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Parkinson's DiseaseNCT02007785

Study of the Effect of the Cognitive Orientation to Daily Occupational Performance (CO-OP) on Cognitive Impairment in Parkinson's Disease

A study testing CO-OP treatment protocol in people with Parkinson's Disease and Cognitive Impairment, run by University of Manitoba at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the study will be to determine the effects of the Cognitive Orientation to daily Occupational Performance (CO-OP) as a treatment program for individuals with Parkinson's disease-related cognitive impairment. Read more about this study

Who is it for?
Ages 40 years and older
Conditions the study is for
Parkinson's Disease, Cognitive Impairment
What is being tested?
CO-OP treatment protocol
Could I receive a placebo?
No, everyone receives an active treatment
How many people
6 participants
Where
1 siteCanada
Study dates
Feb 2014to Oct 2014
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Live in the same residence as participant with Parkinson's
  • Be willing to participate

Who cannot join

  • Scores at or below 16/30 on Montreal Cognitive Assessment (MoCA)

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Deer Lodge Centre

    Winnipeg, Manitoba, R3J 0L3

Other trials in Canada

About this study

Official title: Determining the Applicability of the Cognitive Orientation to Daily Occupational Performance (CO-OP) as a Meta-Cognitive Rehabilitation Strategy for Individuals With Parkinson's Disease-Related Cognitive Impairment

The purpose of the study will be to determine the effects of the Cognitive Orientation to daily Occupational Performance (CO-OP) as a treatment program for individuals with Parkinson's disease-related cognitive impairment. The potential effects of the CO-OP on successful engagement in meaningful activities will be examined from participants' and live-in caregivers' perspectives. Effects of the CO-OP on participant-perceived health-related quality of life and caregiver burden will also be evaluated.

Hypotheses:

  1. Training with the CO-OP will have an effect or multiple effects on participation in meaningful activities and health-related quality of life for individuals with Parkinson's-related cognitive impairment.
  2. Training with the CO-OP will have an effect or multiple effects on caregiver burden and health-related quality of life for caregivers of individuals with Parkinson's-related cognitive impairment.
Being tested
CO-OP treatment protocol
Keywords
Cognitive Orientation to daily Occupational Performance, CO-OP
Medical subject headings
Parkinson Disease, Cognitive Dysfunction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CO-OP treatment protocolBehavioural

    Also called Cognitive Orientation to daily Occupational Performance

    Participants with Parkinson's disease will be participating in up to 12 one-on-one treatment sessions with 2 sessions per week, for up to 6 weeks. Each session will last 45-60 minutes. During these treatment sessions, each participant will be taught a problem-solving strategy that teaches individuals to monitor and adjust their own actions. Participants will be guided by the principal investigator to select 5 individual treatment goals to work on during treatment. Sessions will continue until all 5 treatment goals have been met or until 12 sessions have been completed, whichever occurs earlier. Initially, each participant's respective primary caregiver will be required to attend treatment sessions, so that the caregiver may be familiar with the treatment strategy in order to coach the participant with Parkinson's disease when you he or she uses the strategy at home.

Study groups in NCT02007785
Study groupRoleWhat they receive
CO-OP treatment protocolExperimentalParticipants with Parkinson's disease will be participating in up to 12 one-on-one treatment sessions with 2 sessions per week, for up to 6 weeks. Each session will last 45-60 minutes. During these treatment sessions, each participant will be taught a problem-solving strategy that teaches individuals to monitor and adjust their own actions. Participants will be guided by the principal investigator to select 5 individual treatment goals to work on during treatment. Sessions will continue until all 5 treatment goals have been met or until 12 sessions have been completed, whichever occurs earlier. Initially, each participant's respective primary caregiver will be required to attend treatment sessions, so that the caregiver may be familiar with the treatment strategy in order to coach the participant with Parkinson's disease when you he or she uses the strategy at home.
Receives: Behavioral: CO-OP treatment protocol

