Effects of the Ronnie Gardiner Method - A randomized controlled trial on Parkinson's disease

ISRCTN ISRCTN85547604
DOI https://doi.org/10.1186/ISRCTN85547604
ClinicalTrials.gov number NCT02999997
Secondary identifying numbers RGM/PD
Submission date
04/04/2017
Registration date
05/04/2017
Last edited
03/03/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nervous System Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Parkinson’s disease (PD) is a common movement disorder, affecting approximately 120,000 people in the UK. It is a lifelong condition, which involves the gradual loss of nerve cells (neurons) in a part of the brain called the substantia nigra. These neurons are normally responsible for producing dopamine, a chemical messenger (neurotransmitter) which carries signals around the brain that help to coordinate movement. In people suffering from PD, these neurons gradually die over time, causing the level of dopamine in the brain to gradually fall. As the levels of dopamine become lower, the brain is unable to coordinate movement as effectively, causing abnormal movements such as stiffness, tremor (uncontrollable shaking) and slowness of movement (bradykinesia). As these symptoms worsen, patients often avoid movement and physical activity, for fear of falling, which can greatly impact on quality of life. The aim of this study is to evaluate the new rhythm and music based therapy program Ronnie Gardiner Method, created by Swedish musician Ronnie Gardiner, with the main focus on dual-task performance (doing two things at once).

Who can participate?
People with Parkinson's disease, diagnosed by a movement disorder specialist, in the community of Linköping, Sweden.

What does the study involve?
Participants are randomly allocated to one of two groups. Those in the first group attend the study centre to take part in the Ronnie Gardiner Method exercise program. This consists of planned, structured, repetitive, and purposive tasks performed to the beat of rhythmical music twice a week for 12 weeks in one hour sessions (total 24 sessions). Those in the second group do not attend any extra activities, and continue with their ordinary exercises and activities. Participants in both groups are followed up after three months.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
Rörelse & Hälsa (Sweden)

When is the study starting and how long is it expected to run for?
March 2016 to December 2018

Who is funding the study?
The County Council of Östergötland (Sweden)
The Neuro Association (Sweden)
The Parkinson Disease Research Foundation (Sweden)
The Ståhls Foundation (Sweden)
The Tornspiran Foundation (Sweden)

Who is the main contact?
Dr Petra Pohl

Contact information

Dr Petra Pohl
Scientific

Rehabgruppen NSC
Dept of Rehabilitation and Dept of Medical and Health Sciences
Linköping University
Linköping
58185
Sweden

ORCiD logoORCID ID 0000-0002-3447-6547
Phone +46 725 629882
Email petra.pohl@liu.se

Study information

Study designSingle-blind randomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Community
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet (in Swedish only)
Scientific titleEvaluation of the Ronnie Gardiner Method regarding dual-task performance in Parkinson's disease
Study hypothesis1. Participating in the rhythm and music based therapy program Ronnie Gardiner Method will improve the ability to perform simultaneous motor and cognitive tasks in people with Parkinson's disease
2. The program will improve cognitive function (memory, executive function, speed)
3. The program will have a positive effect on psychological wellbeing and reduce fear of falling
4. The program will improve postural stability
5. The program will enhance increased daily physical activity and reduce sedentary behaviour
Ethics approval(s)Regional Ethical Review Board in Linköping, 16/06/2016, ref: 2016/179-31
ConditionParkinson's disease
InterventionParticipants are randomised to one of two groups.

Intervention group: The intervention is based on the rhythm and music based therapy program Ronnie Gardiner Method (RGM), containing planned, structured, repetitive, and purposive tasks. The program includes complex multicomponent movements and cognitive challenges performed to rhythmic music. The leader projects for this method unique symbols in the shape of red or blue hands and feet. In all, there are 19 symbols, each symbol with a specific movement and unique name. When the symbols appear, the participants must make a certain movement and simultaneously speak the correct name in a loud voice (i.e., dual-tasking). Mostly the exercises are performed standing up, leading to weight-bearing positions, eg. shifting weight from right to left leg while stretching arms, challenging the postural stability. The single exercises last for appr. 3 minutes, i.e., as long as the music lasts. One 1 hour session contains up to 10 different songs, allowing for time to repeat the movements (motor learning). The participants are encouraged to practice some movements at home to their favorite music in between the sessions. The exercises are continuously progressing with higher tempo and more challenging exercises.
The intervention is performed twice weekly for 12 weeks in groups of 15 participants due to size of the intervention facility. The intervention is led by two certified RGM leaders who are also highly skilled registered physiotherapists. The sessions lasts for one hour each, a total of 24 sessions. After each session the leaders register attendance, any adverse events, and intensity achieved, in a structured report.

