Faculty of Medicine, Academic Geriatric Medicine, University of Southampton, Southampton SO17 1BJ, UK.
Parkinsons Dis. 2012;2012:360231. doi: 10.1155/2012/360231. Epub 2011 Oct 20.
Purpose. To trial four-week's physiotherapy targeting chair transfers for people with Parkinson's disease (PwPD) and explore the feasibility of reliance on remote outcome measurement to preserve blinding. Scope. We recruited 47 PwPD and randomised 24 to a focused home physiotherapy programme (exercise, movement strategies, and cueing) and 23 to a control group. We evaluated transfers (plus mobility, balance, posture, and quality of life) before and after treatment and at followup (weeks 0, 4, 8, and 12) from video produced by, and questionnaires distributed by, treating physiotherapists. Participants fed back via end-of-study questionnaires. Thirty-five participants (74%) completed the trial. Excluding dropouts, 20% of questionnaire data and 9% of video data were missing or unusable; we had to evaluate balance in situ. We noted trends to improvement in transfers, mobility, and balance in the physiotherapy group not noted in the control group. Participant feedback was largely positive and assessor blinding was maintained in every case. Conclusions. Intense, focused physiotherapy at home appears acceptable and likely to bring positive change in those who can participate. Remote outcome measurement was successful; questionnaire followup and further training in video production would reduce missing data. We advocate a fully powered trial, designed to minimise dropouts and preserve assessor blinding, to evaluate this intervention.
目的。针对帕金森病患者(PwPD)进行为期四周的针对椅子转移的物理治疗试验,并探索依赖远程结果测量来保持盲法的可行性。范围。我们招募了 47 名 PwPD,并将 24 名随机分为聚焦家庭物理治疗计划(锻炼、运动策略和提示)组和 23 名对照组。我们在治疗前、治疗后和随访(0、4、8 和 12 周)时通过治疗物理治疗师拍摄的视频和分发的问卷评估转移(加上移动性、平衡、姿势和生活质量)。参与者通过结束研究的问卷反馈。35 名参与者(74%)完成了试验。不包括脱落者,20%的问卷数据和 9%的视频数据缺失或无法使用;我们不得不进行现场平衡评估。我们注意到物理治疗组的转移、移动和平衡有改善趋势,而对照组则没有。参与者的反馈大多是积极的,在所有情况下都保持了评估者的盲法。结论。在家中进行强化、集中的物理治疗似乎是可以接受的,并且可能会给那些能够参与的人带来积极的变化。远程结果测量是成功的;问卷随访和进一步的视频制作培训将减少缺失数据。我们提倡进行一项充分的试验,旨在尽量减少脱落并保持评估者的盲法,以评估这种干预措施。