Interest of Hydrophysiotherapy Care in Parkinson Disease's Motor and Non-motor Symptoms (THERMAPARK)
Primary Purpose
Interest of Hydrophysiotherapy Care in Parkinson Disease's Non-motor Symptoms
Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Aquatic rehabilitation
Land based physical activities
Conventional rehabilitation
Sponsored by
About this trial
This is an interventional supportive care trial for Interest of Hydrophysiotherapy Care in Parkinson Disease's Non-motor Symptoms focused on measuring Parkinson's disease, Non motor signs, Postural control, Gait, Hydrophysiotherapy
Eligibility Criteria
Inclusion Criteria, patient:
- having get a complete information on study's organization and having given written informed consent,
- affiliated to a social security system,
- suffering from Parkinson's disease (stage 2 or 3 of Hoehn and Yahr),
- with motor fluctuation lower than 25% of awaked time,
- with dyskinesia lower than 25% of awaked time (according to MDS-UPDRS scale),
- with stable pharmacological treatment during the 30 days before study,
- already benefiting of a physiotherapy.
Exclusion Criteria, patients:
- receiving treatment by apomorphine or Duodopa pump,
- benefiting of brain stimulation,
- taking occasionally benzodiazepine,
- with dementia (MDS-UPDRS 1.1 score > 3),
- having had a sprain on a lower limb joint 3 months or less before the beginning of study,
- having head trauma consequences,
- having vertebrae pain,
- with freezing,
- having skin trouble leading to a contraindication of aquatic activities,
- concerned by L. 1121-5, L. 1121-7 and L 1121-8 articles of French public health code.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Other
Arm Label
Aquatic rehabilitation
Land based physical activities
Conventional rehabilitation
Arm Description
Outcomes
Primary Outcome Measures
Change of score on Parkinson's Disease Questionnaire 39 (PDQ 39) after reeducation
Total score to PDQ 39 (between 0 and 156, a lower score being a better outcome), which evaluates quality of life, before and after reeducation
Secondary Outcome Measures
Persistence of change of score on PDQ 39 after reeducation
Total score to Parkinson Disease Questionnaire 39 (between 0 and 156, a lower score being a better outcome), which evaluates quality of life, before and after reeducation.
PDQ 39 sub-scores
Sub-score for each of the 8 fields composing PDQ 39: mobility, activities of daily living, emotional well-being, stigma, social support, cognition, communication and bodily discomfort
Non-Motors Signs (NMS) Questionnaire score
Questionnaire score for NMS (non motor signs) in its globality.
Parkinson Anxiety Scale (PAS) score
Parkinson's Anxiety Scale, evaluating anxiety (between 0 and 30, a lower score being a better outcome).
Parkinson's Disease specific Pain score
King's Parkinson's Disease Pain Scale (KPPS, between 0 and 168, a lower score being a better outcome)
Global Pain score
Visual Analogic Scale (VAS) (between 0 and 10, a lower score being a better score)
Mean Equilibrium path length
Corresponding to the mean path length travelled by displacement of the Centre of Foot Pressure in four conditions (eyes open or closed, firm or foamed support).
Mean Equilibrium ellipse area
Corresponding to the mean ellipse area covered by displacement of the Centre of Foot Pressure in four conditions (eyes open or closed, firm or foamed support)
Ratio of sensory inputs.
Ratio of sensory inputs in postural control (somatosensory, visual and vestibular ratios).
Entropy
Entropy mathematically evaluates the displacements regularity of the Center of Foot Pressure (CoP). If the CoP displacements are regular (lower entropy), intentionally processes are more implicated in postural control regulation. If the CoP displacements are not regular (higher entropy), automatic processes are more implicated in postural control regulation. Entropy comparison between a single and a dual task is analyzed.
Time for Time Up and Go (TUG)
Timed Up and Go
Distance of walking
Distance walked during the 6 min walk test
Walking velocity
Mean velocity during the 6 min walk test.
Step high
Mean step high during the 6 min walk test.
Step length
Mean step length during the 6 min walk test.
Step width
Mean step width during the 6 min walk test.
