ES-Park (Evaluation de l'Effectivité des Équipes Spécialisées Parkinson) is a pilot interventional study evaluating whether a multidisciplinary specialized Parkinson's team (Équipe Spécialisée Parkinson, ESPark) can improve quality of life for patients with moderate to severe Parkinson's disease through home-based rehabilitation and support[@ctgov].
The trial is modeled on the successful French Équipes Spécialisées Alzheimer (ESA) model, which demonstrated positive outcomes for autonomy and resocialization in Alzheimer's disease. ES-Park adapts this multidisciplinary team approach specifically for Parkinson's disease patients, recognizing that the complexity of PD — spanning motor symptoms, non-motor features, psychosocial challenges, and caregiver burden — requires coordinated care beyond standard medical management.
| Parameter | Details |
|---|---|
| Phase | Not Applicable (Pilot/Health Services Research) |
| NCT Number | NCT05433441 |
| Status | Recruiting |
| Sponsor | University Hospital, Bordeaux |
| Study Design | Randomized, crossover, open-label |
| Allocation | Randomized |
| Intervention Model | Crossover (standard care vs ESPark) |
| Masking | None (open-label) |
| Enrollment | 250 estimated |
| Start Date | December 6, 2022 |
| Primary Completion | December 6, 2025 |
| Study Completion | June 6, 2027 |
| Study ID | CHUBX 2022/02 |
The ESPark Intervention is a 15-session home-based multidisciplinary program delivered once per week by a specialized Parkinson's team. Each session is tailored to the individual patient following an initial assessment.
The ESPark team provides:
| Arm | Type | Description |
|---|---|---|
| Standard Care | No Intervention | Patients continue receiving routine medical and paramedical care |
| ESPark Intervention | Experimental | 15-session home-based multidisciplinary team program in addition to standard care |
| Measure | Description | Timepoints |
|---|---|---|
| IADL | Instrumental Activities of Daily Living scale (9 items, score 0-36) | Day 0, 6 months, 12 months |
| Measure | Description | Timepoints |
|---|---|---|
| MDS-UPDRS Part III | Motor examination subscale — speech, facial expression, rigidity, finger tapping, hand movements, pronation-supination, toe tapping, leg agility, chair rise, gait, postural stability, posture, tremor (rest/action/amplitude/constancy), dyskinesia assessment, Hoehn & Yahr staging | Day 0, 6 months, 12 months |
| Measure | Description | Timepoints |
|---|---|---|
| NMSS | Non-Motor Symptoms Scale for Parkinson's Disease (30 items, 9 dimensions) | Day 0, 6 months, 12 months |
| Measure | Description | Timepoints |
|---|---|---|
| MoCA | Montreal Cognitive Assessment (30-point scale; 27-30: normal, 18-26: mild cognitive impairment, 10-17: moderate, <10: severe) | Day 0, 6 months, 12 months |
| Measure | Description | Timepoints |
|---|---|---|
| BDI-II | Beck Depression Inventory — 21 items, somatic/affective/cognitive symptoms, past 7 days, 0-63 scale (higher = more severe) | Day 0, 6 months |
| Measure | Description | Timepoints |
|---|---|---|
| PQoL Carers | Parkinson's Disease Quality of Life Questionnaire for Caregivers — 26 items, total score 0-104 | Day 0, 6 months, 12 months |
| SCQ | Sense of Competence Questionnaire — 35 items across 3 domains (caregiving impact, performance satisfaction, care recipient satisfaction), scored 1-3 (27-81 scale) | Day 0, 6 months, 12 months |
| Measure | Description | Timepoints |
|---|---|---|
| RUD | Resource Utilization in Dementia — evaluates formal resources (social services, home care) and informal resources (caregiver time), valued at health insurance rates | Day 0, 6 months, 12 months |
Patient:
Caregiver:
Patient:
Caregiver:
| Site | City | Status | Contact |
|---|---|---|---|
| Hôpital Pellegrin (CHU de Bordeaux) | Bordeaux | Recruiting | Dr. Alexandra Foubert-Samier |
| CHU de Lille | Lille | Recruiting | Dr. Nicolas Carriere |
| CHU de Limoges | Limoges | Recruiting | Pr. Jean-Luc Houeto |
| CHU Poitiers | Poitiers | Recruiting | Dr. Isabelle Benatru |
Dr. Alexandra Foubert-Samier
University Hospital, Bordeaux
Parkinson's disease is a complex multifactorial disorder requiring coordinated care across multiple domains:
Standard care often addresses these domains in fragmented ways — neurology visits for medication adjustment, physiotherapy for mobility, psychiatry separately for mood, with limited coordination. The ESPark model seeks to integrate these elements through a single specialized team working in the patient's home environment.
The ESPark model directly adapts the French ESA framework that demonstrated positive outcomes in Alzheimer's disease. The ESA teams showed improvements in:
ES-Park tests whether these benefits extend to PD, where the symptom profile (prominent motor disability, levodopa-induced fluctuations, distinct non-motor features) differs from Alzheimer's disease.
The home-based delivery is a key feature of the ESPark intervention:
ES-Park falls within health services research — evaluating not a drug or device, but a care delivery model. This type of trial addresses:
The crossover design allows each patient to serve as their own control, which can:
The open-label design is appropriate for a behavioral/care delivery intervention where blinding participants and providers is not feasible.