Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05790759
Other study ID # NMSK - Lheureux 03
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date January 1, 2020
Est. completion date March 15, 2020

Study information

Verified date March 2023
Source Cliniques universitaires Saint-Luc- Université Catholique de Louvain
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Parkinson's Disease (PD) patients suffer from gait impairments responsible for falls and bad quality of life: reduced speed and stride length, randomness in the temporal organization of stride duration variability (reduced Long-Range Autocorrelations (LRA)). For years, auditory cueing has been used to modulate PD gait and its effect on LRA is known. Less is known regarding the effects of haptic cueing on PD gait and especially on LRA. This pilot study will compare the spatio-temporal gait parameters and LRA of PD patients tested under three conditions: walking without cueing, walking with auditory cueing and walking with haptic cueing by means of rhythmic vibrations on the patients' wrists.


Description:

1. BACKGROUND Parkinson's disease (PD) is the second most common degenerative neurological disease. PD induces gait disorders that lead to increased risk of falls. These falls seriously affect patients' quality of life and generate significant health care costs. Unfortunately, gait disorders do not respond well to drug treatments and their management is mainly based on rehabilitation treatment. The rehabilitation approach comprises two steps: a functional assessment of locomotor capacities followed by completion of a therapeutic physical exercise program. Like heart rate, stride duration varies in the short and long term according to a complex dynamic of temporal variations. These variations present long-range autocorrelations (LRA): the stride duration does not vary randomly but in a structured way. The study of LRA is based on complex mathematical methods requiring recording of at least 256 consecutive gait cycles. LRA are altered in PD patients whose gait rhythm is excessively random. Alteration of LRA is correlated with neurological impairments (Hoehn & Yahr scale and UPDRS) and patients' locomotor stability (ABC scale & BESTest). Measurement of LRA would be the first available objective and quantitative biomarker of stability and risk of falling in patients with PD. Guidelines concerning rehabilitation programs for PD patients are based on education (prevention of falls and inactivity,...), physical exercises, functional training (double task, complex tasks,...), learning, and adaptation strategies such as the use of rhythmic sensory cueing. Auditory Cueing (AC) has been used for years for clinical and research purposes and its effects on spatio-temporal gait parameters and LRA are known. Less is know regarding Haptic/Somatosensory Cueing (HC). A few research were conducted to study the influence of HC on PD spatio-temporal gait parameters but to the best of our knowledge, none has yet addressed its effects on LRA. The aim of this present study was to compare PD saptio-temporal gait parameters and LRA under three conditions : walking without cueing, walking with AC and walking with HC. 2. METHODS 2.1 Participants : 10 patients suffering from idiopathic Parkinson's Disease were recruited from the local community and from the Neurology and the Physical and Rehabilitation Medicine outpatient clinics of the Cliniques universitaires Saint-Luc (Woluwe-Saint-Lambert, Belgium). 2.2 Functional assessment: Before the expermientations starts, all participants underwent a non harmful assessment including clinical tests and questionnaires PD patients: Age, height, weight, sex, most affected side, Movement Disorder Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS), Mini Balance Evaluation Systems Test (Mini-BESTest), Simplified version of the Activities-specific Balance Confidence Scale (ABC-Scale), modified Hoehn & Yahr scale, Mini Mental State Examination (MMSE). 2.3 Procedure : Every participants walked in three conditions in a randomized order. Each condition lasted ±10 minutes in order to get 256 gait cycles mandatory to assess the presence of LRA using the evenly spaced averaged version of the Detrended Fluctuations Analysis (DFA). The first condition was the control condition (CC), patients walking without any cueing on a rectangular track with rounded corner of 63.2 meters in CUSL at their comfortable walking speed. The second condition was the Auditory Cueing Condition (ACC) and consisted in walking on the same rectangular track using auditory cueing by the mean of a smartphone app called Soundbrenner. This app allowed to precisely deliver rhythmic auditory stimulations through earphones paced 10% faster than each patient's preferred step frequence assessed before the experiment. The last condition was the Haptic Cueing Condition (ACC) and consisted in walking on the same rectangular track using haptic cueing by the mean of a vibratory device called Soundbrenner Pulse and attached to each patient's wrist located on their most affected side. The Soundbrenner app on the smartphone was connected to the Soundbrenner Pulse by Bluetooth to deliver rhythmic vibratory stimulations also paced 10% faster than each patient's preferred step frequence, the same frequence as during ACC. 2.4 Data acquisition: Two Inertial Measurement Units (IMU) (IMeasureU Research, VICON, USA) were taped on patients' both lateral malleoli. This system allowed to record ankle accelerations at 500 Hz. The data were then put on a computer and each peak of acceleration, corresponding to each heel strike, was detected by software internally developed to determine all stride durations. 2.5 Gait assessment: Data were extracted from 256 consecutive gait cycles which is required for LRA computation. 2.5.1 Spatiotemporal gait variables: Mean gait speed, gait cadence and stride length were measured as follow: Mean gait speed (m.s-1) = Total walking distance (m)/ Acquisition duration (s) Gait cadence (#steps.min-1) = Total number of steps (#)/Acquisition duration (min) Step length (m) = Gait speed (m/s)*60/Gait cadence (steps/min) 2.5.2 Stride duration variability : Stride duration variability can be assessed 2 ways: in terms of magnitude or in terms of organization (how stride duration evolves across consecutive gait cycles). 2.5.2.1 Magnitude of the stride duration variability : To determine the effect of the RAS on the magnitude of the stride duration variability during 256 gait cycles, the mean, the standard deviation (SD) and the coefficient of variation (CV = [SD/mean] * 100) were assessed. 2.5.2.2 Temporal organization of the stride duration variability : Temporal organization of stride duration variability were assessed by LRA computation using the evenly spaced averaged version of the Detrended Fluctuation Analysis (DFA) to obtain α exponent. The presence of LRA can be shown with α exponent values between 0.5 and 1. Data were treated by the mean of CVI Labwindows (C++). 2.6 Statistical analyses : Statistical analyses were conducted using Sigmaplot 13. If the normality test passed, a one-way repeated measures ANOVA was applied to determine the effect of the various walking condition on spatiotemporal gait parameters (gait speed, gait cadence, stride length) and on linear and nonlinear measures of stride duration variability (CV, SD, H and α exponents). If a significant difference between groups was detected with the ANOVA, a Holm-Sidak post hoc test was performed to compare each mean with the other means to isolate the groups from each other. Effect size between conditions regarding all parameters was assessed using Cohen's d.


