Effect of Combined PAS Balance Training on Individuals With PD
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 60
- 试验地点
- 2
- 主要终点
- Motor Evoked Potentials (MEPs)
研究概览
简要总结
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:
- To investigate the effects of explicit and implicit training on GI-related APA.
- To evaluate the priming effect of PAS on GI-related APA training and the associated plasticity changes in the motor cortex.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Clinical diagnosis of Parkinson disease.
排除标准
- •Musculoskeletal injuries on legs
- •Osteoporosis.
- •Any peripheral or central nervous system injury or disease patients.
结局指标
主要结局
Motor Evoked Potentials (MEPs)
时间窗: 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
时间窗: 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
时间窗: 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
时间窗: 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)
时间窗: 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)
时间窗: 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
时间窗: 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
时间窗: Baseline, 4 weeks and 8 weeks
The linear distance between the two ankles, typically expressed in centimeter(cm).
Step Time
时间窗: 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.
次要结局
- COP Velocity in Balance Tasks(Baseline, 4 weeks and 8 weeks)
- COP Area in Balance Tasks(Baseline, 4 weeks and 8 weeks)
- Double Support Time(Baseline, 4 weeks and 8 weeks)
- Single Support Time(Baseline, 4 weeks and 8 weeks)
- Swing Time(Baseline, 4 weeks and 8 weeks)
- Stance Time(Baseline, 4 weeks and 8 weeks)
- Cadence(Baseline, 4 weeks and 8 weeks)
研究者
Ya-Ju Chang
Professor
Chang Gung University