Trial Outcomes & Findings for Masked Faces in Parkinson Disease: Mechanism and Treatment (NCT NCT00350402)

NCT ID: NCT00350402

Last Updated: 2012-04-06

Results Overview

Primary outcome is change in entropy score from baseline to immediate completion of 4 week intervention. Entropy is a computer derived index of facial movement that is computed by quantifying changes in pixel intensity as the face moves over a series of video frames. Entropy values range from 0 up to 100. Higher scores reflect greater movement and expressivity (desired). In this condition ("off dopamine), entropy scores were obtained when participants were tested "off" their normal dopamine medications. Off-dopamine testing occurred after a 12-hour overnight washout period.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

44 participants

Primary outcome timeframe

Baseline and 4 weeks (i.e., immediate after 4-week treatment)

Results posted on

2012-04-06

Participant Flow

Parkinson participants were recruited from the University of Florida Center for Movement Disorders and Neurorestoration. Recruitment began in 2004 and ended in 2009.

Several participants were enrolled, but subsequently excluded (prior to randomization) when it was learned that they had medical conditions that had not initially been divulged or detected (i.e., seizure disorder, "booster" ECT for treatment of depression).

Participant milestones

Participant milestones
Measure
Inspiratory Muscle Strength Training (IMST)
high intensity respiratory muscle strength training, 75% MIP
Sham MST
Low intensity muscle strength training (5% MIP)
Overall Study
STARTED
21
21
Overall Study
COMPLETED
20
20
Overall Study
NOT COMPLETED
1
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Inspiratory Muscle Strength Training (IMST)
high intensity respiratory muscle strength training, 75% MIP
Sham MST
Low intensity muscle strength training (5% MIP)
Overall Study
Lost to Follow-up
1
1

Baseline Characteristics

Masked Faces in Parkinson Disease: Mechanism and Treatment

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Inspiratory Muscle Strength Training (IMST)
n=21 Participants
high intensity respiratory muscle strength training, 75% MIP
Sham MST
n=21 Participants
Low intensity muscle strength training (5% MIP)
Total
n=42 Participants
Total of all reporting groups
Age Continuous
66.2 years
STANDARD_DEVIATION 7.3 • n=5 Participants
68.4 years
STANDARD_DEVIATION 6.9 • n=7 Participants
67.3 years
STANDARD_DEVIATION 6.7 • n=5 Participants
Sex: Female, Male
Female
6 Participants
n=5 Participants
8 Participants
n=7 Participants
14 Participants
n=5 Participants
Sex: Female, Male
Male
15 Participants
n=5 Participants
13 Participants
n=7 Participants
28 Participants
n=5 Participants
Region of Enrollment
United States
21 participants
n=5 Participants
21 participants
n=7 Participants
42 participants
n=5 Participants
Education
16.76 years
STANDARD_DEVIATION 2.57 • n=5 Participants
15.52 years
STANDARD_DEVIATION 3.1 • n=7 Participants
16.14 years
STANDARD_DEVIATION 2.88 • n=5 Participants
Dementia Rating Scale-2
140 Units on a scale
STANDARD_DEVIATION 3.49 • n=5 Participants
138 Units on a scale
STANDARD_DEVIATION 4.44 • n=7 Participants
139 Units on a scale
STANDARD_DEVIATION 4.07 • n=5 Participants
Hoehn-Yahr Scale
2.1 units on a scale
STANDARD_DEVIATION .301 • n=5 Participants
2.29 units on a scale
STANDARD_DEVIATION .463 • n=7 Participants
2.19 units on a scale
STANDARD_DEVIATION .397 • n=5 Participants

PRIMARY outcome

Timeframe: Baseline and 4 weeks (i.e., immediate after 4-week treatment)

Population: All participants who completed baseline, intervention, and post-testing. Two participants, one from each group, dropped out during first week of intervention.

Primary outcome is change in entropy score from baseline to immediate completion of 4 week intervention. Entropy is a computer derived index of facial movement that is computed by quantifying changes in pixel intensity as the face moves over a series of video frames. Entropy values range from 0 up to 100. Higher scores reflect greater movement and expressivity (desired). In this condition ("off dopamine), entropy scores were obtained when participants were tested "off" their normal dopamine medications. Off-dopamine testing occurred after a 12-hour overnight washout period.

Outcome measures

Outcome measures
Measure
Inspiratory Muscle Strength Training (IMST): 75% MIP
n=20 Participants
High intensity respiratory muscle strength training took place over 4 weeks, 5 days a week. Each exercise session involved sets of breathing exercises taking approximately 20 minutes/day. The inspiratory exercises involved a breathing device that required individuals to take "deep breaths" and breathe in (i.e., inspire). Settings on breathing device were determined by obtaining the individual's maximal inspiratory pressure (MIP) using a specialized breathing gauge. The MIP was determined each week, and the exercise breathing trainer was adjusted and set at 75% of the participant's MIP. Exercises took place in the home setting, with weekly visit by staff.
Sham IMST: 5% MIP
n=20 Participants
The Sham IMST intervention was identical to the "real" intervention in all ways except that the MIP is set for 5% MIP. Thus, less muscle effort was required during the exercise training.
Change in Facial Entropy Score From Baseline [Off Dopamine Medication]
5.649 units on a scale
Standard Deviation 6.66
-1.605 units on a scale
Standard Deviation 6.16

PRIMARY outcome

Timeframe: Baseline and 4 weeks (i.e., immediate after 4-week intervention)

Population: Based on individuals who completed baseline and post-treatment assessment following 4 weeks of intervention. One individual from each treatment group dropped out during the first week of intervention and were not included in analyses.