Recruitment information / eligibility

Status Completed
Enrollment 10
Est. completion date March 15, 2020
Est. primary completion date March 15, 2020
Accepts healthy volunteers No
Gender All
Age group N/A and older
Eligibility Inclusion Criteria: - Idiopathic PD according to the UK Brain Bank Criteria - modified Hoehn & Yahr scale <= 3 - Mini-Mental State Examination > 24/30 - Ability to walk 256 consecutive strides Exclusion Criteria: - Other pathology interacting with gait - Significant hearing problems not allowing to hear the auditory cueing - Significant somatosensory problems not allowing to feel the haptic cueing on the skin

Study Design


Intervention

Other:
No cueing versus Haptic cueing versus Auditory cueing during parkinson's disease gait
Patients walked in three conditions in a randomized order. During control condition, patients walked without cueing on a rectangular track of 63.2 meters at their comfortable gait speed. During Auditory Cueing Condition (ACC) patients walked on the same track using auditory cueing by the mean of a smartphone app called Soundbrenner thath deliverered rhythmic auditory stimulations through earphones paced 10% faster than each patient's preferred step frequence. During Haptic Cueing Condition (HCC) patients walked on the same track using haptic cueing by the mean of a vibratory device called Soundbrenner Pulse and attached to each patient's wrist located on their most affected side. The Soundbrenner app on the smartphone was connected to the Soundbrenner Pulse by Bluetooth to deliver rhythmic vibratory stimulations also paced 10% faster than each patient's preferred step frequence, the same frequence as during ACC.

