The Effect of Split-belt Treadmill Training on Gait in Parkinson's Disease

Parkinson Disease Clinical Trial

Official title:

The Impact of Split-belt Treadmill Training to Modulate Freezing-related Gait Deficits and Freezing Episodes in Parkinson's Disease

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04176263
• Other study ID #: S62825 (KUL); D454/13 (CAU)
• Secondary ID: None was given
• Status: Completed
• Phase: N/A
• Start date: August 12, 2019
• Est. completion date: May 11, 2021

Study information

• Verified date: August 2021
• Source: KU Leuven
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

People with Parkinson's disease (PD) often show gait impairments such as, shuffling gait, short steps and gait asymmetry and irregularity. These gait problems are already apparent in the early disease stages, having an immense effect on daily life functioning. Especially Freezing of Gait (FOG), where the patients are not able to initiate or continue their movement despite their intention to do so, is a debilitating problem. It is thought that lack of gait adaptability could be an underlying cause of FOG. With a split-belt treadmill the speed of both legs can be controlled independently, which forces participants to actively adapt their gait to the new situation. In a previous study performed at our lab, it was shown that only one session of split-belt training (SBT), in which the speed of one leg was reduced, improved gait adaptability and other gait features compared to tied-belt training (TBT). Furthermore, overground turning speed improved after only one single training session and this was even retained 24 hours later, indicating training induced long-term potentiation. Since the short-term effects of SBT are promising, the objective of this study is to investigate if 4 weeks of SBT, 3 times a week, has an effect on gait deficits found in individuals with PD, compared to 4-weeks, 3 times a week, of TBT.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 52
• Est. completion date: May 11, 2021
• Est. primary completion date: May 11, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

1. Clinical diagnosis of PD according to the recent criteria of the Movement Disorders Society made by a neurologist

2. Participants should be able to walk 5 minutes at a stretch without a walking aid

3. Hoehn & Yahr stage II or III in the ON state of medication

4. Mini Mental State Examination score of 24 or above

5. Participants should have a steady medication schedule at the start of the study (no change in the past month).

6. To be included as a freezer participant a score of at least 1 or higher should be recorded with the New Freezing of Gait Questionnaire.

Exclusion Criteria:

1. Current enrollment in another clinical study which may interfere with the conduction of this study.

2. Orthopedic injuries or other musculoskeletal problems, which could possibly effect balance and/or gait.

3. Unable or unwilling to commit to 4 weeks of training, 3 times a week

4. Participation in walking training in the month prior to the start of the study

5. Other neurological impairments (except PD)

6. Cardiovascular exercise risk factors diagnosed by a doctor

Related Conditions & MeSH terms

• Freezing of Gait
• Parkinson Disease

Intervention

Behavioral:
• SBT
The SBT group will receive a 4-week split-belt treadmill training, 3 times a week using a standardized progression protocol. The sessions, including breaks, will approximately take 1 hour each. The training will be given by a trainer experienced with PD.
• TBT
The TBT group will receive a 4-week tied-belt treadmill training, 3 times a week. To make sure exposure of the two interventions is similar the sessions of the TBT group will be of similar length and progression level (approximately 1 hour each). The training will be given by a trainer experienced with PD.

Locations

Country	Name	City	State
Belgium	KU Leuven	Leuven	Vlaams-Brabant
Germany	University Hospital Schleswig-Holstein (UKSH), Christian-Albrechts-University Kiel	Kiel	Schleswig-Holstein

Sponsors (2)

Lead Sponsor	Collaborator
KU Leuven	University of Kiel

Countries where clinical trial is conducted

Belgium,  Germany, 

References & Publications (1)

Seuthe J, D'Cruz N, Ginis P, Weisser B, Berg D, Deuschl G, Nieuwboer A, Schlenstedt C. Split-belt treadmill walking in patients with Parkinson's disease: A systematic review. Gait Posture. 2019 Mar;69:187-194. doi: 10.1016/j.gaitpost.2019.01.032. Epub 2019 Feb 7. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Average overground 360 degree turning speed (degrees/s)	Participants will be instructed to turn 360 degrees in alternating directions (clockwise/counterclockwise) for 60 seconds. The instruction is to turn as quickly as possible, while still feeling safe doing this. The average overground turning speed will be determined by the use of APDM Opal accelerometers which will be worn on both feet, wrists and the lower back.	Change in performance between the average overground turning speed from pre to post intervention (i.e. the week after the 4-week training period ended)
Secondary	Average dual task overground 360 degree turning speed (degrees/sec)	Participants will be instructed to turn 360 degrees in alternating directions (clockwise/counterclockwise) for 60 seconds. The instruction is to turn as quickly as possible, while still feeling safe doing this. The average overground turning speed will be determined by the use of APDM Opal accelerometers which will be worn on both feet, wrists and the lower back. In addition to this task the participants also have to perform an auditory stroop task. The participant hears the words 'low' and 'high' in either a low or high pitch in random order and timing. The participant has to respond as quickly as possible to the pitch of the word and not to the word itself.	Change in performance between the average overground turning speed from pre to post intervention (i.e. the week after the 4-week training period ended)
Secondary	Retention of average overground 360 degree turning speed (degrees/sec)	Participants will be instructed to turn 360 degrees in alternating directions (clockwise/counterclockwise) for 60 seconds. The instruction is to turn as quickly as possible, while still feeling safe doing this. The average overground turning speed will be determined by the use of APDM Opal accelerometers which will be worn on both feet, wrists and the lower back.	Change in performance from post-intervention 1 week after the 4-week training period ended (Retest 1) to retention, 5 weeks later (Retest 2).
Secondary	Retention of dual task average overground 360 degree turning speed (degrees/sec)	Participants will be instructed to turn 360 degrees in alternating directions (clockwise/counterclockwise) for 60 seconds. The instruction is to turn as quickly as possible, while still feeling safe doing this. The average overground turning speed will be determined by the use of APDM Opal accelerometers which will be worn on both feet, wrists and the lower back. In addition to this task the participants also have to perform an auditory stroop task. The participant hears the words 'low' and 'high' in either a low or high pitch in random order and timing. The participant has to respond as quickly as possible to the pitch of the word and not to the word itself.	Change in performance from post-intervention 1 week after the 4-week training period ended (Retest 1) to retention, 5 weeks later (Retest 2).