Telemedicine Intervention for Chronic Pain in Parkinson's Disease
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: VA Office of Research and Development
Must be taking: Dopaminergic medication
Disqualifiers: Angina, Recent MI, Ventricular dysrhythmia
No Placebo Group
Trial Summary
What is the purpose of this trial?This trial tests home-based physical and mental exercises to reduce pain in Veterans with Parkinson's disease. The exercises aim to make the body stronger and the mind more focused, helping to lessen the feeling of pain.
Do I need to stop my current medications for this trial?
The trial protocol does not specify whether you need to stop taking your current medications. However, since the study involves exercise interventions and not medication changes, you may not need to stop your current medications.
What data supports the effectiveness of the treatment Telemedicine Intervention for Chronic Pain in Parkinson's Disease?
Research shows that home-based physical and cognitive exercises, supported by telehealth, can improve motor skills, cognitive function, and quality of life in Parkinson's patients. Telerehabilitation programs have been effective in increasing adherence to exercise and improving mobility and confidence, even in remote settings.
12345Is telemedicine intervention for chronic pain in Parkinson's disease safe?
Research on home-based exercise programs and telerehabilitation for Parkinson's disease shows that these interventions are generally safe, with no reported adverse effects. They are feasible and well-received by participants, improving adherence and quality of life.
12678How is the telemedicine intervention for chronic pain in Parkinson's disease different from other treatments?
This treatment is unique because it combines cognitive and physical exercises that patients can do at home, using telemedicine to provide remote support and guidance. This approach helps overcome barriers like travel costs and time, making it more accessible and convenient, especially during situations like the COVID-19 pandemic.
13569Eligibility Criteria
This trial is for individuals with Parkinson's Disease who experience chronic pain. Participants must have a physician's diagnosis of idiopathic PD, show at least two key symptoms (resting tremor, rigidity, or slow movement), and respond to medication that increases dopamine. It excludes those with recent heart issues like angina or myocardial infarction within the last six months.Inclusion Criteria
My condition improves with dopamine medication.
I have been diagnosed with Parkinson's disease by a doctor.
I show at least 2 key symptoms of Parkinson's disease.
Exclusion Criteria
I am currently being treated for irregular heartbeats.
I have had a heart attack in the last 6 months.
I have chest pain due to heart problems.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive either cognitive exercise, physical exercise, combined interventions, or health education for 3 months
3 months
Remote access technology used for interventions
Follow-up
Participants are monitored for changes in pain severity after treatment
3 months
Participant Groups
The study tests home-based physical and cognitive exercises along with health education as interventions to reduce pain in Parkinson's patients using telemedicine. This could help veterans maintain these practices indefinitely through remote access technology.
4Treatment groups
Experimental Treatment
Active Control
Group I: Physical exercise interventionExperimental Treatment1 Intervention
Participants will receive the physical exercise intervention for 3 months.
Group II: Combined physical and cognitive exercise interventionExperimental Treatment2 Interventions
Participants will receive both the physical exercise intervention and the cognitive exercise intervention for 3 months.
Group III: Cognitive exercise interventionExperimental Treatment1 Intervention
Participants will receive the cognitive exercise intervention for 3 months.
Group IV: Control groupActive Control1 Intervention
Participants will receive health education for 3 months.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MABoston, MA
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Who Is Running the Clinical Trial?
VA Office of Research and DevelopmentLead Sponsor
References
Tele-Rehabilitation with Virtual Reality: A Case Report on the Simultaneous, Remote Training of Two Patients with Parkinson Disease. [2023]Physical training in Parkinson disease improves motor performance, alleviates nonmotor symptoms, and enhances cognition and quality of life. Nonetheless, adherence to exercise is low and travel costs and time may limit participation and compliance. Training at home can help avoid these burdens and, as needed during the recent global pandemic (COVID-19), reinforce social distancing and reduce the risk of infection. However, training at home requires motivation and self-control and telerehabilitation is time-consuming for both patient and therapist. In recent years, there is growing use of virtual reality and exergaming to increase motivation and adherence for exercising with evidence of improvements in mobility and balance after using virtual reality in the clinic. Here, a novel telerehabilitation training program using a treadmill-virtual reality system for simultaneous training of two patients with Parkinson disease in their homes is described. Remote monitoring software enabled visual and auditory communication with the two patients, allowing the trainer to adapt the settings remotely and provide feedback. Participants received weekly training sessions over 1 yr. The findings show high adherence to training, increased walking duration throughout the sessions, and increased patient confidence, gait speed, and mobility. Training multiple participants simultaneously was feasible, enabling an individualized treatment approach while conserving therapist time.
Design of the STEPS trial: a phase II randomized controlled trial evaluating eHealth-supported motor-cognitive home training for Parkinson's disease. [2023]Electronic health (eHealth) technology offers the potential to support and motivate physical activity for symptom management in Parkinson's disease (PD). It is also recommended that motor exercise in PD be complemented with cognitive training aimed at attentional or executive functions. This paper describes the protocol for a double-blind randomized controlled trial to evaluate the effects of motor-cognitive training in the home environment, supported by eHealth.
