Physiotherapist Manzur Kader from Bangladesh, is currently doing PhD in Physiotherapy concerning “Walking difficulties, mobility devices and activity avoidance in people ageing with Parkinson’s disease”, at Lund University, Sweden. He has been granted for research funding (3800 USD/month for five years) from The Swedish Government. Today he has shared a summary of his five-year PhD research project to Physionews24.com.
Recently, the result of his ongoing current study, as a conference proceeding, has been submitted for presentation at 68th Annual Scientific Meeting of The Gerontological Society of America (GSA), between 18- 22 November, 2015. United States of America, Florida, Orlando.
We wish him all the best in his future endeavors.
PhD Project: Walking difficulties, mobility devices and activity avoidance in people ageing with Parkinson’s disease
Manzur Kader, MSc, MPH, Reg, Physiotherapist
Faculty of Medicine, Lund University, Sweden
Principal investigator and main supervisor for PhD project:
Dr. Maria H Nilsson, Associate Professor in Physiotherapy, Lund University, Sweden
Dr. Susanne Iwarsson, Professor in Occupational therapy & Gerontology; Head, Centre for Ageing and Supportive Environments (CASE), Lund University, Sweden, and
Dr. Per Odin, Professor in Neurology, Lund University, Sweden and Central Hospital Bremerhaven, Germany; President, Swedish Parkinson Academy
Phone: +46 (0)46-222 18 68
About 75 % of people with PD have gait and balance problems, which are known to negatively influence their health–related quality of life. They have specific gait problems that are experienced as a “if the feet were glued to the floor”, i.e. freezing of gait (FOG). FOG episodes most frequently occur in the home environment and are provoked by certain activities (e.g. turning) and environmental factors such as being in a confined space. Overall in PD–research, the use and perceived unmet need as well as impact of mobility devices remain unclear.
Moreover, people with PD have an increased risk of falling than others of the same age. They most commonly fall in the home environment and while walking. A fear of falling (FOF) is also more common and pronounced, and walking difficulties are the strongest contributing factor to FOF among people with PD. However, no PD–study has yet investigated activity avoidance due to the risk of falling out of a longitudinal perspective, which is a prerequisite for determining predictive factors. Such knowledge is highly needed for the development of potent interventions.
The overarching aim of this longitudinal PhD student project is to gain an increased knowledge regarding walking difficulties, fear of falling, the use and perceived need of mobility devices and fall–related activity avoidance in people ageing with PD.
This PhD student project rests upon an already initiated longitudinal cohort study targeting people with PD. All baseline assessments were completed in 2013 (n=255), and all participants will be invited to participate in an equivalent three–year follow–up (2016). Participants: Those with a PD diagnosis (G20.9, ICD–10) for at least one year were included. The exclusion criteria were cognitive difficulties/other reasons making the individual unable to give informed consent or take part in the majority of the data collection. The participants were recruited from three hospitals in Southern Sweden.
– Design of Studies I–V: The first three studies will be cross–sectional, based on the baseline data available.
Studies IV –V will have a longitudinal design, involving baseline data and data collected at the forthcoming three–year follow–up.
– Data collection: Self–administered questionnaires are administered via mail in advance of a subsequent home visit which includes clinical assessments, observations and interview–administered questionnaires.
– Study I
Aim: To investigate how fall-related activity avoidance relates to PD severity, a history of self-reported falls/near falls and fear of falling in people ageing with PD.
Time plan: Manuscript submitted in early 2015.
– Study II
Aim: To investigate how the use of different types of mobility devices relate to freezing of gait and a history of self-reported falls/near falls in people ageing with PD.
Time plan: manuscript submitted in the middle of 2015.
Aim: To investigate factors associated with the frequency of outdoor walking in people ageing with PD, with a specific focus on personal (e.g. general self–efficacy, FOF) and environmental factors (i.e. mobility devices, social support and entrance and outdoor environmental barriers) as well as disease–specific problems.
Time plan: manuscript submitted during 2015–2016.
– Study IV
Aim: To determine how the use and perceived unmet need of mobility devices change over time in people ageing with PD.
Time plan: The PhD student will participate in the 3–year data collection during 2016; submission of manuscript during 2017.
– Study V
Aim: To determine how walking difficulties and activity avoidance due to the risk of falling evolve over time in people ageing with PD.
Time plan: The PhD student will participate in the 3–year data collection during 2016; submission of manuscript during 2017–2018.
The results will be of importance for the planning of health care, including preventive efforts, treatment and rehabilitation targeting people with PD.
Kader’s PhD student project started in late 2014 and is anticipated to be completed in early 2019.
The strategic research area MultiPark, Lund University, Sweden
The Ribbingska Foundation, Lund, Sweden, and
The Swedish Association of Persons with Neurological Disabilities (NHR), Sweden.
The PhD project is accomplished within the context of the Centre for Ageing and Supportive
Environments (CASE), Lund University, Sweden.
Further details regarding the design, recruitment process, ethical considerations, procedure and data collection are to be found in the published study protocol:
Nilsson MH, Iwarsson S. Home and health in people ageing with Parkinson’s disease: study protocol for a prospective longitudinal cohort survey study. BMC neurology. 2013;13:142.