%0 Journal Article
%T The PIT: SToPP Trial¡ªA Feasibility Randomised Controlled Trial of Home-Based Physiotherapy for People with Parkinson's Disease Using Video-Based Measures to Preserve Assessor Blinding
%A Emma Stack
%A Helen Roberts
%A Ann Ashburn
%J Parkinson's Disease
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/360231
%X Purpose. To trial four-week's physiotherapy targeting chair transfers for people with Parkinson's disease (PwPD) and explore the feasibility of reliance on remote outcome measurement to preserve blinding. Scope. We recruited 47 PwPD and randomised 24 to a focused home physiotherapy programme (exercise, movement strategies, and cueing) and 23 to a control group. We evaluated transfers (plus mobility, balance, posture, and quality of life) before and after treatment and at followup (weeks 0, 4, 8, and 12) from video produced by, and questionnaires distributed by, treating physiotherapists. Participants fed back via end-of-study questionnaires. Thirty-five participants (74%) completed the trial. Excluding dropouts, 20% of questionnaire data and 9% of video data were missing or unusable; we had to evaluate balance in situ. We noted trends to improvement in transfers, mobility, and balance in the physiotherapy group not noted in the control group. Participant feedback was largely positive and assessor blinding was maintained in every case. Conclusions. Intense, focused physiotherapy at home appears acceptable and likely to bring positive change in those who can participate. Remote outcome measurement was successful; questionnaire followup and further training in video production would reduce missing data. We advocate a fully powered trial, designed to minimise dropouts and preserve assessor blinding, to evaluate this intervention. 1. Introduction Chair transfers, a common cause of falls [1, 2], are a key domain of physiotherapy for people with Parkinson¡¯s disease (PwPD) [3¨C5]. While weak lower limbs and inflexible, unstable trunks extend rising time [6¨C10], exercise shortens sit-to-stand times and PwPD can relearn motor sequences, facilitating movement through cueing [3, 4, 11¨C14]. In their 2007 evidence-based analysis of physical therapy in Parkinson¡¯s disease (PD), Keus et al. [3] found supportive evidence for improving the performance of transfers among PwPD in just two studies. The potential to improve transfers among PwPD has been underresearched since Kamsma et al. [11] and Nieuwboer et al. [12] evaluated the use of cognitive movement strategies, the former in a randomised controlled trial (RCT; ), the latter in a nonrandomised controlled trial ( ). Over 12 months, Kamsma et al.¡¯s experimental group (mean age 68 years) practiced a seven-step sequence for safe rising (positioning hands, positioning feet, shifting to the seat edge, repositioning hands, leaning forward, rising into standing, and adopting upright posture), a ¡°logical structure¡± that
%U http://www.hindawi.com/journals/pd/2012/360231/