A long-term self-managed handwriting intervention for people with Parkinson's disease: results from the control group of a phase II randomized controlled trial
Autor: | Hooshang Izadi, Derick T Wade, Martin Tims, Johnny Collett, Charlotte Winward, Helen Dawes, Marko Bogdanovic, Marloes Franssen, Andy Meaney, Wala Mahmoud |
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Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_specialty Handwriting Physical Therapy Sports Therapy and Rehabilitation law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Rating scale law medicine Humans Single-Blind Method 030212 general & internal medicine Mobility Limitation Contraindication Aged Self-management business.industry Self-Management Rehabilitation Parkinson Disease Odds ratio Confidence interval Micrographia Exercise Therapy Physical therapy Female medicine.symptom business 030217 neurology & neurosurgery |
Zdroj: | Clinical rehabilitation. 31(12) |
ISSN: | 1477-0873 |
Popis: | Objective: To report on the control group of a trial primarily designed to investigate exercise for improving mobility in people with Parkinson’s disease (pwP). The control group undertook a handwriting intervention to control for attention and time spent practising a specific activity. Design: Secondary analysis of a two-arm parallel phase II randomized controlled trial with blind assessment. Setting: Community. Participants: PwP able to walk ≥100 m and with no contraindication to exercise were recruited from the Thames Valley, UK, and randomized (1:1) to exercise or handwriting, via a concealed computer-generated list. Intervention: Handwriting was undertaken at home and exercise in community facilities; both were delivered through workbooks with monthly support visits and involved practice for 1 hour, twice weekly, over a period of six months. Main measures: Handwriting was assessed, at baseline, 3, 6 and 12 months, using a pangram giving writing speed, amplitude (area) and progressive reduction in amplitude (ratio). The Movement Disorder Society (MDS)–Unified Parkinson’s Disease Rating Scale (UPDRS) item 2.7 measured self-reported handwriting deficits. Results: In all, 105 pwP were recruited (analysed: n = 51 handwriting, n = 54 exercise). A total of 40 pwP adhered to the handwriting programme, most completing ≥1 session/week. Moderate effects were found for amplitude (total area: d = 0.32; 95% confidence interval (CI): −0.11 to 0.7; P = 0.13) in favour of handwriting over a period of 12 months; effects for writing speed and ratio parameters were small ≤0.11. Self-reported handwriting difficulties also favoured handwriting (UPDRS 2.7: odds ratio (OR) = 0.55; 95% CI: 0.34 to 0.91; P = 0.02). No adverse effects were reported. Conclusion: PwP generally adhere to self-directed home handwriting which may provide benefit with minimal risk. Encouraging effects were found in writing amplitude and, moreover, perceived ability. |
Databáze: | OpenAIRE |
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