Outcome is entropy change from baseline to immediate completion of 4 week intervention when participants remained on their normal dosage of dopamine medication. Entropy is quantitative index of facial movement that is computed from changes in pixel intensity as the face moves. Entropy values range from 0 up to 100. Higher scores reflect greater movement and expressivity. Greater expressivity is desired outcome.

Outcome measures

Outcome measures
Measure
Inspiratory Muscle Strength Training (IMST): 75% MIP
n=20 Participants
High intensity respiratory muscle strength training took place over 4 weeks, 5 days a week. Each exercise session involved sets of breathing exercises taking approximately 20 minutes/day. The inspiratory exercises involved a breathing device that required individuals to take "deep breaths" and breathe in (i.e., inspire). Settings on breathing device were determined by obtaining the individual's maximal inspiratory pressure (MIP) using a specialized breathing gauge. The MIP was determined each week, and the exercise breathing trainer was adjusted and set at 75% of the participant's MIP. Exercises took place in the home setting, with weekly visit by staff.
Sham IMST: 5% MIP
n=20 Participants
The Sham IMST intervention was identical to the "real" intervention in all ways except that the MIP is set for 5% MIP. Thus, less muscle effort was required during the exercise training.
Change in Facial Entropy Score From Baseline [On Dopamine Medication]
3.559 Units on a scale
Standard Deviation 9.995
-1.569 Units on a scale
Standard Deviation 4.931

SECONDARY outcome

Timeframe: Baseline and 4 weeks (i.e., immediate post-intervention)

Population: Participants who completed baseline,intervention, and post-intervention testing. Two individuals, one from each group, dropped out of the study during the first week of intervention.

The PDQ-39 is a widely used quality of life measure that is specific to Parkinson disease. Total raw score on the PDQ-39 ranges from 0 to 156. Higher scores reflect worse quality of life rating. Total score on PDQ-39 was used to compute pre-post treatment changes.

Outcome measures

Outcome measures
Measure
Inspiratory Muscle Strength Training (IMST): 75% MIP
n=20 Participants
High intensity respiratory muscle strength training took place over 4 weeks, 5 days a week. Each exercise session involved sets of breathing exercises taking approximately 20 minutes/day. The inspiratory exercises involved a breathing device that required individuals to take "deep breaths" and breathe in (i.e., inspire). Settings on breathing device were determined by obtaining the individual's maximal inspiratory pressure (MIP) using a specialized breathing gauge. The MIP was determined each week, and the exercise breathing trainer was adjusted and set at 75% of the participant's MIP. Exercises took place in the home setting, with weekly visit by staff.
Sham IMST: 5% MIP
n=20 Participants
The Sham IMST intervention was identical to the "real" intervention in all ways except that the MIP is set for 5% MIP. Thus, less muscle effort was required during the exercise training.
Change in Parkinson Disease Quality of Life-39 Scale (PDQ-39)
1.850 units on a scale
Standard Deviation 10.16
-1.550 units on a scale
Standard Deviation 17.57

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 4 weeks (i.e., immediate after 4-week intervention)

Population: Included participants who underwent baseline, intervention, and post-treatment assessment. Two individuals dropped out during the first week of intervention, one from each intervention group. Additionally, there was faulty data, due to equipment failure for one individual in the sham group, thereby reducing N in this group to 19.

The dependent variable is the change in maximal inspiratory pressure (MIP) from baseline to immediate completion of 4-week intervention. MIP refers to how much air pressure force an individual creates by inhaling through the mouth as hard as possible. This was measured over 5-7 trials by placement of lips around a mouthpiece attached to a calibrated fluke digital pressure gauge. From these trials, an average maximum inspiratory pressure (MIP) was computed. This was done at baseline and post-treatment. Greater MIP changes correspond to greater treatment-related effects of exercise.

Outcome measures

Outcome measures
Measure
Inspiratory Muscle Strength Training (IMST): 75% MIP
n=20 Participants
High intensity respiratory muscle strength training took place over 4 weeks, 5 days a week. Each exercise session involved sets of breathing exercises taking approximately 20 minutes/day. The inspiratory exercises involved a breathing device that required individuals to take "deep breaths" and breathe in (i.e., inspire). Settings on breathing device were determined by obtaining the individual's maximal inspiratory pressure (MIP) using a specialized breathing gauge. The MIP was determined each week, and the exercise breathing trainer was adjusted and set at 75% of the participant's MIP. Exercises took place in the home setting, with weekly visit by staff.
Sham IMST: 5% MIP
n=19 Participants
The Sham IMST intervention was identical to the "real" intervention in all ways except that the MIP is set for 5% MIP. Thus, less muscle effort was required during the exercise training.
Change From Baseline in Maximal Inspiratory Pressure (MIP)
13.9 units of pressure (cmH20)
Standard Deviation 12.16
3.47 units of pressure (cmH20)
Standard Deviation 14.16

Adverse Events

Inspiratory Muscle Strength Training (IMST)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Sham MST

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Dawn Bowers

University of Florida

Phone: (352) 392-3450

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place