Acceptability of high intensity functional training in people with Parkinson's: a randomised feasibility trial
Parkinson's disease
Intervention: Delivery of the intervention will be conducted through either a local CrossFit facility or via PD Warrior centres based in Bristol, which conduct in-person and online classes. Participants will be required to attend at least 2 classes per week and maintain an exercise diary for the 12-week intervention period to establish adherence to the protocol. Concordance will be corroborated through class attendance records, collected directly from PD Warrior and CrossFit facilities. Participants will have the following options for completion of the intervention: 1. Attendance of classes at a local CrossFit training facility 2. Attendance of local PD Warrior Classes 3. Attendance of online PD Warrior Classes Classes are anticipated to last approximately 45-60 minutes. Allocation to the intervention will be conducted using the intervention decision tool below (Intervention Decision Tool), and infographics explaining the options for intervention along with demonstration videos. The choice of intervention will be led by the participant in discussion with the Chief Investigator or delegate. Considerations for safety will be made when choosing the intervention at the discretion of the Chief Investigator or delegate. The choice of intervention delivery is provided to account for the variation in preference of people with Parkinson’s regarding attendance of exercise classes. PPI contributors engaged with the study design to date have expressed variation in their preferences for exercise class delivery, whereby whilst some find it helpful to be around other people with Parkinson’s, some do not wish to participate in Parkinson’s-specific environments. Previous studies have shown that ≥2 sessions per week over a minimum of 12 weeks are required to demonstrate clinical effectiveness in people with Parkinson’s; therefore has been selected as the minimum dosage required to demonstrate feasibility. Participants will be able to continue in their exercise class after the
1. Diagnosis of idiopathic Parkinson’s disease 2. Aged ≥18 years 3. Has capacity to provide informed consent 4. Able to walk 10 m independently (with or without walking aid) 5. Stable Parkinson’s medication for previous 6 weeks 6. Able to participate in the intervention and study procedures in the opinion of the Chief Investigator or delegate (with support of clinical team)
1. Comorbidities or medical history which would preclude exercise participation – GP Screening 2. Falls history > 3 falls in previous 12 months – self-reported (telephone screening) 3. Orthostatic hypotension (as defined below) - self-reported (telephone screening) and in-person assessment by research team 4. Regular exercisers (as defined below) – self-reported questionnaire (telephone screening) 5. Cognitive impairment (as defined below) – in person assessment by research team 6. Postural Instability (as defined below) – in-person assessment by research team 7. Freezing of gait – self-reported (telephone screening) and in-person assessment by research team 8. Evidence of clinically moderate to severe motor fluctuations at initial assessment that affect significantly balance, gait or stability, or that are reported to affect a participant’s ability to undertake activities when these occur (as defined below) – in-person assessment by research team 9. Being considered for device-based therapy (including initial referral prior to specialist review) – self-reported (telephone screening) or movement disorder specialist (diagnosis check) 10. Deep brain stimulation where this was inserted less than 6 months ago and has not led to significant improvement of symptoms (i.e., motor fluctuations that render them ineligible as above) – self-reported (telephone screening) or movement disorder specialist (diagnosis check) 11. Current use of an infusion therapy or use in the last 6 months – self-reported (telephone screening) or movement disorder specialist (diagnosis check)