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from Pre-Intervention Phase Baseline Pattern (2 week duration) on Canadian Occupational Performance Measure (COPM) score pattern at Intervention Phase (6 week duration), Post-Intervention Phase (2 week duration), and 3-Month Follow-up

    The COPM is a semi-structured interview focusing on client-centred problem identification that is founded on the Canadian guidelines for client-centred occupational therapy practice and requires approximately 30-40 minutes to administer. The COPM consists of three sections: self-care (basic and instrumental activities of daily living); productivity (education and work); and leisure (play, leisure, and social participation). The assessment begins with self-report of occupational performance issues. The identified occupational performance issues are then rated by the client according to importance on a 10-point Likert scale. The five issues identified as most important to the client are then rated again according to the client's self-determined performance level and satisfaction. Since the COPM is designed to be used as a measure of change, performance and satisfaction levels are scored again after a period of time, (usually during which an intervention has been administered).

    Measured: Pre-Intervention Phase: Days 1, 3, 5, 9 and 11; Intervention Phase: Following treatment sessions 2, 4, 6, 8, and 10; Post-Intervention Phase: Days 1, 3, 5, 9, and 11; Follow-Up Phase: 3 months after completion of Post-Intervention Phase

  2. Change from Pre-Intervention Phase Baseline Pattern (2 week duration) on Parkinson Disease Questionnaire - 39 (PDQ-39) score pattern at Intervention Phase (6 week duration), Post-Intervention Phase (2 week duration), and 3-Month Follow-Up

    The PDQ-39 is the most widely used Parkinson's-specific measure of health-related quality of life. It is a self-administered questionnaire containing thirty nine questions that cover eight aspects of health-related quality of life: mobility (10 items), activities of daily living (6 items), emotional well-being (6 items), stigma (4 items), social support (3 items), cognition (4 items), communication (3 items), and bodily discomfort (3 items). Patients are asked to select the frequency of each problem item occurring over the past month on a 5-point scale (never / occasionally / sometimes / often / always or cannot do at all). The PDQ-39 requires approximately 10-20 minutes to administer.

    Measured: Pre-Intervention Phase: Days 1, 3, 5, 9, and 11; Intervention Phase: Following treatment sessions 2, 4, 6, 8, and 10; Post-Intervention Phase: Days 1, 3, 5, 9, and 11; Follow-Up Phase: 3 months after completion of Post-Intervention Phase

  3. Change from Pre-Intervention Phase Baseline Pattern (2 week duration) on Zarit Burden Interview score pattern at Intervention Phase (6 week duration), Post-Intervention Phase (2 week duration), and 3-Month Follow-Up

    The Zarit Burden Interview (ZBI) is the most widely used measure of caregiver burden. It is a self-administered 22-item questionnaire designed to assess caregivers' perceptions of burden related to caring for an older person with dementia or a person with a disability. Questions on the interview address caregivers' physical health, as well as emotional, social, and financial wellbeing. Caregivers are asked to select the frequency of each problem item on a 5-point scale (never / rarely / sometimes / quite frequently / nearly always). The ZBI takes approximately 5-10 minutes to administer.

    Measured: Pre-Intervention Phase: Days 1, 3, 5, 9, and 11; Intervention Phase: Following treatment sessions 2, 4, 6, 8, and 10; Post-Intervention Phase: Days 1, 3, 5, 9, and 11; Follow-Up Phase: 3 months after completion of Post-Intervention Phase

  4. Change from Pre-Intervention Baseline Observations (2 week duration) on Direct Observation Record at Intervention Phase (6 week duration), Post-Intervention Phase (2 week duration), and 3-Month Follow-Up

    Field notes consisting of direct observations of the behaviours of study participants and their caregivers / significant others and relevant contextual events and environmental features will be recorded with detailed descriptions in a log book. Observational data collected during the proposed study will provide rich,detailed information related to interactions between study participants and the physical and social environments in which the participants will work toward their CO-OP treatment goals, as well as detailed information related to the participants' performance on self-selected CO-OP treatment goals. Examples of observations that will be recorded include non-verbal body language, facial expression, and tone of voice of participants and caregivers, and detailed descriptions of physical environmental aspects that are relevant to the context of the study session.

