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Plzáková V, Mana J, Růžička E, Nikolai T. Efficacy of non-computerized cognitive rehabilitation in Parkinson's disease: A one year follow up study. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-12. [PMID: 38710156 DOI: 10.1080/23279095.2024.2341808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
In this study, we explored the effect of non-computerized cognitive rehabilitation in patients with Parkinson's disease in comparison with an intervention with elements of music therapy after the completion of a three-month program and one year after the end of the intervention. After the initial neuropsychological examination, the respondents were divided into two intervention groups. The experimental group (n = 26) underwent a twelve-week program of cognitive rehabilitation at a frequency of 60 minutes once a week. The control group (n = 27) underwent an intervention program with elements of music therapy at the same frequency. Respondents who underwent the cognitive rehabilitation program improved in the delayed recall from visual memory in the follow-up examination after the end of the cognitive intervention. One year after the end, the effect of cognitive rehabilitation persisted in delayed recall from visual memory and in executive mental flexibility. Cognitive rehabilitation is an effective approach to compensate for cognitive deficits in P D, but other approaches to cognitive stimulation may be equally effective.
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Affiliation(s)
- Vladimíra Plzáková
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
- Institute of Neuropsychiatric Care, Prague, Czech Republic
- Rehabilitation Hospital Beroun, Beroun, Czech Republic
| | - Josef Mana
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Evžen Růžička
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Tomáš Nikolai
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
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Davies SJ, Gullo HL, Doig E. The Priority Goals and Underlying Impairments Contributing to Goal-Related Problems of People with Parkinson's Disease Receiving a Community-Based Rehabilitation Program. PARKINSON'S DISEASE 2024; 2024:9465326. [PMID: 38716035 PMCID: PMC11074914 DOI: 10.1155/2024/9465326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 05/12/2024]
Abstract
Background Goal setting is a core rehabilitation practice in Parkinson's disease (PD). Targeting therapy towards specific goals leads to greater improvements in performance and psychosocial outcomes. Goal setting in PD is feasible, and although the nature of goals has been described in previous studies, the underlying impairments related to goals have not been described. Understanding the nature of goals ensures that interventions for people with PD are aligned with their needs and priorities. Understanding the underlying impairments highlights which symptoms have the biggest impact on daily life and is necessary for planning appropriate interventions to target them. Aim To describe the nature of the goals of people with PD; the underlying impairments related to goals; and to compare differences between high and low priority goals. Method Deductive content analysis was used to map goal statements to the international classification of function (ICF) activity and participation category and to map therapist field notes detailing the primary underlying impairment to the ICF Body Functions category. These results were then compared across goal priority rankings. Results 88 goals of 22 people with PD were analysed. We found that people with PD set diverse goals across all chapters of the ICF Activity and Participation category, with "self-care" goals making up the highest proportion of goals. The primary underlying impairment related to the goals was predominantly related to impairments in "mental functions" under the Body Functions category. Regardless of goal priority, most goal-related underlying impairments were found to be in the "mental functions" category. Conclusion The goals of this sample of community-dwelling people with PD highlight their diverse needs and priorities. These findings indicate that nonmotor symptoms, namely, executive dysfunction and amotivation most commonly impact the performance of and participation in activities of greatest importance to people with PD. This trial is registered with ACTRN12621001483842.
