recorded. The Montreal Cognitive Assessment Scale will be used to determine the cognitive level of patients. The motor assessment of patients will be performed using the Cognitive Parkinson's Disease Assessment Scale III. The Montreal Cognitive Assessment Scale will be used to determine the cognitive level of patients. Functional balance and mobility will be assessed using the Timed Up and Go Test and the 10-meter Walk Test. Repetitive movement performance will be assessed using the 5 Repeat Sit-to-Stand Test, and balance level will be assessed using the Activity-Specific Balance Confidence Scale. Quality of life will be assessed using the Parkinson's Disease Quality of Life Questionnaire. Motivation to exercise and self-assessment will be determined using the Behavioral Modifications to Exercise Scale-2. These assessment criteria will be re-evaluated before and after the exercise program. Patients will be given an exercise diary and asked to keep it throughout the program. The System Usability Scale will be used to evaluate the usability of the website developed for this thesis study.
Participants will be randomly assigned to 2 groups. The control group will complete the exercise program assigned to them continuously via the web-based system. The experimental group will complete the exercise program assigned to them at their preferred time within the same day. Exercise programs will be planned for 8 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Self-Management Group | Experimental | The self-management group will perform the exercise programme prescribed by the physical therapist and tailored to the patient's needs via a web-based system twice a week for eight weeks, at a time of their choosing. |
|
| Telerehabilitation Group | Active Comparator | Telerehabilitation group will perform the exercise programme prescribed by the physical therapist and tailored to the patient's needs via a web-based system twice a week for eight weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Telerehabilitation | Other | The exercises will consist of stretching, strengthening, balance, and neuromotor exercises that the patient can perform independently at home. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in motor impairment | The Unified Parkinson's Disease Rating Scale (UPDRS) is used to determine the symptoms and clinical severity of PD. The UPDRS-III subscore will be used to assess changes in motor impairment. | Baseline and the end of the 8 weeks exercise program |
| Change in behavioral regulations in exercise | Behavioral Regulations in Exercise Questionnaire-2 consists of 19 items and five subscales. The subscales consist of external regulation, internalized regulation, defined regulation, internal regulation and lack of motivation. It is a 5-point Likert-type scale scored between 0-4. | Baseline and the end of the 8 weeks exercise program |
| Change in lower extremity power and endurance | Five Times Sit to Stand Test will be used to measure repetitive movement performance. The patient will be asked to sit down and stand up 5 times as quickly as possible, and this time will be recorded in seconds. | Baseline and the end of the 8 weeks exercise program |
| Change in walking speed | 10-Meter Walk Test will be applied to assess walking speed. The first 2 meters of the 14-meter distance are allocated for acceleration, the last 2 meters for deceleration, and the time taken to walk the 10-meter distance is recorded. Walking speed is calculated in meters per second. | Baseline and the end of the 8 weeks exercise program |
| Change in mobility | Timed Up and Go Test is used to assess mobility, balance, and risk of falling. The patient is asked to stand up from a chair, walk around a cone 3 meters away, and return to sit on the chair. The total time is recorded using a stopwatch. | Baseline and the end of the 8 weeks exercise program |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Gökçe Kartal | Contact | +905055624837 | gokcekrtl2@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Semra Oğuz, PhD | Marmara University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Marmara University | Recruiting | Maltepe | Istanbul | 34852 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24687205 | Background | Franchignoni F, Giordano A, Ronconi G, Rabini A, Ferriero G. Rasch validation of the Activities-specific Balance Confidence Scale and its short versions in patients with Parkinson's disease. J Rehabil Med. 2014 Jun;46(6):532-9. doi: 10.2340/16501977-1808. | |
| 20947672 | Background | Huang SL, Hsieh CL, Wu RM, Tai CH, Lin CH, Lu WS. Minimal detectable change of the timed "up & go" test and the dynamic gait index in people with Parkinson disease. Phys Ther. 2011 Jan;91(1):114-21. doi: 10.2522/ptj.20090126. Epub 2010 Oct 14. |
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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 |
|---|---|
| D000069350 | Telerehabilitation |
| ID | Term |
|---|---|
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
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| Change in body position | Activities-Specific Balance Confidence is a measure that assesses a person's level of confidence in their balance both indoors and outdoors. It consists of 16 different activities and is rated on a scale from no confidence (-0) to complete confidence (-100). A higher score indicates a greater level of confidence in balance. | Baseline and the end of the 8 weeks exercise program |
| Change in quality of life | The Parkinson's Disease Quality of Life Questionnaire (PDQ-39) will be used to assess quality of life. It consists of 39 items and is composed of 8 sub-parameters: mobility, activities of daily living, stigma, social support, communication, emotional well-being, and physical discomfort. As the score increases, quality of life deteriorates. | Baseline and the end of the 8 weeks exercise program |
| 11518442 | Background | Dean CM, Richards CL, Malouin F. Walking speed over 10 metres overestimates locomotor capacity after stroke. Clin Rehabil. 2001 Aug;15(4):415-21. doi: 10.1191/026921501678310216. |
| 21878213 | Background | Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson's disease. Arch Phys Med Rehabil. 2011 Sep;92(9):1431-6. doi: 10.1016/j.apmr.2011.04.008. |
| 17115387 | Background | Goetz CG, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stebbins GT, Stern MB, Tilley BC, Dodel R, Dubois B, Holloway R, Jankovic J, Kulisevsky J, Lang AE, Lees A, Leurgans S, LeWitt PA, Nyenhuis D, Olanow CW, Rascol O, Schrag A, Teresi JA, Van Hilten JJ, LaPelle N. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan. Mov Disord. 2007 Jan;22(1):41-7. doi: 10.1002/mds.21198. |
| Background | Fahn S. Unified Parkinson's disease rating scale. Recent developments in Parkinson's disease. 1987:153-63. |
| 33848468 | Background | Bloem BR, Okun MS, Klein C. Parkinson's disease. Lancet. 2021 Jun 12;397(10291):2284-2303. doi: 10.1016/S0140-6736(21)00218-X. Epub 2021 Apr 10. |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |
| D013812 |
| Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
| D017216 | Telemedicine |
| D003695 | Delivery of Health Care |
| D010346 | Patient Care Management |
| D006298 | Health Services Administration |