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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.
- Source :
-
Clinical Rehabilitation . Dec2017, Vol. 31 Issue 12, p1636-1645. 10p. 1 Diagram, 3 Charts. - Publication Year :
- 2017
-
Abstract
- 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 of12 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- *WRITING evaluation
*CHI-squared test
*CONFIDENCE intervals
*EXERCISE
*NEUROPSYCHOLOGICAL tests
*PARKINSON'S disease
*QUESTIONNAIRES
*REHABILITATION
*RESEARCH funding
*HEALTH self-care
*T-test (Statistics)
*SECONDARY analysis
*EFFECT sizes (Statistics)
*RANDOMIZED controlled trials
*BLIND experiment
*DATA analysis software
*DESCRIPTIVE statistics
*ODDS ratio
WRITING
Subjects
Details
- Language :
- English
- ISSN :
- 02692155
- Volume :
- 31
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Clinical Rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 126317429
- Full Text :
- https://doi.org/10.1177/0269215517711232