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Physical Activity Intervention
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Canning et al. (2015)
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Level 1b Assessor-blind RCT; low risk of bias N = 231 (M age = 71; 59% male) Intervention group, n = 115 allocated, with 91 completing the intervention and 101 analyzed Control group, n = 116 allocated, with 115 completing the intervention and 112 analyzed
Inclusion Criteria
Age ≥40 yr, ability to walk independently (with or without assistive device), stable antiparkinsonian medications for ≥2 wk, 1 or more falls in past year or at risk for falls, MMSE score ≥24, no unstable cardiovascular disease or any other uncontrolled chronic condition that would interfere with safety or participation
Intervention Setting
Home and community, Australia
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Intervention
PD-WEBB, a web-based exercise program consisting of progressive balance and lower limb strengthening, 40–60 min 3×/wk for 6 mo; strategies for freezing of gait; attendance at monthly PT-led exercise classes; PT home visits; and fall prevention booklet
Control
Usual care and fall prevention booklet
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Physical activity level assessed by a habitual physical activity questionnaire measuring hr/wk of exercise at postintervention |
No significant treatment-related improvements were found for the entire sample (M difference = 0.7 hr/wk, 95% CI [–0.2, 1.6], p = .15). Post hoc subgroup analysis showed a significant increase in habitual exercise among participants with lower disease severity (M difference = 1.5 hr/wk, 95% CI [0.03, 3.05], p = .046) but not higher disease severity (M difference = –0.4 hr/wk, 95% CI [–1.2, 0.5], p = .38). |
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Cheung et al. (2018)
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Level 2b Pilot assessor-blind RCT with wait-list control; low risk of bias N = 20 (M age = 63; sex not reported) Intervention group, n = 10 Control group, n = 10, with 9 completing the intervention and 10 analyzed
Inclusion Criteria
H&Y Stage I–III, typical parkinsonism, ages 45–75, on stable dopaminergic therapy for ≥4 wk, able to ambulate 6 m (with or without assistive device), MoCA score ≥26, no other brain condition, no medical condition that would prohibit safe exercise, no spinal fusion or orthopedic surgery in past 6 mo, no significant psychiatric disease, does not require greater than minimal assistance for gait and transfers, able to attend yoga sessions, not already practicing yoga regularly
Intervention Setting
Community (local yoga studio), United States
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Intervention
Hatha yoga program, including poses, breathing techniques, and meditation, 60-min group-based classes 2×/wk for 12 wk
Control
No intervention for first 12 wk, then hatha yoga program
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Physical activity level assessed by the LAPAQ at postintervention |
The intervention group had significantly lower physical activity postintervention compared with the control group (M difference = 3,187, 95% CI [790, 5,584]) and baseline (M difference = –3,138, 95% CI [–6,252, −24]). |
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Colón-Semenza et al. (2018)
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Level 3b Within-subjects, pretest–posttest, feasibility study; moderate risk of bias N = 11 (5 mentees, M age = 63, 60% male; 6 coaches, of which 5 completed the intervention)
Inclusion Criteria
H&Y Stage I–II, MoCA score >24, stable antiparkinsonian medication for ≥2 wk before study onset, able to walk independently (with or without assistive device) ≥10 min, able to effectively communicate with study team, no diagnosis of atypical parkinsonism, ≤2 falls in past month, FOG Item 3 score <3, no serious comorbidities that might interfere with participation
Intervention Setting
Home and community (self-selected walking environment), United States
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Intervention
Mentored walking program in which trained peer coaches were matched with peer mentees and interacted via FitBit Friends and weekly phone calls to develop walking goals and action plans, monitor progress, and provide support; 8 wk
Control
No control
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• Walking activity assessed by an activity tracker (average steps/day for 7 days, active min/wk, frequency of achieving 30 fairly or very active min over 7 days) before and over the last 7 days of the walking program • Activity function (including some IADLs) assessed by the LLFDI disability component
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No significance tests were performed because of the small sample size. The mentee group had a 31% increase in average steps/day (4 of 5 mentees’ increases exceeded the minimally clinically important difference of 779 steps/day), a 42% increase in active min/wk, and a 20% increase in frequency of achieving 30 fairly or very active minutes. LLFDI score changes did not exceed the minimal detectable change of 11.62 points. |
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Demonceau et al. (2017)