Locations

Country Name City State
Belgium Cliniques Universitaires Saint Luc Brussel
Belgium Cliniques Universitaires Saint-Luc Brussels

Sponsors (1)

Lead Sponsor Collaborator
Cliniques universitaires Saint-Luc- Université Catholique de Louvain

Country where clinical trial is conducted

Belgium, 

Outcome

Type Measure Description Time frame Safety issue
Primary Long-Range Autocorrelations Long-Range Autocorrelations computation using the evenly spaced version of the Detrended Fluctuations Analysis Change from baseline in long-range autocorrelations during each intervention condition (3 x 10 min walking)
Secondary Mean Gait Speed otal walking distance (m)/ Acquisition duration (s) Change from baseline in mean gait speed during each intervention condition (3 x 10 min walking)
Secondary Step Length Gait speed (m/s)*60/Gait cadence (steps/min) Change from baseline in step length during each intervention condition (3 x 10 min walking)
Secondary Gait Cadence Total number of steps (#)/Acquisition duration (min) Change from baseline in gait cadence during each intervention condition (3 x 10 min walking)
Secondary Coefficient of variation of stride duration [SD/mean stride duration] * 100 Change from baseline in coefficient of variation during each intervention condition (3 x 10 min walking)
See also
  Status Clinical Trial Phase
Completed NCT05415774 - Combined Deep Brain Stimulation in Parkinson's Disease N/A
Recruiting NCT04691661 - Safety, Tolerability, Pharmacokinetics and Efficacy Study of Radotinib in Parkinson's Disease Phase 2
Active, not recruiting NCT05754086 - A Multidimensional Study on Articulation Deficits in Parkinsons Disease
Completed NCT04045925 - Feasibility Study of the Taïso Practice in Parkinson's Disease N/A
Recruiting NCT04194762 - PARK-FIT. Treadmill vs Cycling in Parkinson´s Disease. Definition of the Most Effective Model in Gait Reeducation N/A
Completed NCT02705755 - TD-9855 Phase 2 in Neurogenic Orthostatic Hypotension (nOH) Phase 2
Terminated NCT03052712 - Validation and Standardization of a Battery Evaluation of the Socio-emotional Functions in Various Neurological Pathologies N/A
Recruiting NCT05830253 - Free-living Monitoring of Parkinson's Disease Using Smart Objects
Recruiting NCT03272230 - Assessment of Apathy in a Real-life Situation, With a Video and Sensors-based System N/A
Recruiting NCT06139965 - Validity and Reliability of the Turkish Version of the Comprehensive Coordination Scale in Parkinson's Patients
Completed NCT04580849 - Telerehabilitation Using a Dance Intervention in People With Parkinson's Disease N/A
Completed NCT03980418 - Evaluation of a Semiconductor Camera for the DaTSCAN™ Exam N/A
Completed NCT04477161 - Effect of Ketone Esters in Parkinson's Disease N/A
Completed NCT04942392 - Digital Dance for People With Parkinson's Disease During the COVID-19 Pandemic N/A
Terminated NCT03446833 - LFP Beta aDBS Feasibility Study N/A
Completed NCT03497884 - Individualized Precise Localization of rTMS on Primary Motor Area N/A
Completed NCT05538455 - Investigating ProCare4Life Impact on Quality of Life of Elderly Subjects With Neurodegenerative Diseases N/A
Recruiting NCT04997642 - Parkinson's Disease and Movement Disorders Clinical Database
Completed NCT04117737 - A Pilot Study of Virtual Reality and Antigravity Treadmill for Gait Improvement in Parkinson N/A
Recruiting NCT03618901 - Rock Steady Boxing vs. Sensory Attention Focused Exercise N/A