Bek Judith, Holmes Paul S, Craig Chesney E, Franklin Zoë C, Sullivan Matthew, Webb Jordan, Crawford Trevor J, Vogt Stefan, Gowen Emma, Poliakoff Ellen
Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Health, Psychology and Communities Research Centre, Department of Psychology, Manchester Metropolitan University, Manchester, UK.
Parkinsons Dis. 2021 Jul 23;2021:4559519. doi: 10.1155/2021/4559519. eCollection 2021.
Parkinson's disease (PD) causes difficulties with hand movements, which few studies have addressed therapeutically. Training with action observation (AO) and motor imagery (MI) improves performance in healthy individuals, particularly when the techniques are applied simultaneously (AO + MI). Both AO and MI have shown promising effects in people with PD, but previous studies have only used these separately.
This article describes the development and pilot testing of an intervention combining AO + MI and physical practice to improve functional manual actions in people with PD.
The home-based intervention, delivered using a tablet computer app, was iteratively designed by an interdisciplinary team, including people with PD, and further developed through focus groups and initial field testing. Preliminary data on feasibility were obtained via a six-week pilot randomised controlled trial (ISRCTN 11184024) of 10 participants with mild to moderate PD (6 intervention; 4 treatment as usual). Usage and adherence data were recorded during training, and semistructured interviews were conducted with participants. Exploratory outcome measures included dexterity and timed action performance.
Usage and qualitative data provided preliminary evidence of acceptability and usability. Exploratory outcomes also suggested that subjective and objective performance of manual actions should be tested in a larger trial. The importance of personalisation, choice, and motivation was highlighted, as well as the need to facilitate engagement in motor imagery.
The results indicate that a larger RCT is warranted, and the findings also have broader relevance for the feasibility and development of AO + MI interventions for PD and other conditions.
帕金森病（PD）会导致手部运动困难，针对这一问题进行治疗的研究较少。通过动作观察（AO）和运动想象（MI）进行训练可提高健康个体的表现，尤其是当这两种技术同时应用时（AO + MI）。AO和MI在帕金森病患者中均显示出有前景的效果，但以往研究仅单独使用过这些方法。
本文描述了一种结合AO + MI与身体练习的干预措施的开发及初步测试，该措施旨在改善帕金森病患者的功能性手部动作。
基于平板电脑应用程序进行的家庭干预由包括帕金森病患者在内的跨学科团队进行迭代设计，并通过焦点小组和初步现场测试进一步完善。通过一项为期六周的10名轻度至中度帕金森病患者的初步随机对照试验（ISRCTN 11184024，6名接受干预；4名接受常规治疗）获得了可行性的初步数据。在训练期间记录使用情况和依从性数据，并对参与者进行半结构化访谈。探索性结局指标包括灵活性和定时动作表现。
使用情况和定性数据提供了可接受性和可用性的初步证据。探索性结局还表明，应在更大规模的试验中测试手部动作的主观和客观表现。强调了个性化、选择和动机的重要性，以及促进参与运动想象的必要性。
结果表明有必要进行更大规模的随机对照试验，这些发现对于针对帕金森病和其他病症的AO + MI干预措施的可行性和开发也具有更广泛的相关性。