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Affiliation(s)
- Sarah J. Davies
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- School of Health, University of the Sunshine Coast, Sunshine Coast, Queensland 4556, Australia
| | - Hannah L. Gullo
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Chermside, QLD 4032, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia
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Davies SJ, Gullo HL, Doig E. Efficacy and Feasibility of the CO-OP Approach in Parkinson's Disease: RCT Study Protocol. Can J Occup Ther 2023; 90:363-373. [PMID: 36785891 PMCID: PMC10647899 DOI: 10.1177/00084174231156287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Background. Parkinson's disease (PD) leads to cognitive dysfunction which limits participation and occupational performance. Cognitive Orientation to Daily Occupational Performance (CO-OP) approach is effective in other adult neurological populations and warrants investigation in PD. Purpose. To describe a study protocol evaluating the preliminary efficacy and feasibility of CO-OP approach in PD. Method. A randomised controlled trial (RCT) with adults with PD was assigned to either: CO-OP training-intensive (CO-OP-I, 20 sessions) or waitlist control (WLC) followed by CO-OP-standard (CO-OP-S, 10 sessions). Outcomes. Occupational performance and satisfaction of adults with PD in chosen goals. Measures will be obtained at baseline, post-intervention, and 3-month follow-up. Implications. As the first RCT focused on CO-OP in PD, this trial will provide evidence for the potential of this approach in PD and lay the groundwork for future large-scale trials. Trial Registration. Australian New Zealand Clinical Trials registry, ACTRN12621001483842. Registered November 1, 2021; retrospectively registered 3 months after commencement.
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Affiliation(s)
- Sarah J. Davies
- Sarah J. Davies, School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland 4072, Australia.
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Tonnesen M, Nielsen CV. Navigating (un)certainty in 'downhill' trajectories: An ethnographic study about rehabilitees' and professionals' experiences of goal-setting in Parkinson's disease rehabilitation. Clin Rehabil 2023; 37:1420-1434. [PMID: 37093740 DOI: 10.1177/02692155231170690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
OBJECTIVE To explore rehabilitees' and professionals' experiences of goal-setting in a context of (un)certainty with a progressive neurodegenerative disease and how they navigate this (un)certainty in Parkinson's disease rehabilitation. DESIGN A long-term multi-sited ethnographic fieldwork (2019-2020) following 20 rehabilitees and their goals over time and settings. Observation at 30 goal-setting meetings. PARTICIPANTS Rehabilitees and professionals in Danish Parkinson's disease rehabilitation. Two randomly chosen groups of rehabilitees attending a Parkinson's disease course at a rehabilitation centre participated. METHODS Semi-structured interviews and participant observation. RESULTS Living with Parkinson's disease holds a certainty that the condition will progress yet an uncertainty regarding the pace and severity, as indicated by the notion (un)certainty. The (un)certainty challenges goal-setting. Reflecting on goal-setting, rehabilitees brought forth existential, economical, and societal considerations. Some expressed an ambivalent view, questioning the value of goal-setting with a progressive condition, yet finding own rehabilitation goals relevant. Others expressed a pragmatic view, attuning goals to fit the situation. Professionals found that the visible and invisible symptoms and the uncertain pace of Parkinson's made goal-setting challenging. They had to strike a balance between mentioning symptoms to come, yet not rendering the future too bleak. CONCLUSIONS Rehabilitees and professionals found that setting goals in a condition that progresses is no easy task. They made use of strategies such as observation, repetition, future-proofing strategies, and attuning goals to navigate the (un)certainty. In goal-setting, to maintain functioning with progressive Parkinson's disease was a viable goal. Participants found they just do the best they can to navigate (un)certainty.
