Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom.
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.
PLoS One. 2022 Oct 7;17(10):e0275738. doi: 10.1371/journal.pone.0275738. eCollection 2022.
Visual and cognitive dysfunction are common in Parkinson's disease and relate to balance and gait impairment, as well as increased falls risk and reduced quality of life. Vision and cognition are interrelated (termed visuo-cognition) which makes intervention complex in people with Parkinson's (PwP). Non-pharmacological interventions for visuo-cognitive deficits are possible with modern technology, such as combined mobile applications and stroboscopic glasses, but evidence for their effectiveness in PwP is lacking. We aim to investigate whether technological visuo-cognitive training (TVT) can improve visuo-cognitive function in PwP. We will use a parallel group randomised controlled trial to evaluate the feasibility and acceptability of TVT versus standard care in PwP. Forty PwP who meet our inclusion criteria will be randomly assigned to one of two visuo-cognitive training interventions. Both interventions will be carried out by a qualified physiotherapist in participants own homes (1-hour sessions, twice a week, for 4 weeks). Outcome measures will be assessed on anti-parkinsonian medication at baseline and at the end of the 4-week intervention. Feasibility of the TVT intervention will be assessed in relation to safety and acceptability of the technological intervention, compliance and adherence to the intervention and usability of equipment in participants homes. Additionally, semi structured interviews will be conducted to explore participants' experience of the technology. Exploratory efficacy outcomes will include change in visual attention measured using the Trail Making Test as well as changes in balance, gait, quality of life, fear of falling and levels of activity. This pilot study will focus on the feasibility and acceptability of TVT in PwP and provide preliminary data to support the design of a larger, multi-centre randomised controlled trial. This trial is registered at isrctn.com (ISRCTN46164906).
视觉和认知功能障碍在帕金森病中很常见，与平衡和步态障碍有关，还会增加跌倒风险和降低生活质量。视觉和认知相互关联（称为视认知），这使得对帕金森病患者（PwP）的干预变得复杂。现代技术可以为视认知缺陷提供非药物干预，例如结合移动应用程序和频闪眼镜，但缺乏其在 PwP 中有效性的证据。我们旨在研究技术视认知训练（TVT）是否可以改善 PwP 的视认知功能。我们将使用平行组随机对照试验来评估 TVT 与 PwP 标准护理相比的可行性和可接受性。符合我们纳入标准的 40 名 PwP 将被随机分配到两种视认知训练干预措施之一。两种干预措施都将由合格的物理治疗师在参与者自己的家中进行（每次 1 小时，每周 2 次，持续 4 周）。在基线和 4 周干预结束时，将根据抗帕金森药物评估结果测量。将根据技术干预的安全性和可接受性、对干预的依从性和参与者家中设备的可用性来评估 TVT 干预的可行性。此外，还将进行半结构化访谈，以探讨参与者对技术的体验。探索性疗效结果将包括使用连线测试测量的视觉注意力变化，以及平衡、步态、生活质量、跌倒恐惧和活动水平的变化。这项初步研究将侧重于 TVT 在 PwP 中的可行性和可接受性，并提供初步数据支持更大规模、多中心随机对照试验的设计。这项试验在 isrctn.com（ISRCTN46164906）注册。
