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      Landing wise program: feasibility study protocol for Parkinson’s disease

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          Abstract

          Regardless of the benefits of fall prevention programs, people with Parkinson’s disease (PD) will still fall. Therefore, it is crucial to explore novel therapeutic approaches that are well-accepted and effective for addressing fall risk and the fear of falls among this population. The present study aims to assess the feasibility of the Landing Wise program as a therapeutic intervention for reducing the fear of falling in people with PD. A mixed-methods study will be conducted using convenience sampling to recruit 20 people with PD with a moderate concern of falling from a Parkinson’s Patients Association. In addition to usual care, participants will attend 2 days per week, 90 min group sessions for 8 weeks. The intervention combines group cognitive behavioral intervention with the training of safe landing strategies. Feasibility will be assessed by six key domains (recruitment strategy and rates, enrollment, retention, acceptability, reasons for decline/withdrawal, and adverse events). Quantitative data will be analyzed using descriptive statistics to characterize the sample, followed by inferential statistics to evaluate differences in the Short Falls Efficacy Scale-International Scale, Movement Disorder Society Unified Parkinson’s Disease Rating Scale, Timed Up Go, 6-Minutes Walking Distance, and fall frequency and severity scores between baseline and final assessment. Qualitative data will be analyzed using an inductive thematic analysis process. There is a growing interest in developing new effective therapeutic approaches for people with PD. If proven program feasibility, this study precedes a randomized controlled trial to establish the effectiveness of the Landing Wise program.

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          Most cited references51

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          Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses.

          G*Power is a free power analysis program for a variety of statistical tests. We present extensions and improvements of the version introduced by Faul, Erdfelder, Lang, and Buchner (2007) in the domain of correlation and regression analyses. In the new version, we have added procedures to analyze the power of tests based on (1) single-sample tetrachoric correlations, (2) comparisons of dependent correlations, (3) bivariate linear regression, (4) multiple linear regression based on the random predictor model, (5) logistic regression, and (6) Poisson regression. We describe these new features and provide a brief introduction to their scope and handling.
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            MDS clinical diagnostic criteria for Parkinson's disease.

            This document presents the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (PD). The Movement Disorder Society PD Criteria are intended for use in clinical research but also may be used to guide clinical diagnosis. The benchmark for these criteria is expert clinical diagnosis; the criteria aim to systematize the diagnostic process, to make it reproducible across centers and applicable by clinicians with less expertise in PD diagnosis. Although motor abnormalities remain central, increasing recognition has been given to nonmotor manifestations; these are incorporated into both the current criteria and particularly into separate criteria for prodromal PD. Similar to previous criteria, the Movement Disorder Society PD Criteria retain motor parkinsonism as the core feature of the disease, defined as bradykinesia plus rest tremor or rigidity. Explicit instructions for defining these cardinal features are included. After documentation of parkinsonism, determination of PD as the cause of parkinsonism relies on three categories of diagnostic features: absolute exclusion criteria (which rule out PD), red flags (which must be counterbalanced by additional supportive criteria to allow diagnosis of PD), and supportive criteria (positive features that increase confidence of the PD diagnosis). Two levels of certainty are delineated: clinically established PD (maximizing specificity at the expense of reduced sensitivity) and probable PD (which balances sensitivity and specificity). The Movement Disorder Society criteria retain elements proven valuable in previous criteria and omit aspects that are no longer justified, thereby encapsulating diagnosis according to current knowledge. As understanding of PD expands, the Movement Disorder Society criteria will need continuous revision to accommodate these advances.
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              Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results.

              We present a clinimetric assessment of the Movement Disorder Society (MDS)-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The MDS-UDPRS Task Force revised and expanded the UPDRS using recommendations from a published critique. The MDS-UPDRS has four parts, namely, I: Non-motor Experiences of Daily Living; II: Motor Experiences of Daily Living; III: Motor Examination; IV: Motor Complications. Twenty questions are completed by the patient/caregiver. Item-specific instructions and an appendix of complementary additional scales are provided. Movement disorder specialists and study coordinators administered the UPDRS (55 items) and MDS-UPDRS (65 items) to 877 English speaking (78% non-Latino Caucasian) patients with Parkinson's disease from 39 sites. We compared the two scales using correlative techniques and factor analysis. The MDS-UPDRS showed high internal consistency (Cronbach's alpha = 0.79-0.93 across parts) and correlated with the original UPDRS (rho = 0.96). MDS-UPDRS across-part correlations ranged from 0.22 to 0.66. Reliable factor structures for each part were obtained (comparative fit index > 0.90 for each part), which support the use of sum scores for each part in preference to a total score of all parts. The combined clinimetric results of this study support the validity of the MDS-UPDRS for rating PD.

                Author and article information

                Contributors
                Journal
                Front Med (Lausanne)
                Front Med (Lausanne)
                Front. Med.
                Frontiers in Medicine
                Frontiers Media S.A.
                2296-858X
                17 October 2023
                2023
                : 10
                : 1247660
                Affiliations
                [1] 1Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science , Almada, Portugal
                [2] 2Nurs* Lab , Almada, Portugal
                [3] 3Molecular Pathology and Forensic Biochemistry Laboratory , Caparica, Portugal
                [4] 4Department of Nursing, Centro Hospitalar de Setúbal , Setúbal, Portugal
                [5] 5Department of Nursing, Hospital Garcia de Orta EPE (HGO) , Almada, Portugal
                [6] 6Department of NursingClínica Cuf Almada (CUF) , Caparica, Portugal
                [7] 7Careceiver and NOVA Medical School (MS) & NOVA School of Business and Economics (SBE) , Lisbon, Portugal
                [8] 8ARS LVT, ACES Arrábida, UCC Palmela , Palmela, Portugal
                [9] 9ARS LVT, ACES Lisboa Norte, UCC Integrar na Saúde - ECCI Benfica , Lisbon, Portugal
                [10] 10LabPSI , Almada, Portugal
                Author notes

                Edited by: Sophia Papadakis, University of Crete, Greece

                Reviewed by: Anna Arnal Gomez, University of Valencia, Spain; Naoya Hasegawa, Hokkaido University, Japan

                *Correspondence: Júlio Belo Fernandes, juliobelo01@ 123456gmail.com
                Article
                10.3389/fmed.2023.1247660
                10616464
                bd9a7e46-f3dd-4bb0-a337-5e62cd8997bb
                Copyright © 2023 Fernandes, Domingos, Família, Santos, Santana, Gregório, Costa, Afonso, Matos, Marques, Santos, Fernandes, Santos, Sousa, Ramos and Godinho.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 26 June 2023
                : 06 October 2023
                Page count
                Figures: 2, Tables: 2, Equations: 0, References: 55, Pages: 8, Words: 6696
                Funding
                This work was financed by national funds through the FCT - Foundation for Science and Technology, I.P., under the project EXPL/SAU-SER/0761/2021.
                Categories
                Medicine
                Study Protocol
                Custom metadata
                Family Medicine and Primary Care

                parkinson’s disease,accidental falls,accident prevention,exercise movement techniques,cognitive behavioral therapy,safe landing,rehabilitation,physiotherapy

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