PAS Balance Training for Parkinson Disease (PD)
- Conditions
- PD - Parkinson's Disease
- Interventions
- Procedure: Weight shift training and APA feedbackProcedure: Paired associative stimulation
- Registration Number
- NCT06598891
- Lead Sponsor
- Chang Gung University
- Brief Summary
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.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 60
- Clinical diagnosis of Parkinson disease.
- Musculoskeletal injuries on legs
- Osteoporosis.
- Any peripheral or central nervous system injury or disease patients.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description PD APA training group Weight shift training and APA feedback Weight shift training and APA feedback. PD PAS group Paired associative stimulation Using PAS to regulate brain plasticity
- Primary Outcome Measures
Name Time Method Motor Evoked Potentials (MEPs) Baseline, 4 weeks and 8 weeks 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)
Balance Performance Baseline, 4 weeks and 8 weeks Measured by the duration the stance or stand can be maintained. Unit：second(s)
COP Path Length in Balance Tasks Baseline, 4 weeks and 8 weeks The total distance traveled by the COP over a specified period. Longer path lengths can indicate increased effort to maintain balance or greater instability.
COP Displacement in Balance Tasks Baseline, 4 weeks and 8 weeks 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)
Intracortical Facilitation (ICF) Baseline, 4 weeks and 8 weeks ICF is measured by applying a pair of TMS pulses with a short interval (e.g., 8-15 ms) where the first (subthreshold) pulse is followed by a second (suprathreshold) pulse, leading to an increased amplitude of the MEP.
Intracortical Inhibition (ICI) Baseline, 4 weeks and 8 weeks ICI is measured similarly to ICF but with a shorter inter-stimulus interval (e.g., 1-5 ms), resulting in a suppressed MEP amplitude. This suppression reflects inhibitory processes within the cortex.
Walking Speed Baseline, 4 weeks and 8 weeks The time taken by participants to walk a standardized distance, typically expressed in centimeters per second (cm/s).
Step Length Baseline, 4 weeks and 8 weeks The linear distance between the two ankles, typically expressed in centimeter(cm).
Step Time Baseline, 4 weeks and 8 weeks The duration taken for one complete step, measuring from foot-off of one foot to the next foot-off of the same foot, usually expressed in seconds.
- Secondary Outcome Measures
Name Time Method COP Velocity in Balance Tasks Baseline, 4 weeks and 8 weeks 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)
COP Area in Balance Tasks Baseline, 4 weeks and 8 weeks 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)
Double Support Time Baseline, 4 weeks and 8 weeks 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.
Single Support Time Baseline, 4 weeks and 8 weeks 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.
Swing Time Baseline, 4 weeks and 8 weeks The portion of the gait cycle where the foot is not in contact with the ground, moving forward to the next step. It is usually expressed as a percentage of the total gait cycle or in seconds.
Stance Time Baseline, 4 weeks and 8 weeks The portion of the gait cycle when the foot is in contact with the ground, supporting body weight. It's typically expressed as a percentage of the total gait cycle or in seconds
Cadence Baseline, 4 weeks and 8 weeks The number of steps an individual takes per minute, providing an overview of gait speed and rhythm, , expressed as steps per minute.
Trial Locations
- Locations (1)
Chang Gung University
🇨🇳Taoyuan, Taiwan