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Affiliation(s)
- Merete Tonnesen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Defactum, Central Denmark Region, Aarhus, Denmark
| | - Claus V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Defactum, Central Denmark Region, Aarhus, Denmark
- Region Hospital Gødstrup, Herning, Denmark
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Kang E, Jethani P, Foster ER. Person-centered goal setting is feasible in people with Parkinson's disease who have subjective cognitive decline: a mixed methods study. Disabil Rehabil 2023; 45:90-97. [PMID: 35023794 PMCID: PMC9719695 DOI: 10.1080/09638288.2022.2025930] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/21/2021] [Accepted: 12/31/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE Evaluate the feasibility of person-centered goal setting in people with Parkinson's disease (PD) who have subjective cognitive decline and explore characteristics of the formulated goals. MATERIALS AND METHODS Participants completed person-centered goal setting as a part of two cognitive intervention studies. Participants were guided to develop at least three goals and rate the importance of each goal using a 10-point scale (1: not at all important - 10: extremely important). To evaluate the feasibility of person-centered goal setting, we calculated the mean number of formulated goals per person and the importance level of all goals. To explore goal characteristics, two independent authors coded all goals and synthesized them using deductive content analysis in consultation with the senior author. RESULTS Thirty participants formulated a total of 166 goals. The mean number of formulated goals per participant was 5.53 (SD = 2.22, range = 3 - 10). The mean importance level of all formulated goals was 8.3 (SD = 1.49, range = 4 - 10). Formulated goals ranged across diverse domains and categories. CONCLUSIONS Person-centered goal setting is feasible to guide people with PD to formulate personally meaningful goals. Findings highlight the diverse cognitive rehabilitation needs of people with PD, potential cognitive rehabilitation priorities, and future goal setting research directions.Implications for rehabilitationRehabilitation clinicians and researchers should not assume that people with PD who have subjective cognitive decline are not capable of engaging in their goal setting.Rehabilitation clinicians and researchers should acknowledge and act on our responsibility to enable people with PD who have subjective cognitive decline to engage in goal setting.Rehabilitation clinicians and researchers are encouraged to explore diverse goal domains to optimize goal setting and rehabilitation care among people with PD who have subjective cognitive decline.
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Affiliation(s)
- Eunyoung Kang
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Pooja Jethani
- Program in Occupational Therapy, Louisiana State University of Health Sciences, Shreveport, LA, USA
| | - Erin R. Foster
- Program in Occupational Therapy, Department of Neurology, & Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Tonnesen M, Nielsen CV, Andersen RS. Moving goals. Goal-work in Parkinson's disease rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:819862. [PMID: 36189001 PMCID: PMC9397665 DOI: 10.3389/fresc.2022.819862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/15/2022] [Indexed: 11/13/2022]
Abstract
Chronic diseases often demand considerable work by patients: they must adhere to medical regimes and engage with social and embodied discontinuities. In Denmark, rehabilitees in Parkinson's disease rehabilitation talk about Parkinson's as their new job. In this article, we introduce goal-work as an optical lens to enlarge and explore the micro-social practices that concern a core practice in rehabilitation where professionals and rehabilitees set goals for the future and work toward the goals. To work with goals adds a new task to living with Parkinson's. Rehabilitation research tends to focus on the actual goal-setting meeting. Drawing on data from long-term ethnographic fieldwork on goals and their setting in Parkinson's disease rehabilitation, we show how participants in rehabilitation imagine, set, enact, review or share their rehabilitation goals, and how goals are worked with before and after the goal-setting meeting, across settings. We conceptualize these micro-social practices as goal-work, which we argue is a spatio-temporal process. The concept of goal-work emphasizes the fact that goal-setting is one event in a string of goal-related activities, and it turns our attention to the intersubjective dimensions inherent in goal-work, such as the role of relatives and how acts of imagination and acts of sharing form part of goal-work.
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Affiliation(s)
- Merete Tonnesen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- *Correspondence: Merete Tonnesen
| | - Claus Vinther Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Danish Region, Aarhus, Denmark
- Department of Clinical Social Medicine and Rehabilitation, Region Hospital West Jutland, Herning, Denmark
| | - Rikke Sand Andersen
- Department of Anthropology, Aarhus University, Aarhus, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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Tonnesen M, Nielsen CV, Andersen RS. What are your goals? Goal-setting logics in Danish Parkinson's rehabilitation. Med Anthropol 2022; 41:574-590. [PMID: 35904254 DOI: 10.1080/01459740.2022.2102493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Across rehabilitation fields, rehabilitees and professionals meet to set rehabilitation goals. Portrayed as an ordinary, yet foundational practice in rehabilitation, participants often find goal-setting meetings challenging; ideal and real seem to clash. Based on a long-term fieldwork in Danish Parkinson's disease rehabilitation, we explore goal-setting and its rationale to gain insight into why goal-setting qualifies as challenging. We find that challenges relate to disease, organizational matters and an imbalance in institutional knowledge, but also that different logics, of choice, interdependence, and accountability, entangle and affect goal-setting. A competitive aspect between goal-setting logics appears pivotal to understand the challenges in goal-setting.
