帕金森病的行为改变:一项随机对照可行性研究,旨在促进帕金森病患者的体育锻炼和坚持锻炼:研究方案

L. Ahern, Suzanne Timmons, Sarah E. Lamb, R. McCullagh
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摘要

背景 帕金森病是一种常见的进行性神经系统疾病,以运动和非运动障碍为特征。体育活动和锻炼可以改善健康状况,但许多帕金森病患者(PwP)难以达到建议的运动量。我们最近的文献综述发现,通过改变行为的干预措施,患者坚持锻炼的情况有所改善,但目前仍不清楚哪些干预措施最为有效。通过进一步的定性研究以及患者和公众的参与,我们提出了一种新的行为改变干预方法,该方法将与现有的锻炼计划一起进行测试。目的 研究行为改变技术与运动计划一起实施的可行性,以改善残疾人的体育锻炼、功能和自我效能(以及研究程序),为未来的 RCT 试验提供参考。方法 平行臂单盲随机可行性研究。将从物理治疗初级保健候诊名单中招募 20 名帕金森病患者(Hoehn 和 Yahr 1-3 期)。在获得书面同意和基线评估后,参与者将被随机分配到干预组(10 人)或对照组(10 人)。两组都将接受常规护理,包括每周一次的多学科教育、有指导的锻炼课程和规定的家庭锻炼计划。干预组将接受额外的行为改变技术,主要针对行为调节、能力信念和社会影响。将记录课堂和家庭锻炼的坚持情况、行为成分的吸收和坚持情况以及负面事件。结果将包括入学率和保持率、身体功能、跌倒、体育锻炼和运动自我效能,在为期 12 周的计划前后进行测量(面对面)。调查将用于比较各组之间的体验和满意度。仅对干预组进行退出访谈,了解他们对行为改变技术的体验。讨论 根据干预的可接受性、同意率、维持率和方案的完整性,研究结果将有助于为未来的试验性 RCT 提供信息。试验注册 ClincialTrials.gov NCT06192628
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Behavioural change for Parkinson’s Disease: A randomised controlled feasibility study to promote physical activity and exercise adherence among people with Parkinson’s: study protocol
Background Parkinson’s is a common progressive neurological condition characterized by motor and non-motor deficits. Physical activity and exercise can improve health, but many people with Parkinson’s (PwP) have trouble reaching the recommended dosage. Our recent literature review found improvements in exercise adherence with behavioural change interventions, but it remains unclear which are most effective. Further qualitative research and patient and public involvement has informed a novel behavioural change intervention to be tested alongside an existing exercise program. Objective To examine the feasibility of behavioural change techniques delivered alongside an exercise programme to improve physical activity, function, and self-efficacy in PwP (and study procedures) to inform a future pilot RCT trial. Methods A parallel-arm single blinded randomised feasibility study. Twenty participants with Parkinson’s (Hoehn and Yahr stage 1-3) will be recruited from a physiotherapy primary-care waiting list. Following written consent, and baseline assessment, the participants will be randomly allocated to the intervention (n=10) or the control group (n=10). Both groups will receive usual care, which includes a weekly program of a multidisciplinary education, a supervised exercise class and a prescribed home exercise program. The intervention group will receive additional behavioural change techniques, targeting behaviour regulation, belief about capabilities and social influences. Class and home exercise adherence, behavioural component uptake and adherence, and negative events will be recorded. Outcomes will include enrolment and maintenance rates, physical function, falls, physical activity, and exercise self-efficacy measured pre- and post- the 12-week program (in-person). Surveys will be used to compare experiences and satisfaction between groups. Exit interviews will be completed with the intervention group only, exploring their experience of the behavioural change techniques. Discussion The results will help inform a future pilot RCT, based on the intervention acceptability, consent rate, maintenance, and protocol integrity. Trial Registration ClincialTrials.gov NCT06192628
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