A New 3D Virtual Reality-based Upper Limb Training to Improve Dexterity in Parkinson's Disease

Study Overview
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Brief Summary
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We investigate the impact of a 4-week virtual reality-based upper limb training in Parkinson's disease. The benefits on dexterity of this training program will be evaluated. For these purposes, a randomised, two arm, single assessor blind, parallel design with a monocentric, study setup will be performed.

Detailed Description
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Patients with Parkinson's disease (PD) suffer from significantly decreased coordination and have difficulties with precise hand/finger movements during the performance of both basic activities of daily living (ADL), such as dressing, grooming as well as higher ADL, such as cooking, shopping and regular medication intake. These difficulties further add to the burden of the disease, leading to reduced quality of life (QoL). A relatively new, but rapidly growing aspect of training in PD neurorehabilitation offers virtual reality (VR). We explore the effects of a VR-based upper limb hand training compared to a VR control training, which is less specific for dexterity. Moreover, we examine the effetcs of the trainings on upper limb related ADL, and therefore the impact on QoL in patients with PD.

Official Title
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A New 3D Virtual Reality-based Upper Limb Training to Improve Dexterity in Parkinson's Disease: a Randomized Pilot Study

Conditions
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Parkinson Disease

Intervention / Treatment
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* Other: virtual reality upper limb hand training
* Other: virtual reality control training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with confirmed PD, according to UK Brain bank Criteria Hoehn & Yahr Stadium I to IV Age 40 to 99 years written and signed informed consent self-reported dexterous difficulties Exclusion Criteria: MoCA <21/30 psychiatric disease participation on other interventional trials Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. severe visual impairment

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 99 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: Randomized pilot study
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Virtual reality upper limb hand training<br>The PD patients randomized in the experimental group will receive virtual reality upper limb hand training. | Other: virtual reality upper limb hand training<br>* The PD patients randomized in the experimental group will receive virtual reality upper limb hand training.<br>|
| Other: Virtual reality control training<br>The PD patients randomized in the control group will receive virtual reality control training. | Other: virtual reality control training<br>* The PD patients randomized in the control group will receive virtual reality control training.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| fine finger movements | Coin rotation task (CRT): The CRT measures fine coordinated finger movements and is a suitable and valid dexterity test in patients with PD. The seconds for 20 halfturns will be measured. | 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| hand dexterity | Nine Hole Peg test (9-HPT): The 9-HPT is a standardized, well established, and reliable measure of hand dexterity in patients with PD. seconds will be measured. | 4 weeks | 
| grip strenght | The handheld JAMAR dynamometer measures the grip strength. kg will be measured. | 4 weeks | 
| motor function | MDS-Sponsored Revision of the Unified Parkinson Disease Rating Scale (MDS-UPDRS III): It evaluates motor aspects of Parkinson's disease | 4 weeks | 
| self-reported dexterity related problems in daily living | Dexterity Questionnaire 24 (DextQ-24): This questionnaire is a standardized patient self-rated outcome measure (PROM) for evaluating dexterity related ADL in PD. score range 24-96, higher scores mean more dexterity problems. | 4 weeks | 
| self-reported problems in quality of life | Parkinson's Disease Questionnaire (PDQ-39): This questionnaire is a standardized patient self-rated outcome measure (PROM) for evaluating QOL in PD. range 0-156, higher values mean more problems. | 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Parkinson Disease, virtual reality training, dexterity, Parkinsonian Disorders, Basal Ganglia Diseases, Brain Diseases, Central Nervous System Diseases, Nervous System Diseases, Movement Disorders, Neurodegenerative Diseases