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基于作业的干预措施与有/无责任反馈的常规干预措施对特发性帕金森病患者参与度影响的比较:一项随机对照试验的研究方案。

A comparison of the effects of occupation-based interventions with and without responsibility feedback and conventional interventions on participation in people with idiopathic Parkinson's disease: study protocol for a randomized controlled trial.

机构信息

Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Shahnazari Street, Mirdamad Boulevard, Tehran, Iran.

Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Trials. 2023 Sep 26;24(1):610. doi: 10.1186/s13063-023-07526-3.

Abstract

BACKGROUND

Parkinson's disease (PD) is a neurodegenerative disorder with debilitating motor and non-motor symptoms which affect participation in meaningful occupations. Occupation-based interventions can improve participation in people with PD. Evidence for incorporating structured and intensive occupational therapy by considering the concept of responsibility is lacking for this population. This trial will compare the effects of occupation-based interventions with and without responsibility feedback and conventional interventions on participation in people with idiopathic PD.

METHODS

A total of 45 people with PD, between 35 and 85 years old and Hoehn and Yahr stages between I to III, will be recruited from movement disorder centers for this three-armed study. Participants will be randomized into three groups (occupation-based interventions with responsibility feedback, occupation-based interventions without responsibility feedback, and conventional interventions). All participants will receive intervention for 24 sessions during a period of 12 weeks (2 sessions per week). The primary outcome measure will be participation satisfaction. Participation frequency and restriction, self-perceived performance, performance satisfaction, motivation, volition, sense of agency, responsibility, physical activity, community integration, activities of daily living (ADL), instrumental ADL, upper extremity function, balance, fatigue, and quality of life will be measured as secondary outcome measures. All outcomes will be measured at baseline, session 9, session 17, post-intervention (week 13), and follow-up (week 25).

DISCUSSION

This home-based high-intensity, structured, client-centered, and occupation-based intervention will be conducted by utilizing the concept of responsibility. This proposed trial may result in enhanced participation that would benefit other motor and non-motor symptoms in people living with PD. Findings from this proposed study are expected to expand the knowledge of clinicians and help them in evidence-based decision-making processes.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials IRCT20140304016830N13. Registered on August 19, 2022.

摘要

背景

帕金森病(PD)是一种神经退行性疾病,其致残的运动和非运动症状会影响到有意义的职业参与。基于职业的干预措施可以改善 PD 患者的参与度。对于这一人群,缺乏考虑责任概念的基于职业的强化治疗的证据。本试验将比较基于职业的干预措施与有责任反馈和无责任反馈以及常规干预措施对特发性 PD 患者参与度的影响。

方法

共有 45 名年龄在 35 至 85 岁之间、Hoehn 和 Yahr 分期在 I 至 III 期的 PD 患者将从运动障碍中心招募入组进行这项三臂研究。参与者将被随机分为三组(有责任反馈的基于职业的干预组、无责任反馈的基于职业的干预组和常规干预组)。所有参与者将在 12 周期间接受 24 次干预(每周 2 次)。主要结局指标将是参与满意度。参与频率和限制、自我感知表现、表现满意度、动机、意志力、代理感、责任感、体力活动、社区融入、日常生活活动(ADL)、工具性日常生活活动(IADL)、上肢功能、平衡、疲劳和生活质量将作为次要结局指标进行测量。所有结局都将在基线、第 9 次治疗、第 17 次治疗、干预后(第 13 周)和随访(第 25 周)时进行测量。

讨论

这项基于家庭的高强度、结构化、以客户为中心的基于职业的干预措施将利用责任的概念来进行。这项拟议的试验可能会导致参与度的提高,从而有益于 PD 患者的其他运动和非运动症状。预计这项拟议研究的结果将扩大临床医生的知识,并帮助他们进行基于证据的决策过程。

试验注册

伊朗临床试验注册处 IRCT20140304016830N13。于 2022 年 8 月 19 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/012a/10521555/581d610bfcc6/13063_2023_7526_Fig1_HTML.jpg

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