一种针对帕金森病患者居家运动认知功能的新型电子健康干预措施的可行性研究。

Feasibility of a novel eHealth intervention for Parkinson's disease targeting motor-cognitive function in the home.

机构信息

Stockholm Sjukhem Foundation, R&D unit, Stockholm, Sweden.

Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 83, Sweden.

出版信息

BMC Neurol. 2024 Apr 5;24(1):114. doi: 10.1186/s12883-024-03614-2.

DOI:10.1186/s12883-024-03614-2

PMID:38580913

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10996106/

Abstract

BACKGROUND

Parkinson's disease (PD) drastically affects motor and cognitive function, but evidence shows that motor-cognitive training improves disease symptoms. Motor-cognitive training in the home is scarcely investigated and eHealth methods can provide continual support for PD self-management. Feasibility testing is however required.

OBJECTIVE

To assess the feasibility (i) Recruitment capability (ii) Acceptability and Suitability (iii) Demand and Safety of a home-based motor-cognitive eHealth exercise intervention in PD.

METHODS

The 10-week intervention was delivered using the ExorLive® application and exercises were individually adapted and systematically progressed and targeted functional strength, cardiovascular fitness, flexibility, and motor-cognitive function. People with mild-to moderate PD were assessed before and after the intervention regarding; gait performance in single and dual-task conditions; functional mobility; dual-task performance; balance performance; physical activity level; health related quality of life and perceived balance confidence and walking ability; global cognition and executive function. Feasibility outcomes were continuously measured using a home-exercise diary and contact with a physiotherapist. Changes from pre- and post-intervention are reported descriptively.

RESULTS

Fifteen participants (mean age 68.5 years) commenced and 14 completed the 10-week intervention. In relation to intervention Acceptability, 64% of the motor sessions and 52% of motor-cognitive sessions were rated as "enjoyable". Concerning Suitability, the average level of exertion (Borg RPE scale) was light (11-12). Adherence was high, with 86% of all (420) sessions reported as completed. No falls or other adverse events occurred in conjunction with the intervention.

CONCLUSIONS

This motor-cognitive eHealth home exercise intervention for PD was safe and feasible in terms of Recruitment capability, Acceptability, Safety and Demand. The intensity of physical challenge needs to be increased before testing in an efficacy trial.

TRIAL REGISTRATION

This trial is registered at Clinicaltrials.gov (NCT05027620).

摘要

背景

帕金森病（PD）严重影响运动和认知功能，但有证据表明，运动认知训练可以改善疾病症状。家庭中的运动认知训练研究甚少，而电子健康（eHealth）方法可以为 PD 的自我管理提供持续支持。然而，需要进行可行性测试。

目的

评估基于家庭的运动认知 eHealth 运动干预在 PD 中的可行性，包括（i）招募能力；（ii）可接受性和适宜性；（iii）需求和安全性。

方法

该 10 周的干预通过 ExorLive®应用程序进行，运动单独进行适应，并系统地进行进展，以针对功能力量、心血管健康、灵活性和运动认知功能。在干预前后，通过单任务和双任务条件下的步态表现、功能性移动能力、双任务表现、平衡表现、身体活动水平、健康相关生活质量以及平衡信心和行走能力的感知、整体认知和执行功能等方面，评估轻度至中度 PD 患者。使用家庭运动日记和与物理治疗师的联系，持续测量可行性结果。描述性报告干预前后的变化。

结果

15 名参与者（平均年龄 68.5 岁）开始并完成了 10 周的干预。关于干预的可接受性，64%的运动课程和 52%的运动认知课程被评为“愉快”。关于适宜性，平均用力水平（Borg RPE 量表）为轻度（11-12）。依从性很高，报告完成了 86%的所有（420）课程。干预过程中未发生跌倒或其他不良事件。