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Title: Effects of training involving patterned sensory enhancement on improving upper-limb movements in patients with Parkinson’s disease : protocol of a randomised controlled trial
Authors: Fan, W 
Fong, KNK 
Wang, SM 
Issue Date: Jul-2023
Source: BMJ open, July 2023, v. 13, no. 7, e072416
Abstract: Introduction: Bradykinesia (ie, slow movements) is one of the most prominent symptoms of Parkinson’s disease (PD) and has a negative impact on quality of life. Rhythmic auditory stimulation (RAS), a widely used and promising treatment technique, has been shown to effectively improve gait speed in patients with PD. The upper-limb movements, which also suffer from bradykinesia, are essential for daily life and directly impact quality of life. The term, patterned sensory enhancement (PSE) instead of RAS, is used when movement training targets the human body except lower limbs. Up until now, scarce studies have explored effects of training involving PSE on upper-limb movements. The purpose of this study is to investigate effects of movement training involving PSE on upper-limb movement speed and function in patients with PD.
Methods and analysis: A total of 138 patients with PD will be randomly assigned into two groups: the PSE group and the no-PSE group. A 21-day upper-limb training involving PSE (for the PSE group) or without PSE (for the no-PSE group) will be provided to the patients. An assessor will administer the box and block test and the Jebsen hand function test before and after training to assess upper-limb movement speed and function. The one-way analysis of covariance will be performed. This randomised controlled trial will provide evidence supporting effectiveness of upper-limb movement training involving PSE on reducing severity of bradykinesia in patients with PD.
Ethics and dissemination: Ethical approval has been obtained from the Institutional Review Board of the Hong Kong Polytechnic University with the reference number HSEARS20221027005. Informed consent forms will be gathered from all patients before their participation. Study results will be disseminated through conferences and peer-reviewed academic journals.
Publisher: BMJ Group
Journal: BMJ open 
EISSN: 2044-6055
DOI: 10.1136/bmjopen-2023-072416
Rights: © Author(s) (or their employer(s)) 2023. Re- use permitted under CC BY- NC. No commercial re- use. See rights and permissions. Published by BMJ.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
The following publication Fan W, Fong KNK, Wang SE. ffects of training involving patterned sensory enhancement on improving upper-limb movements in patients with Parkinson’s disease: protocol of a randomised controlled trial. BMJ Open 2023; 13: e072416 is available at https://doi.org/10.1136/bmjopen-2023-072416.
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