    Measured: Pre-Intervention Phase: Day 1; Intervention Phase: during all treatment sessions (1-12) as well as during an interview session between treatment sessions 6 and 7; Post-Intervention Phase: Day 1; Follow-Up Phase: Day 1

  5. Change from Pre-Intervention Baseline Observations (2 week duration) on Semi-Structured Interview at Intervention Phase (6 week duration), Post-Intervention Phase (2 week duration), and 3-Month Follow-Up

    Semi-structured interviews will resemble guided conversations using an interview guide consisting of open-ended questions. When appropriate, the interviewer will ask value neutral probing follow-up questions in order to elicit more information from the interviewee. Appropriate situations in which probing follow-up questions may be asked include when examples, explanations, and rationales for interviewees' responses are necessary to capture the participants' beliefs and views as thoroughly and accurately as possible. The interviewees' verbal statements will be recorded verbatim in an interview log book. Observations regarding body language and affect will also be recorded in the log book. Interviews will be audio recorded using two digital recorders (in case of failure of one recorder) in order to have as much data as possible available for analysis and to verify the accuracy of the data collected.

    Measured: Pre-Intervention Phase: Day 1; Intervention Phase: between treatment sessions 6 and 7; Post-Intervention Phase: Day 1; Follow-Up Phase: Day 1

  6. Reflective Journal Log

    A reflective journal log will be maintained as a deliberate, systematic self-examination process for the principal investigator. The principal investigator's thoughts, feelings, and reactions related to questions, quandaries, and complexities that arise as the study progresses will be recorded. Awareness of this data is important to identify and account for its potential to bias the processes of data collection and analysis, which may also influence emerging interpretations of study results.

    Measured: From Day 1 of Baseline Phase until completion of Follow-Up Phase (up to 26 weeks in total)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Dec 2013 (estimated)
  2. Study startFeb 2014
  3. Primary completionOct 2014
  4. Study completionOct 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
6 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02007785
Sponsor's protocol ID
H2013:400
Status last verified
Oct 2015
First submitted
14 Nov 2013
Last updated
19 Oct 2015
Results posted
No

Publications

  • Calleo J, Burrows C, Levin H, Marsh L, Lai E, York MK. Cognitive rehabilitation for executive dysfunction in Parkinson's disease: application and current directions. Parkinsons Dis. 2012;2012:512892. doi: 10.1155/2012/512892. Epub 2011 Nov 2.

    PubMed 22135762
  • Dawson DR, Gaya A, Hunt A, Levine B, Lemsky C, Polatajko HJ. Using the cognitive orientation to occupational performance (CO-OP) with adults with executive dysfunction following traumatic brain injury. Can J Occup Ther. 2009 Apr;76(2):115-27. doi: 10.1177/000841740907600209.

    PubMed 19456090
  • DePoy, E., & Gitlin, L. (2005). Case Study Designs. In E. DePoy, & L. Gitlin, Introduction to Reserach: Understanding and Applying Multiple Strategies (3rd Ed.) (pp. 277-283). St. Louis, MO: Mosby.

  • Disbrow EA, Russo KA, Higginson CI, Yund EW, Ventura MI, Zhang L, Malhado-Chang N, Woods DL, Sigvardt KA. Efficacy of tailored computer-based neurorehabilitation for improvement of movement initiation in Parkinson's disease. Brain Res. 2012 May 3;1452:151-64. doi: 10.1016/j.brainres.2012.02.073. Epub 2012 Mar 9.

    PubMed 22459048
  • Emre M, Aarsland D, Brown R, Burn DJ, Duyckaerts C, Mizuno Y, Broe GA, Cummings J, Dickson DW, Gauthier S, Goldman J, Goetz C, Korczyn A, Lees A, Levy R, Litvan I, McKeith I, Olanow W, Poewe W, Quinn N, Sampaio C, Tolosa E, Dubois B. Clinical diagnostic criteria for dementia associated with Parkinson's disease. Mov Disord. 2007 Sep 15;22(12):1689-707; quiz 1837. doi: 10.1002/mds.21507.