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Affiliation(s)
- Merete Tonnesen
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Claus Vinther Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark.,Department of Clinical Social Medicine and Rehabilitation, Region Hospital West Jutland, Herning, Denmark
| | - Rikke Sand Andersen
- Department of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Anthropology, Aarhus University, Aarhus, Denmark
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Foster ER, Carson L, Jonas J, Kang E, Doty T, Toglia J. The Weekly Calendar Planning Activity to Assess Functional Cognition in Parkinson Disease. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:315-323. [PMID: 35713209 DOI: 10.1177/15394492221104075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Weekly Calendar Planning Activity (WCPA) may improve understanding of functional cognition in people with Parkinson disease (PwPD) without dementia. We aimed to determine if WCPA performance (a) discriminates between PwPD with and without cognitive impairment and healthy controls and (b) correlates with other indicators of cognition and daily function. This was a cross-sectional study. Parkinson disease (PD) participants without dementia were divided into normal cognition (PD-NC, n = 25) and possible mild cognitive impairment (PD-MCI, n = 21) groups. Their WCPA performance was compared with that of a normative sample (n = 196) and correlated with neuropsychological test performance and self-reported cognition and participation. Both the PD-MCI and PD-NC groups had impaired WCPA performance. WCPA performance correlated with executive function, processing speed, and self-reported cognition and participation. The WCPA can detect functional cognitive deficits in PwPD without dementia and can inform occupational therapy interventions to support functional cognition, occupational performance, and participation in this population.
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Affiliation(s)
| | | | - Jill Jonas
- Washington University in St. Louis, MO, USA
| | | | - Tasha Doty
- Washington University in St. Louis, MO, USA
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Sheldrake E, McGrath C, Laliberte Rudman D, Holmes J. Understanding Identity Negotiation of Parkinson’s Disease and Occupational Engagement Using Narrative Inquiry. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2021.1989545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Elena Sheldrake
- Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
| | - Colleen McGrath
- School of Occupational Therapy, University of Western Ontario, London, Canada
| | | | - Jeff Holmes
- School of Occupational Therapy, University of Western Ontario, London, Canada
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Giguère-Rancourt A, Plourde M, Racine E, Couture M, Langlois M, Dupré N, Simard M. Goal management training and psychoeducation / mindfulness for treatment of executive dysfunction in Parkinson’s disease: A feasibility pilot trial. PLoS One 2022; 17:e0263108. [PMID: 35180229 PMCID: PMC8856541 DOI: 10.1371/journal.pone.0263108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 01/01/2022] [Indexed: 02/01/2023] Open
Abstract
Introduction As there is currently no pharmacological treatment for Parkinson’s Disease Mild Cognitive Impairment (PD-MCI) with executive dysfunctions, specific cognitive interventions must be investigated. Most previous studies have tested bottom-up cognitive training programs but have not shown very good results. Objectives The aim of this study was to test ease of implementation, differential safety and preliminary efficacy of two top-down (strategy-learning) home-based, individualized, cognitive interventions: Goal Management Training (GMT), adapted for PD-MCI (Adapted-GMT), and a psychoeducation program combined with mindfulness exercises (PSYCH-Mind). Methods This was a single-blind block-randomized between-group comparative study. Twelve PD-MCI with mild executive dysfunctions were divided in four blocks and randomly assigned to any of the two interventions. The participants were included if they had PD-MCI diagnosis (no dementia), with stabilized medication. Both groups (Adapted-GMT and PSYCH-mind) received five intervention sessions each lasting 60–90 minutes for five weeks. Measures were collected at baseline, mid-point, one-week, four-week and 12-week follow-ups. Executive functions were assessed with the Dysexecutive questionnaire (DEX) and the Zoo Map Test (ZMT). Quality of life (QoL) and psychiatric symptoms were also evaluated. Repeated measures ANCOVAs (mixed linear analysis) were applied to all outcomes. Results There was one drop out, and both interventions were feasible and acceptable. Despite the small sample size limiting statistical power, patients of both groups significantly improved executive functions per the DEX-patient (Time: F(4,36) = 2.96, p = 0.033, CI95%: 10.75–15.23) and DEX-caregiver scores (Time: F(4,36) = 6.02, p = 0.017, CI95%: 9.63–17.23). Both groups significantly made fewer errors between measurement times on the ZMT (Time: F(3,36) = 16.66, p = 0.001, CI95%: 1.07–2.93). However, QoL significantly increased only in PSYCH-Mind patients at four-week follow-up (interaction Time*Group: F(4,36) = 5.31, p = 0.002, CI95%: 15.33–25.61). Conclusion Both interventions were easily implemented and proved to be safe. Because both interventions are arguably cost-effective, these pilot findings, although promising, need to be replicated in large samples. ClinicalTrials.gov Identifier NCT04636541.
