Effectiveness of Online Program and Task-related Training for Parkinson's Disease

Purdue Pegboard Test

The change from baseline in dexterity will be measured by the number of pegs participants can put into the holes as quickly as possible. The higher the score, the better the hand dexterity. The test consists of four tasks: inserting pegs with the right hand, inserting pegs with the left hand, inserting pegs with both hands, and assembling pegs with both hands. The time taken to complete the test will be recorded.

Box and Block test

The change from baseline in dexterity will be measured by the number of blocks participants can put to another box as quickly as possible. Box and Block test is a commonly used tool in occupational therapy to assess hand dexterity. The patient is seated and the experimenter sits opposite the patient to confirm the testing process. The patient is asked to perform the test with their dominant hand, picking up one block at a time and crossing the partition with the block, placing it in the empty space on the other side. The faster the better. Before the formal test, the patient is given 15 seconds of practice time. The formal test lasts for 1 minute.

Proprioceptive sensitivity Assessment

The examiner will use a customized apparatus from the Sensorimotor Control Laboratory at the University of Minnesota to assess position sense motion sense acuity. Participants will be tested on the same-side position matching test and the psychophysical discrimination threshold test. The examiner moves the examinee's testing hand from the starting position to the testing position and then moves the examinee's wrist back to the starting position. The instrument will use an adaptive algorithm to determine whether to give a simpler or more difficult displacement for the next trial based on whether the examinee's answer is correct or not. A total of about 20 tests are required, and the test time is about 10-15 minutes. The instrument will record the position matching error.

Nottingham Extended Activities of Daily Living Scale (NEADL)

This assessment tool is used to measure an individual's capacity for instrumental activities of daily living. Based on the classification of the International Classification of Functioning, Disability, and Health (ICF model), the assessment pertains to the level of activities and participation. It includes a total of 22 items, all of which are activities performed in daily life. Participants are asked to respond based on their actual performance or involvement in these activities over the past few weeks. Each item has four response options for the participant to self-report: can complete independently, can complete independently but with some difficulty, requires assistance from others to complete, and did not perform this activity. Each item is scored on a scale of 0-3, with a total score of 66. The higher the score, the better the patient's ability to perform daily activities of living.

Time up and go test (TUG)

The change from baseline in mobility will be measured by the time taken as recorded. Before the test, the examinee sits steadily, readying for the test. Upon the examiner's cue, they stand from the chair and walk three meters, then turn, and sit back down. This duration is timed with a stopwatch by the examiner. To ensure accuracy, the test is repeated three times, averaging the times. The Timed Up and Go test serves as a swift, practical method for assessing functional mobility and pinpointing those at heightened fall risk or needing additional balance or gait training.

Grip Strength measure

The change from baseline in grip strength will be measured by the mean values to the norm according to participant's age and gender. The participant should sit with their upper arms naturally hanging down and their elbows bent at a 90-degree angle. Then, the participant should measure their grip strength three time, and the average of the three measurements should be analyzed.

Pinch Strength measure

The change from baseline in pinch grip will be measured by the mean values to the norm according to participant's age and gender. The participant should sit with their upper arms naturally hanging down and their elbows bent at a 90-degree angle. Then, the participant should measure their lateral /key pinch and palmar /three-jaw chuck pinch strength three times each, and the average of the three measurements for each method should be analyzed.

Hand length measure

Hand length is measured at baseline to provide information for adjusting the value of strength during statistical analysis. To measure the length of the hand, ask the participant to place their palm flat and facing up, and then measure the distance from the tip of the middle finger to the wrist crease.

Mini-Mental Status Examination (MMSE)

To ensure participants do not have dementia or other cognitive impairments. The scale consists of 20 questions and 30 items, including orientation, memory, attention and calculation, recall, and language ability. Each correct answer is scored 1 point, and incorrect or unanswerable questions are scored 0 points. The total score ranges from 0 to 30 points. Lower score indicates more severe cognitive impairment.

Beck depression scale

The objective is to confirm that study participants do not suffer from severe depression. Should severe depression be detected in a potential participant, they will be excluded from recruitment. The scale consists of 21 questions and 30 items, with a total score of 63 points. A score of 14-19 indicates mild depression, 20-28 indicates moderate depression, and 29 or higher indicates severe depression.