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Level 2b 3-arm, pseudo–RCT; moderate risk of bias N = 52 (M age = 65; 65% male) Intervention Group 1, n = 17 allocated, with 15 completing the intervention Intervention Group 2, n = 20 allocated, with 16 completing the intervention Control group, n = 15 allocated and completed the control intervention
Inclusion Criteria
H&Y Stage I–III, MMSE score ≥24, no history of other neurological disease, no other conditions that interfere with exercise, ability to walk independently, no on-state freezing
Intervention Setting
Community and home, Belgium
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Intervention
Group 1: Muscle strength training using machines and weights under direct PT supervision, 60–90 min 2–3×/wk for 12 wk Group 2: Aerobic exercise training on a stationary bike under direct PT supervision, 60–90 min 2–3×/wk for 12 wk
Control
Standard care; participants were asked to avoid any modification to exercise or physical activity
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Physical activity level assessed by the PASS postintervention |
The strength and aerobic training groups’ PASS scores improved more than the control group’s (strength, d = 0.34, 95% CI [–0.17, 1.25]; aerobic, d = 0.54, 95% CI [–0.38, 1.06]; control, d = –0.10, 95% CI [–0.82, 0.61]; interaction p = .022). |
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Foster et al. (2013)
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Level 2b Single-blind RCT; low risk of bias N = 62 (M age = 69; 58% male) Intervention group, n = 32 allocated, with 26 completing intervention and analysis Control group, n = 30 allocated, with 26 completing intervention and analysis
Inclusion Criteria
H&Y Stage I–IV, clear motor benefit from levodopa, able to walk independently 3 m (with or without assistive device), no other neurological deficit or serious medical problem, no evidence of brain abnormality other than PD-related changes, no history of musculoskeletal or psychological problems
Intervention Setting
Community, United States
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IADL participation assessed by the ACS Current Instrumental Activities, % Instrumental Activities Retained, and New Instrumental Activities scores at 3, 6, and 12 mo after baseline assessment |
Significant intervention-related improvements were found in % Instrumental Activities Retained, which increased in the tango group from 76% at baseline to 87% at 3 mo before declining to 81% at 12 mo (p = .02), whereas the control group remained at 80% (p = .70). No significant intervention-related improvements were found for Current and New Instrumental Activities (data not reported). |
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Goodwin et al. (2011)
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Level 1b Pragmatic RCT; moderate risk of bias N = 130 (M age = 71; 57% male) Intervention group, n = 64 allocated, with 61 completing the intervention and assessments Control group, n = 66 allocated, with 63 completing the intervention and postassessment and 62 completing the follow-up assessment
Inclusion Criteria
Self-reported history of ≥2 falls in previous year, able to mobilize independently indoors (with or without assistive device), local resident, no comorbidity or symptoms that affect ability or safety to exercise, able to follow written or verbal instructions in English
Intervention Setting
Community, England
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Physical activity level assessed by the Phone-FITT (household and recreational physical activity) at postintervention and 10-wk follow-up |
The intervention group reported significantly higher recreational physical activity levels than the control group at postintervention (M difference = 0.43, 95% CI [–0.05, 0.90], p = .08) and follow-up (M difference = 0.61, 95% CI [0.12, 1.10], p = .02). No significant effects were found for household physical activity levels (postintervention and follow-up, M difference = –0.25, 95% CI [–0.7, 0.19], p = .26). |
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Li et al. (2014)
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Level 1b 3-arm RCT (secondary analysis of data); low risk of bias N = 195 (M age = 69; 63% male) Intervention Group 1, n = 65 allocated, with 56 completing the intervention and 61 providing outcome data Intervention Group 2, n = 65 allocated, with 59 completing the intervention and 62 providing outcome data Intervention Group 3, n = 65 allocated, with 61 completing the intervention and 62 providing outcome data
Inclusion Criteria
Ages 40–85, H&Y Stage I–IV
Intervention Setting
Community, United States
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Intervention
Group 1: Group tai chi consisting of 6 movements integrated into an 8-form routine, 60 min 2×/wk for 6 mo Group 2: Group resistance training consisting of movement designed to improve strength, balance, and locomotion, with weights added at Wk 10, 60 min 2×/wk for 6 mo Group 3: Group stretching consisting of seated and standing stretches and abdominal breathing, 60 min 2×/wk for 6 mo