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Affiliation(s)
| | - Marika Plourde
- School of Psychology, Laval University, Quebec City, Canada
| | - Eva Racine
- School of Psychology, Laval University, Quebec City, Canada
| | | | - Mélanie Langlois
- Department of Medicine, Faculty of Medicine, Laval University, Quebec City, Canada
- Axe Neurosciences du CHU de Québec, Université Laval, Québec, Quebec City, Canada
| | - Nicolas Dupré
- Department of Medicine, Faculty of Medicine, Laval University, Quebec City, Canada
- Axe Neurosciences du CHU de Québec, Université Laval, Québec, Quebec City, Canada
| | - Martine Simard
- School of Psychology, Laval University, Quebec City, Canada
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Sanchez-Luengos I, Balboa-Bandeira Y, Lucas-Jiménez O, Ojeda N, Peña J, Ibarretxe-Bilbao N. Effectiveness of Cognitive Rehabilitation in Parkinson's Disease: A Systematic Review and Meta-Analysis. J Pers Med 2021; 11:jpm11050429. [PMID: 34069980 PMCID: PMC8157874 DOI: 10.3390/jpm11050429] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/30/2021] [Accepted: 05/13/2021] [Indexed: 12/21/2022] Open
Abstract
Cognitive deficits influence the quality of life of Parkinson’s disease (PD) patients. In order to reduce the impact of cognitive impairment in PD, cognitive rehabilitation programs have been developed. This study presents a systematic review and meta-analysis regarding the effectiveness of cognitive rehabilitation in non-demented PD patients. Twelve articles were selected according to PRISMA guidelines. The systematic review showed that attention, working memory, verbal memory, executive functions and processing speed were the most frequently improved domains. Meta-analysis results showed moderate effects on global cognitive status (g = 0.55) and working memory (g = 0.50); small significant effects on verbal memory (g = 0.41), overall cognitive functions (g = 0.39) and executive functions (g = 0.30); small non-significant effects on attention (g = 0.36), visual memory (g = 0.29), verbal fluency (g = 0.27) and processing speed (g = 0.24); and no effect on visuospatial and visuoconstructive abilities (g = 0.17). Depressive symptoms showed small effect (g = 0.24) and quality of life showed no effect (g = −0.07). A meta-regression was performed to examine moderating variables of overall cognitive function effects, although moderators did not explain the heterogeneity of the improvement after cognitive rehabilitation. The findings suggest that cognitive rehabilitation may be beneficial in improving cognition in non-demented PD patients, although further studies are needed to obtain more robust effects.
