Understanding How Movements Are Transferred From Task to Task in Parkinson's Disease
ConditionPARKINSON DISEASE (Disorder)
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age50+
SponsorMcGill University
About this trial
The purpose of this study is to understand how a specific brain area, the Posterior Parietal Cortex (PPC), plays a role in movement transfer from walking on a split-belt treadmill (SBT) to walking on the ground in people with Parkinson's disease (PwPD).
Here, investigators will apply repeated transcranial magnetic stimulation (rTMS) to upregulate the PPC. Then, the differences in the gait parameters between pre- and post-interventions will be compared between the TMS-active and the TMS-sham.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
a confirmed diagnosis of idiopathic Parkinson's disease
absence of freezing of gait confirmed by a "No" answer to the second item of the New Freezing of Gait Questionnaire (NFOGQ) and no observation of FOG during a freezing provoking test
no other neurological diagnosis
no severe musculoskeletal/orthopedic or vestibular condition that interferes with walking and or significantly affects balance
Disqualifiers
severe dyskinesia that interacts with walking and balance hearing or visual impairment
observed inability to walk safely on a tied-belt treadmill
neurological disorders other than PD or other pathology (e.g., orthopedic) interfering with mobility. - contradiction for TMS
implanted deep brain stimulator.
Trial design
Design model
Parallel
Treatments tested in this trial
Transcranial Magnetic Stimulation Active
Other interventionACTIVE: intermittent Theta Burst Stimulation (a patterned form of rTMS). The participants will receive iTBS (50hz bursts at 5Hz for 600 pulses for a total duration of 3-minutes) over the right PPC at 80% RMT of the FDI.
Transcranial Magnetic Stimulation Sham
Other interventionSHAM: 2 coils on top of each other will be used instead of 1. The coil furthest to the head will be reversed. The coil on the head will not be stimulating but the reversed coil will (current directed away from the brain) with stimulate with the same parameters at the active stimulation (intermittent Theta Burst Stimulation (a patterned form of rTMS). The participants will receive iTBS (50hz bursts at 5Hz for 600 pulses for a total duration of 3-minutes) over the right PPC at 80% RMT of the FDI.
Treatment groups
24 Participants
are divided into 2 treatment groupsGroup A: Active rTMS First followed by Sham rTMS SecondOther 2 interventions
Group B: Sham rTMS First followed by Active rTMS SecondOther 2 interventions
Trial outcomes
Primary outcomes
1
Stride length
The forward distance travelled by a foot during a gait cycle (cm) measured during overground walking and on the SBT with the Ambulatory Parkinson's Disease Monitoring (APDM) mobility lab system. A higher score indicates better gait control.
Time frame
Day 2 and Day 32
Dual Support
The percentage of the gait cycle when both feet are in contact with the ground (%) will be measured during overground walking and on the SBT with the Ambulatory Parkinson's Disease Monitoring (APDM) mobility lab system. A higher score indicates a longer time for both feet to be in contact with the ground.
Time frame
Day 2 and Day 3Secondary outcomes
1
Cadence
The number of steps per minute will be measured during overground walking and on the SBT with the Ambulatory Parkinson's Disease Monitoring (APDM) mobility lab system. A higher score indicates better gait control.
Time frame
Day 2 and Day 32
Gait Speed
The speed of the subject, measured as the distance traveled in the gait cycle divided by the gait cycle duration (m/s) during overground walking and on the SBT will be measured with the Ambulatory Parkinson's Disease Monitoring (APDM) mobility lab system. A higher score indicates better gait control.
Time frame
Day 2 and Day 33
Turning Velocity
The peak angular velocity of the turn (deg/s) during overground walking will be measured with the Ambulatory Parkinson's Disease Monitoring (APDM) mobility lab system. The higher score indicates better turning performance.
Time frame
Day 2 and Day 34
Steps in turn
The number of steps taken in one turn during overground walking will be measured with the Ambulatory Parkinson's Disease Monitoring (APDM) mobility lab system. The higher score indicates better turning performance.
Time frame
Day 2 and Day 3Sponsors and contacts
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Source ClinicalTrials.gov