TY - JOUR
T1 - Passive movement therapy in severe paratonia: a multicenter randomized clinical trial
AU - Hobbelen, Johannes (Hans) S. M.
AU - Tan, Frans E. S.
AU - Verhey, Frans R. J.
AU - Koopmans, Raymond T. C. M.
AU - de Bie, Rob A.
PY - 2012/5
Y1 - 2012/5
N2 - Background: Paratonia causes severemovement dysfunction in late stage dementia. Passive Movement Therapy (PMT) is often used to decrease high muscle tone, but the efficacy has never been shown. The objective of this study is to investigate the effect of PMT on muscle tone after two and four weeks of treatment. Methods: This study comprised a multicenter single-blinded RCT. Nursing home residents with dementia (according to the DSM-IV-TR criteria) and moderate to severe paratonia were randomly assigned to either a PMT or control group. The PMT group received PMT three times a week over four weeks. The control group received no PMT. The primary outcome was the severity of paratonia as measured by the Modified Ashworth scale (MAS). Secondary outcomes were clinical change (Clinical Global Impression; CGI), caregiver's burden (modified patient specific complaints; PSC), and level of pain duringmorning care (Pain Assessment Checklist for Elderly with Limited Ability to Communicate, Dutch version; PACSLAC-D). All outcomes were assessed at baseline and after two and four weeks. The MAS, PACSLAC-D, and PSC data were subjected to multilevel mixed linear analysis, and the CGI data to cross-tabulation chi(2) analysis. Results: One-hundred-and-one patients from 12 Dutch nursing homes participated in the study; data from 47 patients in the PME group and 54 controls were analyzed. Patients receiving PMT performed no better in paratonia assessments, nor on CGI, PSC, or PACSLAC-D, than controls in two and four week's time. Conclusion: PMT has no beneficial effects and should therefore not be recommended as an intervention in severe paratonia.
AB - Background: Paratonia causes severemovement dysfunction in late stage dementia. Passive Movement Therapy (PMT) is often used to decrease high muscle tone, but the efficacy has never been shown. The objective of this study is to investigate the effect of PMT on muscle tone after two and four weeks of treatment. Methods: This study comprised a multicenter single-blinded RCT. Nursing home residents with dementia (according to the DSM-IV-TR criteria) and moderate to severe paratonia were randomly assigned to either a PMT or control group. The PMT group received PMT three times a week over four weeks. The control group received no PMT. The primary outcome was the severity of paratonia as measured by the Modified Ashworth scale (MAS). Secondary outcomes were clinical change (Clinical Global Impression; CGI), caregiver's burden (modified patient specific complaints; PSC), and level of pain duringmorning care (Pain Assessment Checklist for Elderly with Limited Ability to Communicate, Dutch version; PACSLAC-D). All outcomes were assessed at baseline and after two and four weeks. The MAS, PACSLAC-D, and PSC data were subjected to multilevel mixed linear analysis, and the CGI data to cross-tabulation chi(2) analysis. Results: One-hundred-and-one patients from 12 Dutch nursing homes participated in the study; data from 47 patients in the PME group and 54 controls were analyzed. Patients receiving PMT performed no better in paratonia assessments, nor on CGI, PSC, or PACSLAC-D, than controls in two and four week's time. Conclusion: PMT has no beneficial effects and should therefore not be recommended as an intervention in severe paratonia.
KW - paratonia
KW - dementia
KW - passive movement therapy
KW - movement disorders
U2 - 10.1017/S1041610211002468
DO - 10.1017/S1041610211002468
M3 - Article
C2 - 22185768
SN - 1041-6102
VL - 24
SP - 834
EP - 844
JO - International Psychogeriatrics
JF - International Psychogeriatrics
IS - 5
ER -