Parkinson Disease Clinical Trial
Official title:
Effect of Robot-assisted Gait Training in Patients With Parkinson's Disease: a Randomized Controlled Trial
Robot-assisted gait training can improve gait ability of patients with Parkinson's disease by repeating a normal gait pattern with high intensity. This study is a randomized controlled trial to investigate the effect of robot-assisted gait training on walking ability and functional connectivity of brain in patients with Parkinson's disease using an exo-skeletal robot.
Parkinson's disease is a disease caused by dopamine deficiency in the striatum resulting from
the loss of dopaminergic neuronal cells in the cerebral substantia. It is a progressive
neurodegenerative disease characterized by motor symptoms including gait disturbance and
balance instability. In the early stages of Parkinson's disease, dysfunction of the
sensorimotor area of the basal ganglia typically occurs, leading to habitual control hurdles.
Accordingly, cognitive efforts are required to perform habitual tasks such as walking, and
the automaticity of walking is reduced. Walking performance in a dual-task condition has been
used to assess gait automaticity in patients with Parkinson's disease.
Patients with Parkinson's disease are known to exhibit changes in functional connectivity of
the brain from an early stage. In addition, a number of studies have reported that patients
with Parkinson's disease with gait freezing have a change in resting brain activity and
functional connectivity of the brain. However, no studies have examined the functional
connectivity of the brain in patients with Parkinson's disease before and after
rehabilitation.
Robot-assisted gait training is a method of rehabilitation that repeats normal gait patterns
at high intensity. Recent meta-analysis has shown that robot-assisted gait training improved
the recovery of independent gait after stroke compared with conventional rehabilitation
therapy. On the other hand, robot-assisted gait training in Parkinson's disease has been
reported to improve walking speed and walking endurance compared to conventional physical
therapy, but is not superior to treadmill exercise of the same intensity. In addition, it has
been reported that in patients with Parkinson's disease with balance impairment,
robot-assisted gait training can improve balance disorder compared with physical therapy, and
gait freezing has improved in some small-scale patients. However, studies on the
effectiveness of robot-assisted gait training in Parkinson's disease are still lacking, and
the mechanism of the effect has not been elucidated. In particular, the effect on gait
automaticity, which is a characteristic of Parkinson 's disease, and functional connectivity
of the brain has not been studied. Therefore, this study is aimed to investigate the effect
of robot-assisted gait training on walking ability and functional connectivity of brain in
patients with Parkinson's disease using an exo-skeletal robot.
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