1. Is passive movement therapy an effective intervention on the severity of paratonia in comparison with usual care without passive movement therapy?2. Is passive movement therapy an effective intervention for improvement of daily care?
ID
Source
Brief title
Condition
- Muscle disorders
- Dementia and amnestic conditions
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Modified Ashworth scale. The modified Ashworth scale is a 5 point scale from 0
to 4, in which 0 = no resistance to passive movement, 1= slight resistance
during passive movement, 2= more marked resistance to passive movement, 3 =
considerable resistance to passive movement, 4= severe resistance, passive
movement is impossible. To assess the severity of paratonia all four limbs will
be passively moved in flexion and extension with the participant in a
comfortable position in bed.
Secondary outcome
The Pain Assessment Checklist for Seniors with Limited Ability to Communicate
(PACSLAC)[Fuchs et al 2004, Zwakhalen et al 2006].
the Clinical Global Impressions (CGI) to assess the clinical improvement and a
derived form of the Patient Specifieke Klacht (PSK) assessment in which the
carers are asked to address the 3 most difficult items in daily care and rate
these items on a 10 point rating scale.
Global Deterioration Scale (GDS) to assess the severity of the dementia.
Background summary
Paratonia is associated, especially in the late stages of the dementia, with a
loss of mobility and with the development of contractures [Souren et al., 1997,
Franssen et al., 1993]. Practical consequences for carers and nurses hold
difficulties to wash and dress patients with paratonia. Passive movement
therapy, to decrease the high muscle tone and to sustain the range of motion of
the affected joints, is the main therapy applied by physiotherapists in Dutch
nursing homes. Carers and nurses claim that this therapy, if given shortly
before their interaction with the patient, reduces the difficulties they
encounter. In a pilot study [Hobbelen et al., 2003], we found that their claims
hold some truth; passive movement therapy had a positive short term effect yet
worsened the joint and limb stiffness after 3 weeks. Unfortunately, the study
was underpowered, and the lack of a clear operational definition of paratonia
meant that the study population was heterogeneous.
Study objective
1. Is passive movement therapy an effective intervention on the severity of
paratonia in comparison with usual care without passive movement therapy?
2. Is passive movement therapy an effective intervention for improvement of
daily care?
Study design
radomised partially blinded clinical trial with 1 intervention group and 1
control group.
Intervention
passive movement therapy
Study burden and risks
The aim of this study is to analyse the effect of passive movement therapy in 4
weeks time with a frquency of 3 times a week. A trend analysis of our pilot
study (n=15) showed a slight negative effect in the treatment group (n=5)
compared with stabilising cushions and a control group. However afterwards no
negative effect were observed with the participants
Postbus 9101, 229VPG
6500 HB Nijmegen
Nederland
Postbus 9101, 229VPG
6500 HB Nijmegen
Nederland
Listed location countries
Age
Inclusion criteria
patients with dementia (according to the DSM-IV-TR Criteria) and paratonia with a score on the modified Ashworth scale of 2 or more in one of the limbs are included in the study. They are recruited out of the psycho-geriatric population in one of the participating nursing homes. Patients are only included after Proxy consent
Exclusion criteria
Patients with an unstable disease like progressive malignant cancer or other disease with an obvious progressive negative effect on the motor function will be excluded. Patients who receive passive movement therapy prior to admission or use neuroleptic drug will also be exluded. participants who refuse to collaborate during the assessment
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL13777.091.06 |