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Can the Executive Control Network be Used to Diagnose Parkinson's Disease and as an Efficacy Indicator of Deep Brain Stimulation? PARKINSONS DISEASE 2020; 2020:6348102. [PMID: 32148755 PMCID: PMC7042555 DOI: 10.1155/2020/6348102] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 01/07/2020] [Accepted: 01/17/2020] [Indexed: 01/19/2023]
Abstract
Objective The aim of this work was to investigate whether there are differences in the executive control network (ECN) between patients with Parkinson's disease (PD) before and after deep brain stimulation (DBS) surgery and to explore how deep brain stimulation (DBS) surgery affects ECN connectivity in patients with PD. Methods Resting-state magnetic resonance imaging (MRI) data were obtained from 23 patients with Parkinson's disease preoperatively (pre-PD) and postoperatively (post-PD) and 14 normal controls (CN). The right dorsolateral prefrontal cortex (DLPFC) was used as the seed region of interest (ROI) to study the characteristics of the functional connectivity of the ECN in these subjects. Results There were differences in the ECN among PD patients before and after surgery and between the CN. Compared with the CN group, the pre-PD patients showed significantly reduced functional connectivity (FC) between the DLPFC and the left inferior frontal gyrus, left precuneus, left cerebellum posterior lobe, right middle frontal gyrus, right inferior parietal gyrus, right posterior central gyrus, right precuneus, and right inferior frontal gyrus. Compared to the CN group, the post-PD patients showed significantly reduced FC between the DLPFC and left inferior frontal gyrus, left precuneus, left cerebellum posterior lobe, right middle frontal gyrus, right inferior frontal gyrus, and right parietal lobule. There is no difference in the ECN between the pre-PD patients and the post-PD patients. Conclusions The FC of ECN in PD patients was different from that in normal controls, but the FC of the ECN in patients with PD may not be altered by DBS. This suggests that the ECN may be considered an imaging biomarker for the identification of PD but may not be a good imaging biomarker for the evaluation of DBS efficacy.
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Spencer KA, Paul J, Brown KA, Ellerbrock T, Sohlberg MM. Cognitive Rehabilitation for Individuals With Parkinson's Disease: Developing and Piloting an External Aids Treatment Program. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1-19. [PMID: 31697899 DOI: 10.1044/2019_ajslp-19-0078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Cognitive deficits are common in Parkinson's disease (PD) and can have a detrimental effect on daily activities. To date, most cognitive treatments have had an impairment-based focus with primary outcome measures of formal neuropsychological test scores. Few, if any, studies have focused on functional improvement or patient-centered goals. Method Three individuals with idiopathic PD participated in an 8-week pilot treatment program to train for the use of compensatory external aids to achieve personalized goals. Goal attainment scaling was the primary outcome measure, which was independently judged by multiple raters at baseline, postintervention, and 1 month posttreatment and analyzed via T-score analysis. Descriptive measures, including self-report and spouse-report rating scales of cognitive functioning, were employed. Results All 3 participants improved in the majority of their laboratory and home goals posttreatment, as measured by goal attainment scaling, and maintained gains for the majority of goals 1 month posttreatment. Conclusions This is the 1st known study to implement an external aids treatment program with patient-centered goals for individuals with cognitive deficits from PD. Positive outcomes were likely influenced by 3 factors: (a) a theoretically motivated focus on external aids; (b) a well-documented, systematic approach to instruction; and (c) the personalization of goals. Supplemental Material https://doi.org/10.23641/asha.10093493.
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Affiliation(s)
- Kristie A Spencer
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Jennifer Paul
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Katherine A Brown
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Taylor Ellerbrock
- Department of Speech and Hearing Sciences, University of Washington, Seattle
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Swales M, Theodoros D, Hill AJ, Russell T. Communication service provision and access for people with Parkinson's disease in Australia: A national survey of speech-language pathologists. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 21:572-583. [PMID: 30496696 DOI: 10.1080/17549507.2018.1537372] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/30/2018] [Accepted: 10/04/2018] [Indexed: 06/09/2023]
Abstract
Purpose: To determine the clinical practices of Australian speech-language pathologists in the management of communication disorders in people with Parkinson's disease (PwPD) and their perspectives on service provision.Method: A cross-sectional, mix-methods online survey was conducted. Nonprobability, purposive sampling was utilised to recruit speech-language pathologists who currently work with PwPD. Descriptive statistics and thematic analysis were employed.Result: Ninety-nine clinicians responded. Most offered services for both motor speech and cognitive-communication disorders, but a greater focus on the motor speech disorder was evident. A range of impairment and functional assessments and interventions were reported. Therapy was most commonly delivered one session a week over 4 or 6 weeks. Service, client and evidence barriers in the management of both communication disorders were identified. Most clinicians felt PwPD accessed communication services at stages later than optimal, they recognised a need to improve their services in varying degrees (92.3%), and believed not enough services exist for PwPD in Australia (78%). Cognitive-communication management was the highest requested area for further research evidence.Conclusion: This study captured the current practices of Australian speech-language pathologists in the management of communication disorders in PwPD. Findings may inform future service planning, research on service effectiveness and new management targets.
