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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
30
Both groups will receive exercise-based training
Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation
Ankara, Turkey (Türkiye)
Manual dexterity performance - Baseline
Nine Hole Peg test (9-HPT)
Time frame: Assessment will be conducted before the intervention
Manual dexterity performance - Post intervention
Nine Hole Peg test (9-HPT)
Time frame: Assessment will be conducted immediately after the intervention
Finger and hand function - Baseline
Jebsen-Taylor Hand Function Test (JTHFT)
Time frame: Assessment will be conducted before the intervention
Finger and hand function - Post intervention
Jebsen-Taylor Hand Function Test (JTHFT)
Time frame: Assessment will be conducted immediately after the intervention
Upper extremity performance (coordination, dexterity and functioning) - Baseline
Action Research Arm Test (ARAT)
Time frame: Assessment will be conducted before the intervention
Upper extremity performance (coordination, dexterity and functioning) - Post intervention
Action Research Arm Test (ARAT)
Time frame: Assessment will be conducted immediately after the intervention
Isometric hand strength - Baseline
J-Tech ™
Time frame: Assessment will be conducted before the intervention
Isometric hand strength - Post intervention
J-Tech ™
Time frame: Assessment will be conducted immediately after the intervention
Isometric pinch strength - Baseline
Baseline® pinch meter
Time frame: Assessment will be conducted before the intervention
Isometric pinch strength - Post intervention
Baseline® pinch meter
Time frame: 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)
Time frame: 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)
Time frame: 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
Time frame: 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
Time frame: Assessment will be conducted immediately after the intervention
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