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Physical activity level assessed by self-report of “continuing to exercise” after the intervention (defined as exercising ≥2×/wk for ≥30 min per session) at 3 mo postintervention |
63% (n = 123) of all participants reported continuing to exercise. Significantly more participants in the tai chi group (n = 47) continued to exercise than in the resistance training (n = 41) and stretching (n = 35) groups (p < .05). |
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Nakae & Tsushima (2014)
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Level 3b 1 group, pretest–posttest; moderate risk of bias N = 14 (10 completed the intervention and analysis; 20% male)
Inclusion Criteria
No change in antiparkinsonian medication for ≥2 mo, H&Y Stage II–III, capable of independent walking and participation in the intervention
Intervention Setting
Home, Japan
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Intervention
Home exercise program consisting of self-guided exercise using a booklet, instructed to perform at least 3×/wk for 2 mo, and a home exercise visit by a PT, 30 min 1×/wk for 2 mo
Control
No control
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Participants spent a significantly lower percentage of their time lying (36.7 vs. 29.3, p < .05) and sitting (24.0 vs. 31.9, p < .05) per day postintervention compared with preintervention. No significant change was found in TMIG Index of Competence scores (data not reported). |
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Nascimento et al. (2014)
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Level 2b Single-blind, nonrandomized controlled trial; moderate risk of bias N = 42 (M age = 67; 50% male) Intervention group, n = 23 allocated, with 17 analyzed Control group, n = 19 allocated, with 17 analyzed
Inclusion Criteria
H&Y Stage I–III, under regular pharmacological treatment, did not take part in any physical activity program in previous year, no neurocognitive or locomotive impairment affecting the comprehension or performance of the exercise intervention
Intervention Setting
Community, Brazil
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Intervention
Mild- to moderate-intensity multimodal exercise program consisting of muscular resistance, balance and motor coordination, and aerobic exercises, 1 hr 3×/wk for 6 mo
Control
Standard medical care routine, no exercise
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IADL function assessed by the Brazilian version of the PIAQ at postintervention |
The exercise group’s PIAQ scores improved (% improvement = 24.6%), whereas the control group’s worsened (% improvement = –17.5%) from pre- to postintervention, F(1, 23) = 14.6, p = .001. |
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Pretzer-Aboff et al. (2011)
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Level 3b 1 group, 2 pretest, 3 posttest repeated measures; low risk of bias N = 24 (M age = 71; 71% male)
Inclusion Criteria
Age ≥55, H&Y Stage II–IV, MMSE score >17, caregiver willing to participate
Intervention Setting
Home, United States
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Intervention
Function-focused care intervention in which caregivers were taught methods of encouraging the person with PD to engage in functional and physical activities, 1 home visit for PD participant and caregiver and follow-up telephone calls 1×/wk for 4 wk, followed by monthly calls for the rest of the 12-mo study period
Control
No control
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Physical activity level assessed by the YPAS at 2, 6, and 12 mo after baseline |
There were significant increases from baseline to 12 mo in hours spent exercising, F(1, 24) = 4.95, p = .004; energy expended, F(2, 43) = 4.32, p = .017; and hours spent in all physical activities, F(3, 60) = 6.06, p < .001. |
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Reuter et al. (2011)
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Level 1b Randomized trial; moderate risk of bias N = 90 (M age = 62; 50% male) Intervention Group 1, n = 30 Intervention Group 2, n = 30 Intervention Group 3, n = 30
Inclusion Criteria
H&Y Stage II–III, no severe concomitant disease that limits physical performance, no other neurological disease
Intervention Setting
Park and forest (Nordic walking and walking) and gym (flexibility and relaxation), Germany
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Intervention
Group 1: Nordic walking training consisting of technique and endurance training with encouragement to increase intensity, 70 min 3×/wk for 6 mo Group 2: Walking training consisting of technique and endurance training with emphasis on arm swing and limb coordination, 70 min 3×/wk for 6 mo Group 3: Flexibility and relaxation training consisting of stretching, balance, and range of movement exercises and relaxation training, 70 min 3×/wk for 6 mo
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Physical activity level assessed by an activity log the last week of the intervention and a phone interview (e.g., Do you continue the training you practiced during the study? How often do you exercise per week?) 6 mo after intervention completion |