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Affiliation(s)
- Megan Swales
- Division of Speech Pathology, Centre for Research in Telerehabilitation, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia and
| | - Deborah Theodoros
- Division of Speech Pathology, Centre for Research in Telerehabilitation, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia and
| | - Anne J Hill
- Division of Speech Pathology, Centre for Research in Telerehabilitation, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia and
| | - Trevor Russell
- Division of Physiotherapy, Centre for Research in Telerehabilitation, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
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15
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Cognitive Problems in Parkinson Disease: Perspectives and Priorities of Patients and Care Partners. Cogn Behav Neurol 2019; 32:16-24. [DOI: 10.1097/wnn.0000000000000184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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16
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Costa A, Caltagirone C, Carlesimo GA. Prospective memory functioning in individuals with Parkinson’s disease: a systematic review. Clin Neuropsychol 2017; 32:937-959. [DOI: 10.1080/13854046.2017.1407457] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Alberto Costa
- Psychology Department, Niccolò Cusano University, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Carlo Caltagirone
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Dipartimento di Medicina dei Sistemi, Tor Vergata University, Rome, Italy
| | - Giovanni Augusto Carlesimo
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Dipartimento di Medicina dei Sistemi, Tor Vergata University, Rome, Italy
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17
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Vlagsma TT, Koerts J, Tucha O, Dijkstra HT, Duits AA, van Laar T, Spikman JM. Objective Versus Subjective Measures of Executive Functions: Predictors of Participation and Quality of Life in Parkinson Disease? Arch Phys Med Rehabil 2017; 98:2181-2187. [DOI: 10.1016/j.apmr.2017.03.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/09/2017] [Accepted: 03/18/2017] [Indexed: 11/27/2022]
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18
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Kudlicka A, Hindle JV, Spencer LE, Clare L. Everyday functioning of people with Parkinson’s disease and impairments in executive function: a qualitative investigation. Disabil Rehabil 2017; 40:2351-2363. [DOI: 10.1080/09638288.2017.1334240] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Aleksandra Kudlicka
- School of Psychology, University of Exeter, Exeter, UK
- PenCLAHRC, Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom
| | - John V. Hindle
- School of Psychology, Bangor University, Bangor, United Kingdom
- Department of Care of the Elderly, Llandudno Hospital, Betsi Cadwaladr University Health Board, Llandudno, United Kingdom
| | | | - Linda Clare
- School of Psychology, University of Exeter, Exeter, UK
- PenCLAHRC, Institute of Health Research, University of Exeter Medical School, Exeter, United Kingdom
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19
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Foster ER, Spence D, Toglia J. Feasibility of a cognitive strategy training intervention for people with Parkinson's disease. Disabil Rehabil 2017. [PMID: 28637142 DOI: 10.1080/09638288.2017.1288275] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To investigate the feasibility of a novel client-centered cognitive strategy training intervention for people with Parkinson's disease (PD). MATERIALS AND METHODS This was a case series of seven people with PD without dementia but with subjective cognitive decline. The intervention involved ≥5 treatment sessions at the participant's home. Participant acceptance and engagement were assessed by the Credibility/Expectancy Questionnaire (CEQ), Client Satisfaction Questionnaire (CSQ), enjoyment and effort ratings, and homework completion. Logistical information was tracked, and the Canadian Occupational Performance Measure (COPM) was an exploratory outcome measure. Data analysis was descriptive. RESULTS CEQ scores were positive and increased over time. CSQ scores were high (M = 30.8, SD = 0.75), with all participants rating all items positively. Almost all (95%) effort and enjoyment ratings were ≥3 (Much), and homework completion