Subjective effort
Ratio of Perceived Exertion (RPE) score, evaluated by Borg Scale (according to the 6 min walk test). Score is between 6 and 20, 6 being a better outcome.
Full Information
NCT ID
NCT03960931
First Posted
April 12, 2019
Last Updated
June 21, 2019
Sponsor
Central Hospital, Nancy, France
Collaborators
Institut Régional de Médecine Physique et de Réadaptation
1. Study Identification
Unique Protocol Identification Number
NCT03960931
Brief Title
Interest of Hydrophysiotherapy Care in Parkinson Disease's Motor and Non-motor Symptoms
Acronym
THERMAPARK
Official Title
Interest of Hydrophysiotherapy Care in Parkinson Disease's Non-motor Symptoms
Study Type
Interventional
2. Study Status
Record Verification Date
June 2019
Overall Recruitment Status
Unknown status
Study Start Date
July 1, 2019 (Anticipated)
Primary Completion Date
September 30, 2021 (Anticipated)
Study Completion Date
November 30, 2021 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Central Hospital, Nancy, France
Collaborators
Institut Régional de Médecine Physique et de Réadaptation
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
Parkinson Disease (PD) is a neurodegenerative disorder who begin around 55 years old, characterized by brain's backmatter's dopamine neuron destruction, involved in motor control. Diagnosis is made with presence of 3 of 4 disease's cardinal sign: bradykinesia, rigidity, resting tremor, walking troubles. Treatments enhance patient's quality of life, but do not allow to stop disease's evolution, who is specific depending on a lot of factors. For some years, PD's non motor symptoms (NMS) - in particular pain, anxiety, depression, sleep disorders - have been highlighted and turn out to impair sometimes quality of life even though motor symptoms are controlled. This project's main aim is to evaluate if aquatic environment's care lead to an advantage on PD's NMS, symptoms currently underestimated, insufficiently in care and having a harmful influence on quality of life. Collaboration of the University Hospital (Neurology Dpt), the Physical Medicine and Rehabilitation Regional Institute, Grand Nancy Thermal, and France Parkinson Association, will allow in this way to offer on PD's NMS, postural control impairments, and walking troubles an alternative or further non-pharmacological therapy.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Interest of Hydrophysiotherapy Care in Parkinson Disease's Non-motor Symptoms
Keywords
Parkinson's disease, Non motor signs, Postural control, Gait, Hydrophysiotherapy
7. Study Design
Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
126 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Aquatic rehabilitation
Arm Type
Experimental
Arm Title
Land based physical activities
Arm Type
Experimental
Arm Title
Conventional rehabilitation
Arm Type
Other
Intervention Type
Other
Intervention Name(s)
Aquatic rehabilitation
Other Intervention Name(s)
Hydrophysiotherapy
Intervention Description
Rehabilitation sessions using hydrophysiotherapy will occur in a pool of Grand Nancy Thermal, three times per week during 4 weeks, and each will last 45 min. They will begin with 10 min of warm-up, then 30 min of walking. Sessions will end cool-down during 5 min, which will be a reduction of intensity every 30 sec. Rehabilitation will be carried out by physiotherapist chosen for the study.
Intervention Type
Other
Intervention Name(s)
Land based physical activities
Intervention Description
Rehabilitation sessions on treadmill will occur at Physical Medicine and Rehabilitation Regional Institute (IRR), on the University Hospital's site, three times per week during 4 weeks, and each will last 45 min. They will begin with 10 min of warm-up, then 30 min of walking, where intensity of effort can be modulated by speed and inclination of treadmill. Sessions will end cool-down during 5 min, which will be a reduction of intensity every 30 sec. Rehabilitation will be carried out by physiotherapist chosen for the study.
Intervention Type
Other
Intervention Name(s)
Conventional rehabilitation
Intervention Description
Conventional rehabilitation sessions will occur in private practices in which patients receive their habitual care (same physiotherapist). This care will be guided by prescription delivered by the neurologist. This prescription suggests to work on active and passive upper and lower limb stretching, on hip and shoulder dissociation, and balance control management on unstable ground.
