The Effectiveness of Telerehabilitation in Improving Upper Extremity in Parkinson's Patients

Study Overview
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Brief Summary
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Parkinson's Disease (PD) is a disease that affects the functional skills of the upper extremity with clinical findings such as bradykinesia, rigidity, and hypokinesia and causes limitations in the daily life activities of the patients. Task-oriented training (TOT) is a highly individualized, client-centered, occupational therapy, functional-based intervention compatible with motor learning and motor control principles such as intensive motor training, variable practice, and intermittent feedback. Few studies have been found on the TOT of the upper extremity in PD. Telerehabilitation of Parkinson's patients shows many strengths, such as cost-related and time-dependent ease, and the possibility of telecommunication with clinicians. In addition, the refinement of digital health solutions with the goal to offer a patient-tailored intervention remains an ongoing process. There are a limited number of studies on TOT and telerehabilitation of the upper extremity in PD. In addition, no studies have been found applying TOT through telerehabilitation. For this purpose, a study including TOT-based telerehabilitation in upper extremity education in PD was planned.

Detailed Description
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This study is a randomized controlled study. The patients will be randomly divided into two groups as exercise and control. Balance and walking exercises consisting of 3 days a week for 6 weeks will be given to both groups as a home program. In addition, the exercise group will receive TOT-based telerehabilitation via video conferencing 3 days a week for 6 weeks. TOT will be formed from daily life activities such as reaching out, grasping, writing, and manual skills, which are frequently used in daily life. As the outcome measures, disease severity and disability, finger and hand function, hand strength, and quality of life will be evaluated.

Official Title
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The Effectiveness of Task-Oriented Training Based Telerehabilitation in Improving Upper Extremity Motor Function in Parkinson's Patients

Conditions
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Parkinson Disease

Intervention / Treatment
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* Other: Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 45- 70 years of age Having diagnosed with Parkinson's Disease by a specialist physician Having between 1-3 stages according to the Hoehn and Yahr Scale Mini-Mental Test score more than or equal 24 Exclusion Criteria: - Any orthopedic, vision, hearing, cardiovascular, or perception problems that may affect the research results

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Two groups as exercise group and control group
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Exercise group<br>The group that will receive task-oriented training via telerehabilitation | Other: Exercise<br>* Both groups will receive exercise-based training<br>|
| Placebo Comparator: Control group<br>The control group only will be given a home program that includes walking and balance exercises | Other: Exercise<br>* Both groups will receive exercise-based training<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Manual dexterity performance - Baseline | Nine Hole Peg test (9-HPT) | Assessment will be conducted before the intervention | 
| Manual dexterity performance - Post intervention | Nine Hole Peg test (9-HPT) | Assessment will be conducted immediately after the intervention | 
| Finger and hand function - Baseline | Jebsen-Taylor Hand Function Test (JTHFT) | Assessment will be conducted before the intervention | 
| Finger and hand function - Post intervention | Jebsen-Taylor Hand Function Test (JTHFT) | Assessment will be conducted immediately after the intervention | 
| Upper extremity performance (coordination, dexterity and functioning) - Baseline | Action Research Arm Test (ARAT) | Assessment will be conducted before the intervention | 
| Upper extremity performance (coordination, dexterity and functioning) - Post intervention | Action Research Arm Test (ARAT) | Assessment will be conducted immediately after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Isometric hand strength - Baseline | J-Tech ™ | Assessment will be conducted before the intervention | 
| Isometric hand strength - Post intervention | J-Tech ™ | Assessment will be conducted immediately after the intervention | 
| Isometric pinch strength - Baseline | Baseline® pinch meter | Assessment will be conducted before the intervention | 
| Isometric pinch strength - Post intervention | Baseline® pinch meter | Assessment will be conducted immediately after the intervention | 
| Disease severity and disability - Baseline | MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The MDS-UPDRS has a maximum score of 272 and is composed of four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications) (UPDRS). (0= best , 272= worst) | Assessment will be conducted before the intervention | 
| Disease severity and disability - Post intervention | MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The MDS-UPDRS has a maximum score of 272 and is composed of four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications) (UPDRS). (0= best , 272= worst) | Assessment will be conducted immediately after the intervention | 
| Health-related Quality of Life - Baseline | Parkinson's Disease Questionnaire 8 (PDQ-8). There are 8 questions in total and each question is scored from 0-4 points. High score indicates decreased quality of life | Assessment will be conducted before the intervention | 
| Health-related Quality of Life - Post intervention | Parkinson's Disease Questionnaire 8 (PDQ-8). There are 8 questions in total and each question is scored from 0-4 points. High score indicates decreased quality of life | Assessment will be conducted immediately after the intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Parkinson Disease, Telerehabilitation, Task-oriented, upper extremity