4.4 Article

TURN-IT: a novel turning intervention program to improve quality of turning in daily life in people with Parkinson's disease

Journal

BMC NEUROLOGY
Volume 22, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12883-022-02934-5

Keywords

Parkinson disease; Turning; Physical rehabilitation; Falls; Inertial sensors

Funding

  1. NIH [R01 HD100383]
  2. National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) [UL1TR002369]
  3. NIH Roadmap for Medical Research [UL1TR002369]

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This study aims to explore the effects of rehabilitation on turning ability in Parkinson's disease (PD) patients. Sixty PD patients with a history of falls will be randomly assigned to receive a turning intervention or no intervention. Wearable sensors will be used to measure turning quality, and blinded assessments will be conducted to evaluate gait, mobility, and turns. Falls will be monitored for twelve months post intervention through email questionnaires. This study has the potential to change the rehabilitation and assessment of turning in PD patients and may improve daily turning ability and reduce falls.
Background: People with Parkinson's disease (PD) have a high fall rate and many falls are associated with turns. Despite this, there is minimal research on effects of rehabilitation on the quality of turns. Further, quantifying turns in the home may have broader implications since rehabilitation of turns would ideally improve turning in real world mobility. Methods: Sixty people with PD and a history of falls will be randomized to receive either a novel TURNing InTervention (TURN-IT) or no intervention (control group). The TURN-IT group will be seen for 6 weeks (18 visits) for an individualized, progressive program that is based on the specific constraints of turning in PD. Wearable sensors will be used to measure 7 days of mobility, including turns, before and after intervention or control period. In addition, blinded assessments of gait, mobility and turns will occur before and after intervention for both groups and falls will be monitored for twelve months post intervention with bimonthly email questionnaires. Discussion: This study has the potential to change how we rehabilitate and assess turning in people with PD and falls. There are several novel aspects to our study including a comprehensive turning-focused intervention that is tailored to the underlying constraints that impair turning in people with PD. Further, our outcome measure of turning quality during 7 days of daily life is novel and has implications for determining real-life changes after rehabilitation. The ultimate goal of this rehabilitation intervention is to improve how patients turn in daily life and to reduce falls.

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