rates averaged 84% (SD = 18). Intervention duration was 6-15 weeks (M = 9.2, SD = 2.8), with treatment sessions averaging 1.7 h (SD = 0.5). Group and most individual COPM ratings improved ≥2 points. CONCLUSIONS These findings support the feasibility of the intervention for people with PD. It was acceptable, engaging, and promising in terms of its effect on self-identified functional cognitive problems. Implications for Rehabilitation People with Parkinson's disease (PD) without dementia can experience cognitive decline that negatively impacts function and quality of life. Strategy-based interventions that explicitly train for transfer may mitigate the negative functional consequences of cognitive decline in this population. We developed a client-centered cognitive strategy training intervention for people with PD. This small case series supports its feasibility, indicating that it is acceptable and engaging for people with PD and promising in terms of its effect on self-identified functional cognitive problems.
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Affiliation(s)
- Erin R Foster
- a Program in Occupational Therapy , Washington University in School of Medicine , St. Louis , MO , USA.,b Department of Neurology , Washington University in School of Medicine , St. Louis , MO , USA.,c Department of Psychiatry , Washington University in School of Medicine , St. Louis , MO , USA
| | - Daniel Spence
- a Program in Occupational Therapy , Washington University in School of Medicine , St. Louis , MO , USA
| | - Joan Toglia
- d School of Health and Natural Sciences , Mercy College , Dobbs Ferry , NY , USA
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20
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Radder DL, Sturkenboom IH, van Nimwegen M, Keus SH, Bloem BR, de Vries NM. Physical therapy and occupational therapy in Parkinson's disease. Int J Neurosci 2017; 127:930-943. [DOI: 10.1080/00207454.2016.1275617] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Danique L.M. Radder
- Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ingrid H. Sturkenboom
- Department of Rehabilitation-Occupational Therapy, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marlies van Nimwegen
- Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Samyra H. Keus
- Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Bastiaan R. Bloem
- Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nienke M. de Vries
- Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
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21
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Goal Setting for Cognitive Rehabilitation in Mild to Moderate Parkinson's Disease Dementia and Dementia with Lewy Bodies. PARKINSONS DISEASE 2016; 2016:8285041. [PMID: 27446628 PMCID: PMC4942668 DOI: 10.1155/2016/8285041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/01/2016] [Indexed: 02/08/2023]
Abstract
Alongside the physical symptoms associated with Parkinson's disease dementia and dementia with Lewy bodies, health services must also address the cognitive impairments that accompany these conditions. There is growing interest in the use of nonpharmacological approaches to managing the consequences of cognitive disorder. Cognitive rehabilitation is a goal-orientated behavioural intervention which aims to enhance functional independence through the use of strategies specific to the individual's needs and abilities. Fundamental to this therapy is a person's capacity to set goals for rehabilitation. To date, no studies have assessed goal setting in early-stage Parkinson's disease dementia or dementia with Lewy bodies. Semistructured interviews were carried out with 29 participants from an ongoing trial of cognitive rehabilitation for people with these conditions. Here, we examined the goal statements provided by these participants using qualitative content analysis, exploring the types and nature of the goals set. Participants' goals reflected their motivations to learn new skills or improve performance in areas such as technology-use, self-management and orientation, medication management, and social and leisure activities. These results suggest that goal setting is achievable for these participants, provide insight into the everyday cognitive difficulties that they experience, and highlight possible domains as targets for intervention. The trial is registered with ISRCTN16584442 (DOI 10.1186/ISRCTN16584442 13/04/2015).
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