Control group: Participants will not attend to any extra activity, but are allowed to continue their everyday life, including therapies or exercises.

Both groups will be re-assessed within two weeks after the intervention period of 12 weeks, and again after another three months for a long term follow up. The assessments involve the same cognitive and physical tests and questionnaires as the pre-assessment, as well as wearing the actigraph armband for seven days.
Intervention typeBehavioural
Primary outcome measureMotor-cognitive dual-task performance measured with Timed-Up-and-Go test while subtracting 7 from 100, 90, or 80 at baseline, after 12 weeks, and at 3 months post-intervention.
Secondary outcome measures1. Balance is assessed using the Berg Balance Scale and Mini-BESTest, at baseline, after 12 weeks, and at 3 months post-intervention
2. Mobility is assessed using the Chair-stand test and Four-Step-Square-Test (FSST) at baseline, post-intervention (after 12 weeks), and at 3 months post-intervention
3. Cognitive function is assessed using the Montreal Cognitive Assessment, MoCA (C) (multiple cognitive domains); Symbol Digit Modalities test (attention); Rey Complex Figure (visuospatial skills); Victoria Stroop test and Trails A and B test (executive function); Grooved Pegboard (motor speed); and memory (instant and recalled) at baseline, post-intervention (after 12 weeks), and at 3 months post-intervention
4. Sedentary behaviour and physical activity levels are assessed using GENEActive actigraphy, worn for 7 days at baseline, post-intervention (after 12 weeks), and at 3 months post-intervention
5. Attendance, adverse events and intensity achieved are assessed using a structured report completed by the leaders after each session in the intervention group
6. Psychological wellbeing is assessed using the Parkinson's Disease Questionnaire, 39 items (PDQ-39) at baseline, post-intervention (after 12 weeks), and at 3 months post-intervention
7. Fear of falling is assessed using Falls Efficacy Scale International, Swedish version (FES-I) at baseline, post-intervention (after 12 weeks), and at 3 months post-intervention
8. Participants experiences of participating in the intervention group is assessed by face-to-face interviews and focus groups with 5 participants in each group within one week post-intervention (after 12 weeks)
Overall study start date01/03/2016
Overall study end date21/03/2018

Eligibility

Participant type(s)Patient
Age groupAll
Lower age limit18 Years
Upper age limit75 Years
SexBoth
Target number of participants60
Total final enrolment54
Participant inclusion criteria1. Diagnosed Parkinson's disease living in the community, stage 1.5 - 3 on H & Y scale
2. Age 18-75
3. Able to walk at least 10 m with or without walking aid
4. No colour blindness
5. Must be able to see and hear with or without aids
Participant exclusion criteriaDoes not meet inclusion criteria
Recruitment start date01/01/2017
Recruitment end date17/09/2017

Locations

Countries of recruitment

  • Sweden

Study participating centre

Rörelse & Hälsa
Neurorehab
Region Östergötland
Linköping
58185
Sweden

Sponsor information

The County Council of Östergötland
University/education

Region Östergötland
Linköping
58191
Sweden

Phone +46 10 103 0000
Email region@regionostergotland.se
Website www.regionostergotland.se
ROR logo "ROR" https://ror.org/0326gsy75

Funders

Funder type

Charity

Henry and Margareta Ståhls Foundation

No information available

Tornspiran Foundation

No information available

The Neuro Association

No information available

Parkinson Disease Research Foundation

No information available

Results and Publications

Intention to publish date31/12/2018
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a high-impact peer reviewed journal end of 2018.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from petra.pohl@liu.se

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/04/2020 03/03/2020 Yes No

Editorial Notes

03/03/2020: Publication reference added.
03/05/2019: The following changes were made:
1. The recruitment end date was updated from 31/08/2017 to 17/09/2017.
2. The overall trial end date was updated from 31/12/2018 to 21/03/2018.
3. The total final enrolment was added.
02/05/2019: No publications found, verifying study status with principal investigator.