A novel conceptual framework for balance training in Parkinson’s disease-study protocol for a randomised controlled trial
Identifieur interne : 000153 ( Main/Exploration ); précédent : 000152; suivant : 000154A novel conceptual framework for balance training in Parkinson’s disease-study protocol for a randomised controlled trial
Auteurs : David Conradsson [Suède] ; Niklas Löfgren [Suède] ; Agneta St Hle [Suède] ; Maria Hagströmer [Suède] ; Erika Franzén [Suède]Source :
- BMC Neurology [ 1471-2377 ] ; 2012.
Abstract
There is increasing scientific knowledge about the interaction between physiological (musculoskeletal, neuromuscular, cognitive and sensory) systems and their influence on balance and walking impairments in Parkinson’s disease. We have developed a new conceptual framework for balance training, emphasising specific components of balance control related to Parkinson’s disease symptoms by using highly challenging, progressive and varying training conditions. The primary aim of this proposed randomised controlled trial will be to investigate the short-term and long-term effects of a 10-week balance training regime in elderly with Parkinson’s disease.
Eighty participants with mild to moderate idiopathic Parkinson’s disease will be recruited and randomly allocated to an intervention group receiving balance training or a control group whose participants will continue to receive their usual care. The intervention will consist of a 10-week group training regime (1-hour training, three times per week), which will be led by two physiotherapists to ensure training progression and safety. The conceptual framework will be applied by addressing specific balance components (sensory integration, anticipatory postural adjustments, motor agility, stability limits) through varying training conditions and structured progression. Assessment will be conducted through a multi-dimensional battery of outcomes, prior to and immediately after the 10-week intervention, and at 9 and 15 months’ follow-up after entering the study. Primary outcome measures will be balance performance (assessed using the Mini Balance Evaluation Systems Test), change in gait velocity (m/s) between single and dual task walking, and fear of falling (evaluated using the Fall Efficacy Scale International).
This study has the potential to provide new insight and knowledge of the effects of specific, varied and challenging balance training on a wide health spectrum in elderly with PD. If found to be effective, this pragmatic approach with translation of theory into practice, can be implemented in existing outpatient care.
NCT01417598
Url:
DOI: 10.1186/1471-2377-12-111
PubMed: 23017069
PubMed Central: 3482553
Affiliations:
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Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, 23100, SE-14183, Huddinge, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, 23100, SE-14183, Huddinge</wicri:regionArea><wicri:noRegion>Huddinge</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Physical Therapy, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Lofgren, Niklas" sort="Lofgren, Niklas" uniqKey="Lofgren N" first="Niklas" last="Löfgren">Niklas Löfgren</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, 23100, SE-14183, Huddinge, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, 23100, SE-14183, Huddinge</wicri:regionArea><wicri:noRegion>Huddinge</wicri:noRegion></affiliation></author><author><name sortKey="St Hle, Agneta" sort="St Hle, Agneta" uniqKey="St Hle A" first="Agneta" last="St Hle">Agneta St Hle</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, 23100, SE-14183, Huddinge, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, 23100, SE-14183, Huddinge</wicri:regionArea><wicri:noRegion>Huddinge</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Physical Therapy, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Hagstromer, Maria" sort="Hagstromer, Maria" uniqKey="Hagstromer M" first="Maria" last="Hagströmer">Maria Hagströmer</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, 23100, SE-14183, Huddinge, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, 23100, SE-14183, Huddinge</wicri:regionArea><wicri:noRegion>Huddinge</wicri:noRegion></affiliation></author><author><name sortKey="Franzen, Erika" sort="Franzen, Erika" uniqKey="Franzen E" first="Erika" last="Franzén">Erika Franzén</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, 23100, SE-14183, Huddinge, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, 23100, SE-14183, Huddinge</wicri:regionArea><wicri:noRegion>Huddinge</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="I2">Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Physical Therapy, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author></analytic><series><title level="j">BMC Neurology</title><idno type="eISSN">1471-2377</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>There is increasing scientific knowledge about the interaction between physiological (musculoskeletal, neuromuscular, cognitive and sensory) systems and their influence on balance and walking impairments in Parkinson’s disease. We have developed a new conceptual framework for balance training, emphasising specific components of balance control related to Parkinson’s disease symptoms by using highly challenging, progressive and varying training conditions. The primary aim of this proposed randomised controlled trial will be to investigate the short-term and long-term effects of a 10-week balance training regime in elderly with Parkinson’s disease.</p></sec><sec><title>Methods/Design</title><p>Eighty participants with mild to moderate idiopathic Parkinson’s disease will be recruited and randomly allocated to an intervention group receiving balance training or a control group whose participants will continue to receive their usual care. The intervention will consist of a 10-week group training regime (1-hour training, three times per week), which will be led by two physiotherapists to ensure training progression and safety. The conceptual framework will be applied by addressing specific balance components (sensory integration, anticipatory postural adjustments, motor agility, stability limits) through varying training conditions and structured progression. Assessment will be conducted through a multi-dimensional battery of outcomes, prior to and immediately after the 10-week intervention, and at 9 and 15 months’ follow-up after entering the study. Primary outcome measures will be balance performance (assessed using the Mini Balance Evaluation Systems Test), change in gait velocity (m/s) between single and dual task walking, and fear of falling (evaluated using the Fall Efficacy Scale International).</p></sec><sec><title>Discussion</title><p>This study has the potential to provide new insight and knowledge of the effects of specific, varied and challenging balance training on a wide health spectrum in elderly with PD. If found to be effective, this pragmatic approach with translation of theory into practice, can be implemented in existing outpatient care.</p></sec><sec><title>Trial registration</title><p>NCT01417598</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Dorsey, Er" uniqKey="Dorsey E">ER Dorsey</name></author><author><name sortKey="Constantinescu, R" uniqKey="Constantinescu R">R Constantinescu</name></author><author><name sortKey="Thompson, Jp" uniqKey="Thompson J">JP Thompson</name></author><author><name sortKey="Biglan, Km" uniqKey="Biglan K">KM Biglan</name></author><author><name sortKey="Holloway, Rg" uniqKey="Holloway R">RG Holloway</name></author><author><name sortKey="Kieburtz, K" uniqKey="Kieburtz K">K Kieburtz</name></author><author><name sortKey="Marshall, Fj" uniqKey="Marshall F">FJ Marshall</name></author><author><name sortKey="Ravina, Bm" uniqKey="Ravina B">BM Ravina</name></author><author><name sortKey="Schifitto, 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first="Erika" last="Franzén">Erika Franzén</name><name sortKey="Hagstromer, Maria" sort="Hagstromer, Maria" uniqKey="Hagstromer M" first="Maria" last="Hagströmer">Maria Hagströmer</name><name sortKey="Lofgren, Niklas" sort="Lofgren, Niklas" uniqKey="Lofgren N" first="Niklas" last="Löfgren">Niklas Löfgren</name><name sortKey="St Hle, Agneta" sort="St Hle, Agneta" uniqKey="St Hle A" first="Agneta" last="St Hle">Agneta St Hle</name><name sortKey="St Hle, Agneta" sort="St Hle, Agneta" uniqKey="St Hle A" first="Agneta" last="St Hle">Agneta St Hle</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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