At the end of the training period, the Nordic walking and walking groups spent significantly more time than the flexibility and relaxation group doing heavy exertion (9.4 and 6.3 hr/wk vs. 3.8 hr/wk), F(2, 87) = 11.25, p < .001, and less time sitting (5.6 and 5.7 hr/day vs. 8.9 hr/day), F(2, 87) = 14.22, p < .001. 6 mo after study completion, 100% of Nordic walking participants continued Nordic walking, 60% of the walking group continued walking and 30% switched to Nordic walking, and 50% of the flexibility and relaxation group continued their training regimen. |
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Ridgel et al. (2016)
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Level 2b Single-blind RCT; moderate risk of bias N = 30 (M age = 70; 63% male) Intervention group, n = 15 allocated, with 13 assessed at 12 wk and 12 at 24 wk Control group, n = 15 allocated, with 15 assessed at 12 wk and 12 at 24 wk
Inclusion Criteria
H&Y Stage I–III, unipolar major depression and MADRS score ≥14, ability to walk independently, no changes to PD medication within previous 2 wk and antidepressants within previous 4 wk, MMSE score ≥24, no unstable cardiovascular disease, not at high fall risk, no uncontrolled chronic condition that would risk safety, medically cleared for exercise
Intervention Setting
Community fitness center, United States
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Intervention
Enhanced Exercise Therapy (EXCEED), consisting of group psychoeducation, peer education and support, and manualized group exercise, exercise sessions 45–60 min 3×/wk and psychoeducational session 60 min 1×/wk for 12 wk, then continuing exercise manual and free access to the fitness facility for the next 12 wk
Control
Self-guided exercise therapy (SGE) intended to replicate the EXCEED activities in a self-guided format
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Physical activity level assessed by the IPAQ at 12 wk postintervention and 24-wk follow-up |
A significant intervention-related effect was found; the EXCEED group showed a 34% increase in physical activity from Wk 12 to Wk 24, whereas the SGE group showed a 32% reduction in activity over this period (p = .03). The EXCEED group had 56% more physical activity than the SGE group at 24 wk (1,472.7 MET min/wk vs. 646.5 MET min/wk). |
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van Nimwegen et al. (2013)
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Level 1b Multicenter, assessor-blind RCT; low risk of bias N = 586 (M age = 65; 65% male) Intervention group, n = 299 allocated, with 273 completing 24-mo assessment Control group, n = 287 assigned, with 267 completing 24-mo assessment
Inclusion Criteria
Ages 40–75, sedentary lifestyle, H&Y Stage I–III; MMSE score >24, able to complete Dutch questionnaires, no comorbidities that interfere with daily functioning, not receiving institutionalized care, no prior deep brain surgery
Intervention Setting
Community, Netherlands
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Intervention
ParkFit, an individually tailored, multifaceted behavioral change program designed to increase levels of physical activity that included personal activity coaching sessions, an educational brochure about physical activity, goal setting, coping planning, stimulation to participate in group exercise, an ambulatory monitor with feedback about daily physical activity levels, a personalized website for monitoring progress, and regular physiotherapy sessions, maximum of 35 in-person sessions per year over 2 yr
Control
General physiotherapy aimed at promoting safety of movements that included an educational brochure about safety of movements and individualized treatment sessions, maximum of 35 in-person sessions per year over 2 yr
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Physical activity level assessed by the LAPAQ (primary outcome), an activity diary, and an ambulatory activity monitor at 6, 12, 18, and 24 mo (6- and 24-mo data averaged for analysis) |
No significant treatment-related improvements were found on the LAPAQ (group difference = 7%, 95% CI [–3%, 17%], p = .19). The ParkFit group had significantly greater increases in physical activity levels compared with the control group according to the activity diary (difference = 30%, 95% CI [17%, 45%], p < .001) and activity monitor (difference = 12%, 95% CI [7%, 16%], p < .001). |
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Specific IADL-Focused Interventions
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Collett et al. (2017)
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Level 1b Secondary evaluation of the control group from a single-blind, Phase 2 RCT; low risk of bias N = 105 (M age = 67; 63% male) Intervention Group 1, n = 51 analyzed, with 40 completing the intervention Intervention Group 2, n = 54 analyzed, with 37 completing the intervention
Inclusion Criteria
Able to walk ≥100 m; no contraindication to exercise including cardiac precautions; no diagnosis of dementia or MMSE score <23; no other neurological diagnoses; no severe depression, psychosis, or other mental state that would preclude study involvement; no orthopedic condition that would limit walking
Intervention Setting
Home (handwriting) and community (exercise), United Kingdom
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Intervention
