Is Remote Physiotherapy Effective for People With Early Parkinson's (PEEP)

Summary

Participation Requirements

Description

The Principle research question is: To explore the experience and opinions of people with Parkinson's in relation to physiotherapy and exercise in early disease. To develop a physiotherapy exercise intervention for people with early Parkinson's disease using insights from patients and professionals....

The Principle research question is: To explore the experience and opinions of people with Parkinson's in relation to physiotherapy and exercise in early disease. To develop a physiotherapy exercise intervention for people with early Parkinson's disease using insights from patients and professionals. To explore the feasibility of a future definitive randomised controlled trial, which would investigate the clinical and cost effectiveness of the physiotherapy intervention The project has 3 elements: A survey of people with Parkinson's exploring their views about physiotherapy and exercise. A feasibility randomised trial of Parkinson's versus usual care for people with Parkinson's. A qualitative process evaluation exploring view of participants, research nurses and treating physiotherapists on the acceptability and of the intervention and the research assessments. Survey of people with Parkinson's: Online and paper survey will be available for people with Parkinson's to complete. The survey will be posted on the Parkinson's UK website. The survey will be open to UK residents with Parkinson's who have been diagnosed within the last 4 years. Feasibility Randomised Controlled Trial The project will also consist of a Feasibility trial of physiotherapy for early Parkinson's versus usual care. Randomised controlled trial. Blinded assessment of outcomes. Parallel group design. Patient will be followed up at 3 and 6 months after the baseline visit. The RCT will be set in two NHS tertiary care centres. At baseline, the following study procedures will be completed. Eligibity assessment by the PI or delegated research team member. 1. Demographics, medical history, medication history, physical examination (DOB, Height, Weight, Sex) The following Standard Questionnaires will be completed at the baseline visit. Montreal cognitive assessment (MoCA). This is a measure of cognition widely used in Parkinson's clinics (38). PDQ-39. UPDRS. This is a Parkinson's assessment tool that includes subsections looking at motor symptoms and signs, non-motor symptoms, activities of daily living and mood. SF-12. This is a measure of health related quality of life. Where the participant with Parkinson's has a carer who has agreed to take part in the study the investigator will ask the carer to complete this assessment. LPAS Mini-BEST Tragus to wall distance. Activity diaries: Participants will be given an activity diary and asked to record their activity over the next 7 days (starting the day after the initial visit). The activity diary will be returned to the research team in a pre-paid addressed envelope that will be provided to the participant. Activity monitors: The research nurse will provide each participant with a activity monitor and provide instruction on how to use and charge at home. The monitor will be provided fully charged. The device will be worn on the wrist. Participants will be asked to wear the device for the next 7 days. The device can be worn while showering or swimming. The device should then be returned to the research team in a stamped addressed envelope provided, along with the completed activity diary. The main outcomes of interest from the activity monitors will be average daily step count and active minutes/day. For Participants randomised to the intervention arm, they will attend an initial assessment visit followed by 4 physiotherapy intervention visits. At each of these 5 visits, a checklist will be completed by the physiotherapist to document what has been delivered as part of the intervention. The following assessments will take place at 3 months and 6 months after baseline visit. Medication history. PDQ-39 SF-12 Number of falls 7 day activity diary Activity monitor (7days) LPAS Tragus to wall Record of outside of study therapy interventions. Adverse event register The outcome assessor will be asked if they have been unblinded. The mini-BEST will be measured at 3 months. Qualitative Process evaluation. Both staff and participants will be interviewed to explore views on care and the intervention. Interviews will last roughly 1 hour. Interviews will include: 6-10 physiotherapists 6-8 Participants from the Randomised controlled trial 2-4 Research Nurses from the Randomised controlled trial.

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