Gwak Jiyoung, Park Jinse
Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, Korea (the Republic of).
BMJ Neurol Open. 2024 Aug 30;6(2):e000796. doi: 10.1136/bmjno-2024-000796. eCollection 2024.
This study aimed to evaluate the efficacy of acceptance and commitment therapy (ACT) in reducing the fear of falling (FOF) and promoting physical activity in individuals diagnosed with Parkinson's disease (PD).
This is a prospective, multicentre, rater-blinded and randomised controlled trial. Patients with PD and a history of falls will be randomly assigned to either an 8-week ACT intervention group or a control group receiving standard care. The primary outcomes measured will include FOF assessment using the Falls Efficacy Scale-International and physical activity levels measured via wearable sensor devices. Secondary outcomes will encompass the assessment of motor function, balance and fall frequency using the Movement Disorder Society Unified Parkinson's Disease Rating Scale, Berg Balance Scale and Timed Up and Go test. Objective measures of balance and physical activity will be obtained through static posturography and wearable sensors over a 3-day period, both before and after the intervention. Data will be analysed using mixed-effects models to evaluate the impact of ACT on FOF and physical activity.
We hypothesised that ACT would lead to a significant reduction in FOF and an increase in physical activity levels compared with standard care. Additionally, this study will also examine the relationship between reduced FOF and improvements in balance and motor function. Our results will provide valuable evidence to support the effectiveness of ACT in reducing FOF and promoting physical activity among patients with PD, and if validated, ACT could be recommended as a beneficial intervention to enhance the quality of life and reduce fall-related morbidity in patients with PD.
本研究旨在评估接受与承诺疗法（ACT）在降低帕金森病（PD）患者跌倒恐惧（FOF）及促进其身体活动方面的疗效。
这是一项前瞻性、多中心、评估者盲法的随机对照试验。有跌倒史的PD患者将被随机分配至接受为期8周ACT干预的试验组或接受标准护理的对照组。所测量的主要结局将包括使用国际跌倒效能量表进行的FOF评估，以及通过可穿戴传感器设备测量的身体活动水平。次要结局将包括使用运动障碍协会统一帕金森病评定量表、伯格平衡量表和计时起立行走测试对运动功能、平衡能力和跌倒频率进行评估。在干预前后的3天内，通过静态姿势描记法和可穿戴传感器获取平衡能力和身体活动的客观测量数据。将使用混合效应模型分析数据，以评估ACT对FOF和身体活动的影响。
我们假设，与标准护理相比，ACT将导致FOF显著降低，身体活动水平提高。此外，本研究还将考察FOF降低与平衡能力及运动功能改善之间的关系。我们的研究结果将为支持ACT在降低PD患者FOF及促进其身体活动方面的有效性提供有价值的证据，并且如果得到验证，ACT可被推荐为一种有益的干预措施，以提高PD患者的生活质量并降低与跌倒相关的发病率。
