The Learning Effects of Attentional Strategy on Dual-task Walking in Patients With Parkinson's Disease: Behavioral Performance and Neural Plasticity

NCT ID: NCT03895125

Last Updated: 2020-02-13

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: NA
• Total Enrollment: 1 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-03-07
• Study Completion Date: 2020-02-12

Brief Summary

[year1]

1. To compare the effects of dual-task training with two different task priority instruction in people with Parkinson's disease and healthy controls on dual-task weight shifting performances.

2. Investigate the changes of brain activities and functional connectivity after dual-task training with different task priority instructions.

[year 2-3]

To investigate the learning effects of walking with internal/external focus on walking automaticity and brain plasticity in dual-task walking training for PD patients with/without freezing of gait.

Detailed Description

Postural-suprapostural task is defined as postural control takes place while another concurrent task is being performed, belonging to dual-task paradigms. Effective dual-task training is important to patients with Parkinson disease (PD), because they often lose balance and fall in dual-task conditions. Attentional strategy includes 1) task-priority between postural and suprapostural tasks and 2) internal and external focus for the postural task, which is the critical factor for both dual-task control and motor learning. However, the appropriateness of attentional strategy has not been investigated in dual-task training in patients with PD. Besides, there is lack of neural evidence of brain plasticity for previous studies about dual-task training in patients with PD. With the uses of EEG, EMG and behavioral measures, the purpose of this 3-year research project is to investigate the differences in performance quality and intrinsic neural mechanisms of dual-task training in PD, by adopting task-priority strategy and internal/external strategy during weight-shifting and walking. In the first year, the investigators will characterize task-priority effect (posture-priority vs. supraposture-priority) on dual-task training, with a special focus on modulation of brain plasticity and muscle activity patterns in weight-shifting posture for patients with PD. In the second and third years, the learning effects of walking internal/external focus on walking automaticity and brain plasticity will be investigated in dual-task walking training for PD patients with/without freezing of gait. Besides, the transfer effects of dual-task learning will be also investigated on medication "off" state. The present project is expected to have significant contributions not only to gain a better insight to neural correlates of dual-task training with different attentional strategies under weight-shifting and walking, but to optimize treatment strategy for PD patients with balance or dual-tasking disturbances.

Conditions

Parkinson Disease

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

[year1] PD group

Group Type: EXPERIMENTAL

[year1] dual-task training with task priority strategy

Intervention Type: BEHAVIORAL

postural focus: focus mainly on postural performances while dual-tasking suprapostural focus: focus mainly on suprapostural performances while dual-tasking

[year1] healthy control group

Group Type: ACTIVE_COMPARATOR

[year1] dual-task training with task priority strategy

Intervention Type: BEHAVIORAL

postural focus: focus mainly on postural performances while dual-tasking suprapostural focus: focus mainly on suprapostural performances while dual-tasking

[year2-3] freezer

Group Type: EXPERIMENTAL

[year2-3] dual-task training with internal and external focus

Intervention Type: BEHAVIORAL

internal focus: focus mainly on body movements external focus: focus mainly on object in the environment

[year2-3] non-freezer

Group Type: EXPERIMENTAL

[year2-3] dual-task training with internal and external focus

Intervention Type: BEHAVIORAL

internal focus: focus mainly on body movements external focus: focus mainly on object in the environment

Interventions

[year1] dual-task training with task priority strategy

postural focus: focus mainly on postural performances while dual-tasking suprapostural focus: focus mainly on suprapostural performances while dual-tasking

Intervention Type: BEHAVIORAL

[year2-3] dual-task training with internal and external focus

internal focus: focus mainly on body movements external focus: focus mainly on object in the environment

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

1. For people with Parkinson's disease

1. modified Hoehn & Yahr stage 2-3

2. without dementia and able to follow instructions

2. For healthy controls

age and gender matched healthy subjects as control group

1. idiopathic Parkinson's disease

2. modified Hoehn & Yahr stage 2-3

3. without marked action or postural tremor

Exclusion Criteria

1. MMSE < 26

2. with other disease that may influence balance ability

3. with marked action and postural tremor

1. MMSE < 26

2. with other disease that may influence balance ability

• Minimum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Taiwan University Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Cheng-Ya Huang

Role: PRINCIPAL_INVESTIGATOR

School & Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University

Locations

National Taiwan University Hospital

Taipei, , Taiwan

Countries

Taiwan

Other Identifiers

201812110RINC

Identifier Type: -

Identifier Source: org_study_id