Goal-oriented Intervention in Parkinson's Disease

Study Overview
=================
Brief Summary
-----------------
Upper-limb disorders in patients with Parkinson's disease include decreased speed and amplitude of movements, difficulty in sequential tasks, and disrupted execution of fine manipulative hand activities.The aim of the study was to evaluate the effects of home-based goal-oriented upper limb intervention in patients with Parkinson's disease.

Detailed Description
-----------------
Parkinson's disease is a neurodegenerative neurological disorders involving progressive impairment in motor, mood and cognitive functions. Movement disorders have a negative impact on individual's ability to perform well-learned motor skills. These include akinesia, bradykinesia, rigidity and tremor at rest. A goal-planning process should be useful to ensure that patients agree on the goals of rehabilitation. Thus, the purpose of the study was to evaluate the effects of home-based goal-oriented upper limb intervention in patients with Parkinson's disease.

Official Title
-----------------
Effects of a Goal-oriented Upper-limb Intervention in Patients With Parkinson's Disease

Conditions
-----------------
Parkinson's Disease

Intervention / Treatment
-----------------
* Other: Goal-oriented upper-limb intervention
* Other: Standard upper limb intervention


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Clinical diagnosis of Parkinson's Disease. Stage II-III of disease progression as defined by the Hoehn and Yahr scale. Upper limbs impairment Exclusion Criteria: Clinical signs of dementia or psychiatric disturbance. Comprehension deficits that prevented them from following verbal commands. Visual or acoustic limitations. A neurologic condition other than Parkinson's Disease. Musculoskeletal disorders and/or if they had previous trauma or fracture of upper extremity.

Ages Eligible for Study
-----------------
Minimum Age: 50 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental group<br>Patients in the experimental group received a Goal-oriented upper limb intervention. | Other: Goal-oriented upper-limb intervention<br>* The Goal-oriented upper-limb intervention evaluated patients' expectations and the environmental factors influencing the performance of the specific task were identified for each of the three tasks. Patients were asked to perform the activity at home. After this, the observable target behavior corresponding to the target activity was determined. Then, an occupational and a physical therapist worked together with the patient to identify the assistance required to perform this activity such as human assistance, technical aids, assistive devices or verbal guidance.<br>|
| Active Comparator: Control group<br>Patients in the control group received a standard upper limb intervention | Other: Standard upper limb intervention<br>* The standard upper limb intervention involved active upper limb range of motion, manual dexterity involving grasp and manipulation of small pieces such as marbles and stretching upper limb exercises.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Goals attainment | Attainment of goals was assessed using the Goal Attainment Scaling, a method for quantifying progress on the achievement of specific goals | Change from baseline goals attainment assessment at 4 weeks. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Manual dexterity | Manual dexterity was assessed using Purdue Pegboard test (one task with the dominant hand, one with the non-dominant hand, one with both hands and assembly task). | Change from baseline manual dexterity at 4 weeks | 
| Handgrip strength | Handgrip strength was assessed using a dynamometer | Change from baseline handgrip strength at 4 weeks | 
| Finger prehension force | Finger prehension force was assessed using a pinch meter | Change from baseline finger prehension force at 4 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
upper limbs, physiotherapy