Group 1: Handwriting training delivered through a workbook including hand exercises and a variety of writing activities, 1 hr 2×/wk for 6 mo, plus monthly visits to review progress Group 2: Exercise delivered through a booklet including aerobic and resistance training, 1 hr 2×/wk for 6 mo, plus monthly visits to review progress
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• Perceived handwriting difficulty (MDS–UPDRS Item 2.7) • Handwriting speed, amplitude, and progressive reduction assessed by a pangram at 3, 6, and 12 mo after start of intervention
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A significant improvement was found for the handwriting training group in perceived handwriting difficulty (OR = 0.55, 95% CI [0.34, 0.91], p = .02). Moderate effect sizes of the handwriting intervention were found for writing amplitude (total area, d = 0.32, 95% CI [–0.11, 0.70], p = .13), but there were small or no effects for writing speed or progressive reduction (d ≤ 0.11). |
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Daley et al. (2014)
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Level 1b Phase 2 RCT; moderate risk of bias N = 76 (M age = 71; 65% male) Intervention group, n = 38 Control group, n = 38
Inclusion Criteria
Prescribed ≥1 antiparkinsonian medication, on a stable regimen, no dementia, MMAS–4 score ≥1
Intervention Setting
Hospital and home, United Kingdom
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Intervention
Routine care plus 1:1 adherence therapy sessions at home that included assessment of medications, problem solving of nonadherence issues, reflection on experience with medication, and discussion of beliefs regarding taking medication, 1×/wk for 7 wk
Control
Routine care
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Medication adherence assessed by the MMAS–4 at 7 and 12 wk postrandomization (primary outcome, 12 wk) |
Significant treatment-related improvements were found at both 7 and 12 wk; more people had improved MMAS–4 scores in the adherence therapy group compared with the control group (at 7 wk, 64.8% vs. 26.3%, OR = 6.1, 95% CI [2.2, 16.4]; at 12 wk, 60.5% vs. 15.8%, OR = 8.2, 95% CI [2.8, 24.3]). |
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Nackaerts et al. (2016)
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Level 2b
RCT; moderate risk of bias
N = 38 (M age = 63; 61% male)
Intervention group, n = 18
Control group, n = 20
Inclusion Criteria
H&Y Stage I–III, right-handed as determined by the Edinburgh Handedness Inventory; score ≥1 on Item 2.7 of the MDS–UPDRS, MMSE score ≥24, no visual impairments, no upper limb problems that would impede handwriting, no deep brain stimulation
Intervention Setting
Home, Belgium |
Intervention
Intensive writing amplitude training consisting of pen-and-paper writing and exercises on a touch-sensitive tablet with colored target zones and gradual progression of difficulty, 30 min of practice 5 days/wk for 6 wk, plus weekly observations
Control
Stretch and relaxation exercises provided on a DVD, 30 min of practice 5 days/wk for 6 wk, plus weekly observations |
Handwriting amplitude assessed by a touch-sensitive tablet and paper-and-pencil (SOS) test at postintervention and 6-wk follow-up |
Significant treatment-related improvements were found for various measures of handwriting amplitude assessed by the tablet; the intervention group had increased amplitude at postintervention and follow-up compared with the control group and with baseline (ps ≤ .05). The intervention group had increased writing size on the SOS test at postintervention compared with the control group, F = 3.69, p = .034, and with baseline (p = .037). |
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Ziliotto et al. (2015)
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Level 2b 2 groups, nonrandomized; moderate risk of bias N = 60 (M age = 66; 45% male) Intervention group, n = 30 Control group, n = 30
Inclusion Criteria
Handwriting problems; MMSE score >26; no severe dominant hand tremor or dyskinesia; no history of other neurological diseases, osteoarticular diseases affecting the hand, or other medical condition that could diminish dominant-hand skills
Intervention Setting
Hospital movement disorders unit, Argentina
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Handwriting amplitude, progressive reduction, direction, surface area, superior margin, force exerted, and velocity assessed using a written phrase postintervention |
At postintervention, the handwriting group had significantly increased writing amplitude, surface area, and superior margin compared with the control group and with baseline (ps ≤ .02). No significant treatment-related effects were found in progressive reduction, direction, force exerted, or velocity (data not reported). |
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Cognitive Rehabilitation Interventions
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Disbrow et al. (2012)
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Level 3b 1 group, pretest–posttest; moderate risk of bias N = 30 (M age = 68; 70% male)
Inclusion Criteria
History of good clinical response to antiparkinsonian medication, no dementia or immediate memory impairment, no history of other neurological or psychiatric disorders, physical fitness to complete the study
