The impact of occupational therapy in Parkinson’s disease: a randomized controlled feasibility study

Sturkenboom, Ingrid H.W.M.; Graff, Maud; Borm, George F.; Veenhuizen, Yvonne; Bloem, Bastiaan R.; Munneke, Marten; Sanden, Maria W. G. Nijhuis-van der

doi:10.1177/0269215512448382

Cited by 45 publications

(78 citation statements)

References 35 publications

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“…The publication of feasibility studies before a planned RCT, especially related to process, resources, and management of the RCT, was unusual in the past and is now becoming more common in the broader medical literature. Publication of these types of studies is rare in occupational therapy (e.g., Sturkenboom et al, 2012). The typology developed by Thabane et al (2010) and slightly modified for occupational therapy intervention research provides guidance on how to approach pre-RCT studies systematically.…”

Section: Resultsmentioning

confidence: 99%

Nuts and Bolts of Conducting Feasibility Studies

Tickle-Degnen

2013

The American Journal of Occupational Therapy

287

278

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Many factors can affect the successful implementation and validity of intervention studies. A primary purpose of feasibility and pilot studies is to assess the potential for successful implementation of the proposed main intervention studies and to reduce threats to the validity of these studies. This article describes a typology to guide the aims of feasibility and pilot studies designed to support the development of randomized controlled trials and provides an example of the studies underlying the development of one rehabilitation trial. The purpose of most feasibility and pilot studies should be to describe information and evidence related to the successful implementation and validity of a planned main trial. Null hypothesis significance testing is not appropriate for these studies unless the sample size is properly powered. The primary tests of the intervention effectiveness hypotheses should occur in the main study, not in the studies that are serving as feasibility or pilot studies. P lanning intervention research takes creativity and innovation, a bit like building castles in the air. Feasibility studies are studies designed to build the foundation for the planned intervention study. For several reasons, it is challenging to define feasibility studies for occupational therapy research. Although many types of feasibility studies could be applicable to intervention research in occupational therapy, no typology has been developed specifically for the research done in our field. Published feasibility study typologies are rare and typically focus on preparing for drug trials in which a single "active" ingredient is being tested, such as a chemical that is posited to be the causal effect of intervention outcomes.As we know, occupational therapy is not implemented with the assumption of a single active factor inducing change in our clients. Our intervention outcomes are derived from "blended" active agents. Person, environment, and occupation factors compose an interactional network of potential agents that create the quality of occupational performance and health outcomes (Law et al., 1996). Moreover, our outcomes are often theoretical constructs (e.g., occupational performance, quality of life) rather than direct observables (e.g., cure of disease or a change in bodily function), and they generally are measured along a conceptual continuum that is not a true count (e.g., cell counts, tumor size). Our interventions in actual practice are client centered and highly individualized as opposed to highly standardized.Feasibility studies in occupational therapy must build the foundations that support intervention trials that involve a blending of active agents; a theoretical perspective that reflects an understanding of occupational performance and outcomes as being at the intersection of person, environment, and occupation; a measurement paradigm based on constructs and continua; and client-centered, individualized intervention. Feasibility studies are rare in our field. Many, if not

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Section: Resultsmentioning

confidence: 99%

Nuts and Bolts of Conducting Feasibility Studies

Tickle-Degnen

2013

The American Journal of Occupational Therapy

287

278

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“…Occupational therapy can help PD patients to better manage their problems in daily functioning and to facilitate meaningful activities and social participation. Evidence on occupational therapy long remained scarce, but one large randomized controlled trial has been reported on occupational therapy (Table ), which was informed by a pilot study . The study had two distinctive methodological innovations: first, the investigators enrolled and randomized couples rather than patients, because occupational therapy also targets the care partner; second, the intervention was delivered by occupational therapists who were PD specialists with extensive experience with PD, and part of the Dutch ParkinsonNet, specifically trained to deliver the intervention according to a best‐practice guideline.…”

Section: New Treatments and Discoveriesmentioning

confidence: 99%

Nonpharmacological treatments for patients with Parkinson's disease

2015

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Since 2013, a number of studies have enhanced the literature and have guided clinicians on viable treatment interventions outside of pharmacotherapy and surgery. Thirty-three randomized controlled trials and one large observational study on exercise and physiotherapy were published in this period. Four randomized controlled trials focused on dance interventions, eight on treatment of cognition and behavior, two on occupational therapy, and two on speech and language therapy (the latter two specifically addressed dysphagia). Three randomized controlled trials focused on multidisciplinary care models, one study on telemedicine, and four studies on alternative interventions, including music therapy and mindfulness. These studies attest to the marked interest in these therapeutic approaches and the increasing evidence base that places nonpharmacological treatments firmly within the integrated repertoire of treatment options in Parkinson's disease.

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“…As cognition plays an important role in instrumental activities of daily living, changes in cognition can have a significant negative influence on occupational performance and result in decreased quality of life and independence (Koerts et al, 2011;Pirogovsky et al, 2013). Thus, monitoring cognition is important for informing occupational therapy interventions with this population, which target optimising functional performance and engagement in activities of daily living and life roles (Sturkenboom et al, 2013).…”

Section: Introductionmentioning

confidence: 99%