PAS Balance Training for Parkinson Disease (PD)
ConditionPD - Parkinson's Disease
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age20+
SponsorChang Gung University
About this trial
Gait initiation (GI) difficulty is a common problem in individuals with Parkinson's disease (PD), often linked to impaired anticipatory postural adjustments (APA). Currently, there are no targeted rehabilitation programs designed specifically for GI-related APA in PD patients. Research has shown that while motor learning deficits are common in PD, explicit learning is better preserved than implicit learning. Therefore, a GI-related APA training system using an explicit learning model could be particularly effective for this population.
During motor learning, long-term potentiation (LTP) increases the excitability of the primary motor cortex. Paired associative stimulation (PAS) has been demonstrated to induce LTP-like changes in the motor cortex, making it a potential priming method to enhance motor learning. However, the priming effect of PAS targeted at leg muscles and the motor cortex on motor learning related to GI-APA has not been previously studied.
The objectives of this study are:
1. To investigate the effects of explicit and implicit training on GI-related APA. 2. To evaluate the priming effect of PAS on GI-related APA training and the associated plasticity changes in the motor cortex.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
None
Disqualifiers
Musculoskeletal injuries on legs
Osteoporosis.
Any peripheral or central nervous system injury or disease patients.
Trial design
Design model
Parallel
Treatments tested in this trial
Weight shift training and APA feedback
Procedure/SurgeryUse COP trajectory to train weight shift on force plate. To give APA visual feedback for subjects after weight shift training.
Paired associative stimulation
Procedure/SurgeryUse TMS combine ES to stimulate TA nerve and M1 cortical
Treatment groups
60 Participants
are divided into 2 treatment groupsGroup A: PD APA training groupExperimental treatment 1 intervention
Group B: PD PAS groupExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Balance Performance
Measured by the duration the stance or stand can be maintained. Unit：second(s)
Time frame
Baseline, 4 weeks and 8 weeks2
COP Path Length in Balance Tasks
The total distance traveled by the COP over a specified period. Longer path lengths can indicate increased effort to maintain balance or greater instability.
Time frame
Baseline, 4 weeks and 8 weeks3
COP Displacement in Balance Tasks
Measures of COP movement in the anterior-posterior (AP) and medial-lateral (ML) directions, offering insights into the directional tendencies of balance control. Unit：millimeter(mm)
Time frame
Baseline, 4 weeks and 8 weeks4
Motor Evoked Potentials (MEPs)
MEPs are the electrical responses recorded from muscles following stimulation of the motor cortex. They reflect the efficiency of neural transmission from the cortex to the muscle. Unit：millivolts (mV)
Time frame
Baseline, 4 weeks and 8 weeksSecondary outcomes
1
COP Velocity in Balance Tasks
The speed at which the COP moves, calculated over the duration of the balance task. Higher velocities may reflect more dynamic balance adjustments or instability. Unit：millimeter per second(mm/s)
Time frame
Baseline, 4 weeks and 8 weeks2
COP Area in Balance Tasks
The area covered by the COP trajectory during the balance task, providing an estimate of the sway envelope. A larger area might indicate poorer balance control. Unit：square millimeter(mm\^2)
Time frame
Baseline, 4 weeks and 8 weeks3
Double Support Time
The portion of the gait cycle where both feet are in contact with the ground, indicating the transition phase between steps, expressed as a percentage of the gait cycle or in seconds.
Time frame
Baseline, 4 weeks and 8 weeks4
Single Support Time
The duration within the gait cycle when only one foot is in contact with the ground, typically measured in seconds or as a percentage of the total gait cycle.
Time frame
Baseline, 4 weeks and 8 weeksOther outcomes
1
Total UPDRS-III Score
The Unified Parkinson's Disease Rating Scale (UPDRS) Part III, also known as the UPDRS-III or the Motor Examination, is a critical component of the UPDRS used to assess the motor symptoms of Parkinson's disease (PD). To provide a comprehensive assessment of motor function in individuals with Parkinson's disease, covering aspects such as bradykinesia (slowness of movement), rigidity, tremors, and postural instability. The UPDRS-III consists of 14 items, each rated on a scale from 0 (normal) to 4 (severe), with a total possible score range from 0 to 108. Higher scores indicate greater motor impairment.
Time frame
BaselineSponsors and contacts
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Source ClinicalTrials.gov