Intervention Setting
Home, United States
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IADL performance assessed by the TIADL postintervention |
No significant treatment-related improvements were found on the TIADL (data not reported). |
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Hindle et al. (2018)
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Level 2b 3-arm, single-blind pilot RCT; low risk of bias N = 29 (M age = 76; 79% male) Intervention Group 1, n = 10, with 7 completing 6-mo assessment Intervention Group 2, n = 10, with 9 completing 6-mo assessment Control group, n = 9
Inclusion Criteria
Diagnosis of PDD or DLB, ACE–III score ≤82, stable PD medications, no cognitive enhancers or psychotropic medication, no major psychiatric disorder, no major depression or other significant neurological disease
Intervention Setting
Community based, United Kingdom
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Intervention
Group 1: Cognitive rehabilitation consisting of compensatory strategies and/or restorative approaches, 1 hr 1×/wk for 8 wk Group 2: Relaxation therapy consisting of progressive muscle relaxation and breathing exercises, 1 hr 1×/wk for 8 wk
Control
Standard care
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IADL function assessed by the FAQ at 6 mo postrandomization |
No significant treatment-related improvements were found on the FAQ (data not reported). |
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París et al. (2011)
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Level 2b Blind multicenter RCT; low risk of bias N = 33 (M age = 65; 50% male) Intervention group, n = 18 allocated, with 16 completing postintervention assessment Control group, n = 15 allocated, with 12 completing postintervention assessment
Inclusion Criteria
Ages 50–80 yr; H&Y Stage I–III; not receiving any other cognitive, psychological, speech, or physical treatment; MMSE score ≥23; WAIS–III vocabulary score ≥40; GDS–15 score ≤10; not on anticholinergic medication; no changes in medication during study; completed 75% of the training
Intervention Setting
Hospital movement disorders unit and home, Spain
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Intervention
Computerized cognitive training using the SmartBrain tool, paper-and-pencil and homework exercises to stimulate cognitive domains affected by PD, and nonspecific cognitive exercises, 45 min 3×/wk for 4 wk (12 sessions total), plus weekly homework exercise and weekly individual tutored sessions
Control
Speech therapy aimed at awareness of speech and communication difficulties, 45 min 3×/wk for 4 wk (12 sessions total), plus weekly homework exercise and weekly individual tutored sessions
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Difficulty with everyday cognition (including some IADLs) assessed by the CDS postintervention |
No significant treatment-related improvements were found on the CDS (d = 0.09, F = 0.06, p = .81). |
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Individualized Occupational Therapy Interventions
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Clarke et al. (2016)
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Level 1b Multicenter, pragmatic, open-label RCT; moderate risk of bias N = 762 (M age = 70; 65% male) Intervention group, n = 381 allocated, with 350 completing 3-mo assessment Control group, n = 381 allocated, with 349 completing 3-mo assessment
Inclusion Criteria
Idiopathic PD, self- or caregiver-reported limitations in ADLs, no diagnosis of dementia, uncertainty about need for OT or PT services, no OT or PT services received in previous 12 mo
Intervention Setting
Community and/or outpatient, United Kingdom
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IADL function assessed by the NEADL Kitchen Activity and Domestic Tasks domains at 3, 9, and 15 mo postrandomization (primary outcome, 3 mo) |
No significant treatment-related improvements were found for the NEADL total score (difference = 0.5, 95% CI [–0.74, 1.7], p = .41) or any of the NEADL domains (Kitchen Activities difference = 0.005, 95% CI [–0.3, 0.3], p = .97; Domestic Tasks difference = 0.5, 95% CI [–0.06, 1.0], p = .08) at 3 mo or across all time points. |
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Sturkenboom et al. (2014)
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Level 1b Multicenter, assessor-blind RCT; low risk of bias N = 191 (M age = 70.5; 62% male) Intervention group, n = 124 allocated, with 122 completing 3-mo assessment Control group, n = 67 allocated, with 63 completing 3-mo assessment
Inclusion Criteria
Living at home, reporting difficulties in meaningful daily activities, typical parkinsonism, had not received OT in preceding 3 mo, no predominant disabling comorbidity, sufficient understanding of the Dutch language, MMSE score ≥24
Intervention Setting
Home, Netherlands
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The intervention group had significantly better ACS % Instrumental Activities Retained compared with the control group after the intervention (M difference = 5.9%, 95% CI [8%, 10%], p = .006). There was no effect for the PRPP (M difference = 0.8%, 95% CI [–7.5, 9.0], p = .848). |
