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

Not Applicable

Terminated

• Conditions: Parkinson Disease
• Interventions: Behavioral: [year1] dual-task training with task priority strategy; Behavioral: [year2-3] dual-task training with internal and external focus

• Registration Number: NCT03895125
• Lead Sponsor: National Taiwan University Hospital

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.

Study Timeline

• Status Verified: 2019-03
• Study Start: 2019-03-07
• Study First Submitted: 2019-03-13
• Study First Submitted QC: 2019-03-27
• Study First Posted: 2019-03-29
• Last Update Submitted: 2020-02-11
• Primary Completion: 2020-02-12
• Study Completion: 2020-02-12
• Last Update Posted: 2020-02-13

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 1

Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
[year1] healthy control group	[year1] dual-task training with task priority strategy	-
[year1] PD group	[year1] dual-task training with task priority strategy	-
[year2-3] non-freezer	[year2-3] dual-task training with internal and external focus	-
[year2-3] freezer	[year2-3] dual-task training with internal and external focus	-

Primary Outcome Measures

Name	Time	Method
postural performance	about 36 seconds for each trial for a total of 25 minutes	measuring the amount of body weight shifting (unit: kg)
Gait symmetry	about 10-20 seconds for each trial	collecting single leg supporting time of right and left leg by using the GAITRite
suprapostural performance	about 36 seconds for each trial for a total of 25 minutes	measuring the rotation angle of box on the hand (unit: degree)
Walking speed	about 10-20 seconds for each trial	collecting by using the GAITRite electronic walkway (CIR systems, Inc. ,USA) 24 inches(61cm) wide and 192 inches (488cm, 16ft) long, total 18,432 sensor (unit: m/s)
Cadence	about 10-20 seconds for each trial	collecting by using the GAITRite (unit: step/s)

Secondary Outcome Measures

Name	Time	Method
electroencephalography (EEG)	about 36 seconds for each trial for a total of 25 minutes	to collect the brain activity (unit: uV)
electromyography (EMG)	about 36 seconds for each trial for a total of 25 minutes	to collect the muscle activity (unit: mV)

Trial Locations

Locations (1)

National Taiwan University Hospital; 🇨🇳 Taipei, Taiwan