Feasibility and effectiveness of a remote individual rehabilitation program for people with Parkinson's disease living in the Brazilian Amazon: a randomized clinical trial. [2023]Parkinson's disease (PD) is a chronic and progressive neurodegenerative disorder, and the current treatment involves pharmacological intervention and physiotherapy. Telerehabilitation, which involves remote support and guidance for patients undergoing rehabilitation, can potentially improve access to physiotherapy services for people with Parkinson's disease, especially those who face geographic barriers to healthcare. The primary aim of this study was to assess the feasibility and efficacy of a telerehabilitation program for people with Parkinson's disease living in an underrepresented community of the Brazilian Amazon. We conducted a parallel-group, single-center, single-blind, phase 2 randomized controlled clinical trial involving 19 participants diagnosed with Parkinson's disease from Belém, Brazil. Participants were assigned to a 4-week individual telerehabilitation program or a booklet-based exercise program (control group). Assessments were conducted before the intervention, immediately after the intervention, and 4 weeks after the end of the intervention. We showed that our telerehabilitation program had high adherence among patients, with minimal adverse effects. Both telerehabilitation and booklet orientation reduced the time to complete the Timed Up and Go test. In conclusion, our telerehabilitation program was feasible and effective for people with Parkinson's disease in an Amazonian setting. This trial was registered at the Registro Brasileiro de Ensaios Clínicos (ReBEC) under the identifier: RBR-6sz837s.
Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease: A Randomized Clinical Trial. [2018]Comparative studies of exercise interventions for people with Parkinson disease (PD) rarely considered how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by (1) home exercise program, (2) individualized physical therapy, or (3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention.
Telehealth For Individuals with Parkinson's Disease During Covid-19 In Brazil: A Prospective Case Series. [2023]To implement a telerehabilitation prevention, treatment, and follow-up physical therapy protocol for monitoring individuals with Parkinson's disease (PD) and to verify its effectiveness in minimizing the deleterious effects of the COVID-19 pandemic.
The effects of an individualized smartphone-based exercise program on self-defined motor tasks in Parkinson's disease: a long-term feasibility study. [2023]Exercise therapy is considered effective for the treatment of motor impairment in patients with Parkinson's disease (PD). During the COVID-19 pandemic, training sessions were cancelled and the implementation of telerehabilitation concepts became a promising solution. The aim of this controlled interventional feasibility study was to evaluate the long-term acceptance and to explore initial effectiveness of a digital, home-based, high-frequency exercise program for PD patients. Training effects were assessed using patient-reported outcome measures combined with sensor-based and clinical scores.
Home-based exercise program for older adults with Motoric Cognitive Risk syndrome: feasibility study. [2021]Aim: We developed a home-based goal-directed exercise program with telephonic coaching to overcome barriers to exercise participation in cognitively impaired older adults. Methods: Six patients with Motoric Cognitive Risk syndrome at high risk for dementia were enrolled, three assigned to goal-directed exercises and three to stretching exercises. All participants underwent an in-person training session followed by a session at home with a telephonic coach. Sessions were supervised by a physiatrist, and exercise programs were personalized. Results: In-person training and remote telephonic coaching support promoted adherence. There were no adverse effects and interventions were rated highly. Participant and logistical barriers were identified that can inform design of home-based clinical trials. Conclusion: Home-based exercises are safe and feasible in older adults with Motoric Cognitive Risk.
Effectiveness of Telerehabilitation on Motor Impairments, Non-motor Symptoms and Compliance in Patients With Parkinson's Disease: A Systematic Review. [2021]Introduction: Parkinson's disease (PD) is a chronic neurodegenerative disease involving a progressive alteration of the motor and non-motor function. PD influences the patient's daily living and reduces participation and quality of life in all phases of the disease. Early physical exercise can mitigate the effects of symptoms but access to specialist care is difficult. With current technological progress, telemedicine, and telerehabilitation is now a viable option for managing patients, although few studies have investigated the use of telerehabilitation in PD. In this systematic review, was investigated whether telerehabilitation leads to improvements in global or specific motor tasks (gait and balance, hand function) and non-motor dysfunction (motor speech disorder, dysphagia). The impact of TR on quality of life and patient satisfaction, were also assessed. The usage of telerehabilitation technologies in the management of cognitive impairment was not addressed. Method: An electronic database search was performed using the following databases: PubMed/MEDLINE, COCHRANE Library, PEDro, and SCOPUS for data published between January 2005 and December 2019 on the effects of telerehabilitation systems in managing motor and non-motor symptoms. This systematic review was conducted in accordance with the PRISMA guideline and was registered in the PROSPERO database (CRD42020141300). Results: A total of 15 articles involving 421 patients affected by PD were analyzed. The articles were divided into two categories based on their topic of interest or outcome. The first category consisted of the effects of telerehabilitation on gait and balance (3), dexterity of the upper limbs (3), and bradykinesia (0); the second category regarded non-motor symptoms such as speech disorders (8) and dysphagia (0). Quality of life (7) and patient satisfaction (8) following telerehabilitation programs were also analyzed, as well as feasibility and costs. Conclusion: Telerehabilitation is feasible in people affected by PD. Our analysis of the available data highlighted that telerehabilitation systems are effective in maintaining and/or improving some clinical and non-clinical aspects of PD (balance and gait, speech and voice, quality of life, patient satisfaction). Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier: CRD42020141300.
Telerehabilitation during social distancing for people with Parkinson's disease: a retrospective study. [2023]Clinical worsening has been common in people with Parkinson's disease (PD) during the social distancing due to pandemic. It is unclear if telerehabilitation applied during social distancing preserves clinical aspects of people with PD who are frequent exercisers before the pandemic. Thus, we compared the effects of 10 months of supervised, home-based, real-time videoconferencing telerehabilitation (SRTT) and nonexercising control on clinical aspects in people with PD who are frequent exercisers before the pandemic.