Effects of Attentional Focus Strategy on Dual-task Walking Training in Patients With Parkinson's Disease

Parkinson Disease Clinical Trial

Official title:

Effects of Attentional Focus Strategy on Dual-task Walking Training in Parkinson's Disease With and Without Freezing of Gait

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04364152
• Other study ID #: 202001029RIND
• Status: Completed
• Phase: N/A
• Start date: August 6, 2020
• Est. completion date: August 1, 2023

Study information

• Verified date: August 2023
• Source: National Taiwan University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Walking deficits and altered brain capacity have been proved to be two of the main contributing factors in dual-task walking deficits in patients with Parkinson's disease (PD). In the past, patients with PD were usually suggested not to walk in dual-task conditions in order to concentrate on their walking performance better. However, since dual-task walking is really common in daily-life, this limitation usually lead to a decrease in quality of life for PD patients. In previous studies, effects of using attentional strategies in dual-task walking training remain unclear, while suitable attentional strategies and corresponded neuroplasticity for patients with and without freezing of gait have not been well discussed, either. Accordingly, this study is aimed to identify (1) whether internal or external attentional strategies is more ideal for PD patients with and without freezing of gait in dual-task walking training, and (2) changes in brain activity after receiving dual-task walking training with different attentional strategies in patients with or without freezing of gait. Our hypothesis are (1) patients with or without freezing of gait will react differently in dual-gait training with different attentional strategies, and (2) changes in brain activities will be different according to different attentional strategies given in the training.

Description:

The hypothesis will be tested by gait performance, suprapostural tasks performance, relative power spectrum of EEG, and scales including MDS-UPDRS, ABC, BBS, and TUG.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 50
• Est. completion date: August 1, 2023
• Est. primary completion date: August 1, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 40 Years and older

Eligibility

Inclusion Criteria:

for PD patients:

• (1) a diagnosis of idiopathic PD by a neurologist expert in movement disorders (2) onset age > 40 years old, (3) presence of gait disorders or freezing of gait (points on 3.10 in MDS-UPDRS>=1 or points on item 3 in NFOG-Q >0) (4) able to walk independently without an assistance device at least for 20 meters (5) without obvious action or postural tremor, according to the score of 3.15 and 3.16 (action and postural tremor of hands) in MDS-UPDRS

for healthy elders:

• (1) without musculoskeletal of neurological diseases which may affect balance or walking performance (2) no medication that might influence their balance or cognition (3) MMSE> 26 points.

Exclusion Criteria:

for PD patients:

• (1) with other neurological or musculoskeletal disease that might affect balance or walking (2) have a Mini-Mental State Examination (MMSE) < 27 points (3) have a history of brain surgery (4) have to modulate their medication for duration of the experiment.

Related Conditions & MeSH terms

• Dual-task Walking
• Parkinson Disease

Intervention

Behavioral:
• Dual-task walking training
Participants will be instructed to perform both motor and cognitive dual-task walking during exercise training. For example, for motor dual-task walking, the participants may be instructed to throw and catch a ball while walking. As for cognitive dual-task walking, the participants may be instructed to name animals or perform calculation while walking.

Locations

Country	Name	City	State
Taiwan	School and Graduate Institute of Physical Therapy, National Taiwan University	Taipei

Sponsors (1)

Lead Sponsor	Collaborator
National Taiwan University Hospital

Country where clinical trial is conducted

Taiwan, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Gait velocity from GAITRite	gait performance	60 minutes
Primary	Cadence from GAITRite	gait performance	60 minutes
Primary	Mean step length from GAITRite	gait performance	60 minutes
Primary	Step-to-step variability from GAITRite	gait performance	60 minutes
Primary	Amplitude from a triaxial accelerometer, X axes	motor suprapostural task performance	25 minutes
Primary	Amplitude from a triaxial accelerometer, Y axes	motor suprapostural task performance	25 minutes
Primary	Amplitude from a triaxial accelerometer, Z axes	motor suprapostural task performance	25 minutes
Primary	Correct rate on working memory task	cognitive suprapostural task performance	25 minutes
Secondary	EEG relative power in the delta band	brain activity under single, motor dual-task, and cognitive dual-task walking conditions	60 minutes
Secondary	EEG relative power in the theta band	brain activity under single, motor dual-task, and cognitive dual-task walking conditions	60 minutes
Secondary	EEG relative power in the alpha band	brain activity under single, motor dual-task, and cognitive dual-task walking conditions	60 minutes
Secondary	EEG relative power in the beta band	brain activity under single, motor dual-task, and cognitive dual-task walking conditions	60 minutes
Secondary	EEG relative power in the low gamma band	brain activity under single, motor dual-task, and cognitive dual-task walking conditions	60 minutes