Strategy-based cognitive intervention for Parkinson disease: A pilot randomizedcontrolled trial

基于策略的帕金森病认知干预：一项随机对照试验

• 批准号: 10444191
• 负责人: ERIN R FOSTER
• 金额: $ 13.17万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10444191
• 关键词: Affect; Age; American; Attenuated; Behavior Therapy; Brain Injuries; Clinical Trials; Cognitive; Data; Development; Dissemination and Implementation; Educational Intervention; Educational process of instructing; Effectiveness; Future; Goals; Impaired cognition; Infrastructure; Intervention; Intervention Studies; Life; Medical; Neurodegenerative Disorders; Operative Surgical Procedures; Parkinson Disease; Participant; Pharmacological Treatment; Population; Preparation; Procedures; Psychological Transfer; Quality of life; Randomized Controlled Trials; Reproducibility; Research; Research Design; Research Personnel; Research Priority; Role; Sample Size; Single-Blind Study; Stroke; Testing; Training; Training Technics; Translations; Work; base; clinical practice; cognitive rehabilitation; cognitive training; cost; daily functioning; disability; efficacy clinical trial; evidence base; experience; improved; non-demented; novel; personalized strategies; recruit; socioeconomics; standard of care; trial comparing

PROJECT SUMMARY/ABSTRACT The long term goal of this work is to reduce disability among people with Parkinson disease (PD) by enabling them to cope with cognitive decline so they can perform and participate in desired activities and roles. PD is the second most prevalent neurodegenerative disease, affecting over 1 million Americans and causing considerable personal and socioeconomic costs that are expected to rise as the population ages. Cognitive impairment produces significant disability and reduced quality of life among non-demented people with PD. Unfortunately, existing medical (i.e. surgical and pharmacological) treatments for PD do not prevent, treat, or mitigate the negative functional consequences of cognitive impairment. As such, the development of new, effective cognitive rehabilitation treatments for PD is a top research priority. The investigators have developed a novel, individualized, strategy training intervention to attenuate cognitive decline and improve or maintain daily function in PD (Strategy Training for Transfer, STRAIT). It involves teaching people to use targeted compensatory or adaptive strategies in everyday life to work around or through cognitive challenges and achieve functional goals. Strategy training is a practice standard for cognitive rehabilitation in brain injury and stroke, but its application in PD is novel. Furthermore, STRAIT incorporates specific evidence-based training techniques to support the transfer of strategy use and its benefits to real-world activities and contexts. This explicit focus on generalization to daily function is critically lacking in cognitive rehabilitation approaches for people with PD to-date. The current project objective is to test and optimize the intervention and study procedures for future clinical trials and eventual translation into clinical practice. The study design is a single- blind pilot randomized controlled trial (RCT) comparing STRAIT to a standard-of-care control (task-oriented cognitive training). The research plan has three specific aims: Aim 1 will examine general feasibility (e.g. recruitment, retention), Aim 2 will examine participant- and therapist-related aspects of treatment fidelity, and Aim 3 will generate preliminary estimates of STRAIT’s effect on daily function to inform sample size calculations for a definitive RCT. The results from this study will directly inform an R01 application for an RCT to test STRAIT’s efficacy and/or effectiveness. It will also provide the investigators with critical data, experience, and infrastructure to facilitate future efficiency, rigor, and reproducibility in clinical trials and dissemination and implementation in real-world clinical practice. This work will meet the pressing need for effective cognitive interventions for people with PD and will ultimately positively impact function and quality of life in this population.

项目摘要/摘要 这项工作的长期目标是通过使帕金森病(PD)患者能够减少残疾 他们需要应对认知衰退，这样他们才能执行和参与所需的活动和角色。帕金森是 第二种最常见的神经退行性疾病，影响100多万美国人，并导致 相当大的个人和社会经济成本，预计将随着人口老龄化而上升。认知 在非痴呆的帕金森病患者中，功能障碍会导致严重的残疾和生活质量下降。 不幸的是，现有的治疗帕金森病的药物(即手术和药物治疗)并不能预防、治疗或 减轻认知障碍的负面功能后果。因此，新的、 有效的认知康复治疗是帕金森病研究的重中之重。调查人员已经开发出 一种新颖的、个性化的、策略训练干预，以减轻认知衰退并改善或保持 PD(海峡转移策略培训)的日常工作。它涉及到教人们使用有针对性的 日常生活中的补偿性或适应性策略，以绕过或克服认知挑战 实现职能目标。策略训练是脑损伤患者认知康复的实践标准 卒中，但其在帕金森病中的应用是新颖的。此外，海峡组织还纳入了具体的循证培训 支持将战略使用及其好处转移到现实世界活动和背景中的技术。这 认知康复方法严重缺乏对日常功能概括的明确关注 到目前为止，帕金森病患者。目前的项目目标是测试和优化干预和研究 未来临床试验和最终转化为临床实践的程序。研究设计是一个单一的- 随机对照试验(RCT)比较海峡与标准护理对照(以任务为导向 认知训练)。研究计划有三个具体目标：目标1将审查总体可行性(例如： 招聘、保留)，AIM 2将检查与参与者和治疗师相关的治疗忠诚度方面，以及 目标3将生成海峡对日常功能影响的初步估计，以告知样本大小 确定的随机对照试验的计算。这项研究的结果将直接为R01申请随机对照试验提供参考 以测试海峡的效力和/或效力。它还将为调查人员提供关键数据， 经验和基础设施，以促进未来临床试验和 在现实世界的临床实践中的传播和实施。这项工作将满足……的迫切需要 对帕金森病患者进行有效的认知干预，最终将对患者的功能和质量产生积极影响 在这个种群中的生命。

项目成果

Development of a goal setting and goal management system: Intervention Mapping.

• DOI: 10.3389/fresc.2023.1274191
• 发表时间: 2023
• 期刊: FRONTIERS IN REHABILITATION SCIENCES
• 作者: Kang, Eunyoung;Foster, Erin R
• 通讯作者: Foster, Erin R

Use of Implementation Mapping With Community-Based Participatory Research: Development of Implementation Strategies of a New Goal Setting and Goal Management Intervention System.

• DOI: 10.3389/fpubh.2022.834473
• 发表时间: 2022
• 期刊: FRONTIERS IN PUBLIC HEALTH
• 影响因子: 5.2
• 作者: Kang, Eunyoung;Foster, Erin R.
• 通讯作者: Foster, Erin R.

The Weekly Calendar Planning Activity to Assess Functional Cognition in Parkinson Disease.

评估帕金森病功能认知的每周日历计划活动。

• DOI: 10.1177/15394492221104075
• 发表时间: 2022-10
• 期刊: OTJR-OCCUPATIONAL THERAPY JOURNAL OF RESEARCH
• 影响因子: 1.4
• 作者: Foster, Erin R.;Carson, Lisa;Jonas, Jill;Kang, Eunyoung;Doty, Tasha;Toglia, Joan
• 通讯作者: Toglia, Joan