Primary Outcome Measure Information:
Title
Change of score on Parkinson's Disease Questionnaire 39 (PDQ 39) after reeducation
Description
Total score to PDQ 39 (between 0 and 156, a lower score being a better outcome), which evaluates quality of life, before and after reeducation
Time Frame
Day 1, day 28 (+7)
Secondary Outcome Measure Information:
Title
Persistence of change of score on PDQ 39 after reeducation
Description
Total score to Parkinson Disease Questionnaire 39 (between 0 and 156, a lower score being a better outcome), which evaluates quality of life, before and after reeducation.
Time Frame
Day 28(+7), day 56 (+/-7)
Title
PDQ 39 sub-scores
Description
Sub-score for each of the 8 fields composing PDQ 39: mobility, activities of daily living, emotional well-being, stigma, social support, cognition, communication and bodily discomfort
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Non-Motors Signs (NMS) Questionnaire score
Description
Questionnaire score for NMS (non motor signs) in its globality.
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Parkinson Anxiety Scale (PAS) score
Description
Parkinson's Anxiety Scale, evaluating anxiety (between 0 and 30, a lower score being a better outcome).
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Parkinson's Disease specific Pain score
Description
King's Parkinson's Disease Pain Scale (KPPS, between 0 and 168, a lower score being a better outcome)
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Global Pain score
Description
Visual Analogic Scale (VAS) (between 0 and 10, a lower score being a better score)
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Mean Equilibrium path length
Description
Corresponding to the mean path length travelled by displacement of the Centre of Foot Pressure in four conditions (eyes open or closed, firm or foamed support).
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Mean Equilibrium ellipse area
Description
Corresponding to the mean ellipse area covered by displacement of the Centre of Foot Pressure in four conditions (eyes open or closed, firm or foamed support)
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Ratio of sensory inputs.
Description
Ratio of sensory inputs in postural control (somatosensory, visual and vestibular ratios).
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Entropy
Description
Entropy mathematically evaluates the displacements regularity of the Center of Foot Pressure (CoP). If the CoP displacements are regular (lower entropy), intentionally processes are more implicated in postural control regulation. If the CoP displacements are not regular (higher entropy), automatic processes are more implicated in postural control regulation. Entropy comparison between a single and a dual task is analyzed.
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Time for Time Up and Go (TUG)
Description
Timed Up and Go
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Distance of walking
Description
Distance walked during the 6 min walk test
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Walking velocity
Description
Mean velocity during the 6 min walk test.
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Step high
Description
Mean step high during the 6 min walk test.
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Step length
Description
Mean step length during the 6 min walk test.
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Step width
Description
Mean step width during the 6 min walk test.
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
Title
Subjective effort
Description
Ratio of Perceived Exertion (RPE) score, evaluated by Borg Scale (according to the 6 min walk test). Score is between 6 and 20, 6 being a better outcome.
Time Frame
Day 1, day 28 (+7), day 56 (+/-7)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria, patient:
having get a complete information on study's organization and having given written informed consent,
affiliated to a social security system,
suffering from Parkinson's disease (stage 2 or 3 of Hoehn and Yahr),
with motor fluctuation lower than 25% of awaked time,
with dyskinesia lower than 25% of awaked time (according to MDS-UPDRS scale),
with stable pharmacological treatment during the 30 days before study,
already benefiting of a physiotherapy.
Exclusion Criteria, patients:
receiving treatment by apomorphine or Duodopa pump,
benefiting of brain stimulation,
taking occasionally benzodiazepine,
with dementia (MDS-UPDRS 1.1 score > 3),
having had a sprain on a lower limb joint 3 months or less before the beginning of study,
having head trauma consequences,
having vertebrae pain,
with freezing,
having skin trouble leading to a contraindication of aquatic activities,
concerned by L. 1121-5, L. 1121-7 and L 1121-8 articles of French public health code.
12. IPD Sharing Statement
Learn more about this trial
Interest of Hydrophysiotherapy Care in Parkinson Disease's Motor and Non-motor Symptoms
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