    PubMed 17542011
  • Foster ER, Hershey T. Everyday Executive Function Is Associated With Activity Participation in Parkinson Disease Without Dementia. OTJR (Thorofare N J). 2011;31(1):16-22. doi: 10.3928/15394492-20101108-04.

    PubMed 21921994
  • Hoops S, Nazem S, Siderowf AD, Duda JE, Xie SX, Stern MB, Weintraub D. Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease. Neurology. 2009 Nov 24;73(21):1738-45. doi: 10.1212/WNL.0b013e3181c34b47.

    PubMed 19933974
  • Leroi I, Collins D, Marsh L. Non-dopaminergic treatment of cognitive impairment and dementia in Parkinson's disease: a review. J Neurol Sci. 2006 Oct 25;248(1-2):104-14. doi: 10.1016/j.jns.2006.05.021. Epub 2006 Jun 27.

    PubMed 16806271
  • Mohlman J, Chazin D, Georgescu B. Feasibility and acceptance of a nonpharmacological cognitive remediation intervention for patients with Parkinson disease. J Geriatr Psychiatry Neurol. 2011 Jun;24(2):91-7. doi: 10.1177/0891988711402350.

    PubMed 21546649
  • Paris AP, Saleta HG, de la Cruz Crespo Maraver M, Silvestre E, Freixa MG, Torrellas CP, Pont SA, Nadal MF, Garcia SA, Bartolome MV, Fernandez VL, Bayes AR. Blind randomized controlled study of the efficacy of cognitive training in Parkinson's disease. Mov Disord. 2011 Jun;26(7):1251-8. doi: 10.1002/mds.23688. Epub 2011 Mar 25.

    PubMed 21442659
  • Polatajko, H., & Mandich, A. (2004). Enabling Occupation in Children: The Cognitive Orientation to daily Occupational Performance (CO-OP) Approach. Ottawa: CAOT Publications ACE.

  • Sammer G, Reuter I, Hullmann K, Kaps M, Vaitl D. Training of executive functions in Parkinson's disease. J Neurol Sci. 2006 Oct 25;248(1-2):115-9. doi: 10.1016/j.jns.2006.05.028. Epub 2006 Jun 12.

    PubMed 16765378
  • Sinforiani E, Banchieri L, Zucchella C, Pacchetti C, Sandrini G. Cognitive rehabilitation in Parkinson's disease. Arch Gerontol Geriatr Suppl. 2004;(9):387-91. doi: 10.1016/j.archger.2004.04.049.

    PubMed 15207437
  • Skidmore ER, Holm MB, Whyte EM, Dew MA, Dawson D, Becker JT. The feasibility of meta-cognitive strategy training in acute inpatient stroke rehabilitation: case report. Neuropsychol Rehabil. 2011 Apr;21(2):208-23. doi: 10.1080/09602011.2011.552559.

    PubMed 21391121
  • Vale S. Current management of the cognitive dysfunction in Parkinson's disease: how far have we come? Exp Biol Med (Maywood). 2008 Aug;233(8):941-51. doi: 10.3181/0707-MR-193. Epub 2008 Jun 5.

    PubMed 18535172

Questions about this trial

What is this clinical trial studying?

A study testing CO-OP treatment protocol in people with Parkinson's Disease and Cognitive Impairment, run by University of Manitoba at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Oct 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Pre-Intervention Phase Baseline Pattern (2 week duration) on Canadian Occupational Performance Measure (COPM) score pattern at Intervention Phase (6 week duration), Post-Intervention Phase (2 week duration), and 3-Month Follow-up (time frame: Pre-Intervention Phase: Days 1, 3, 5, 9 and 11; Intervention Phase: Following treatment sessions 2, 4, 6, 8, and 10; Post-Intervention Phase: Days 1, 3, 5, 9, and 11; Follow-Up Phase: 3 months after completion of Post-Intervention Phase). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02007785, which also lists 15 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Oct 2015.

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