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Training With Exergame and Treadmill on Executive Function and Dual-task Performance

Not Applicable
Completed
Conditions
Stroke
Parkinson's Disease
Interventions
Other: Dual-task training
Other: Treadmill training
Registration Number
NCT03623841
Lead Sponsor
National Yang Ming Chiao Tung University
Brief Summary

This study aimed to investigate the effects of dual-task training with exergame and treadmill on executive function and dual-task performance in individuals with PD and stroke and discuss the correlation between the change values of executive function and dual-task performance after training. Besides, investigate cortical activation after training.

Detailed Description

Background: In daily living, walking usually combines with cognitive or motor dual tasks. For individuals with Parkinson's disease (PD), gait performance becomes worse while doing dual tasks, which may due to insufficient executive function. Declined executive function may occur in early stage of PD. For those with stroke, impaired dual-task performance also exists. Although 75% of patients with stroke may suffer from impaired executive function, impaired dual-task performance correlates with declined executive function directly or not still unknown. Undoubtedly, impaired executive function decreases their daily activities. Recently, dual-task training by walking with secondary tasks resulted in improvement of single or dual-task gait performance in individuals with PD. As for stroke, dual-task training performed in walking with secondary tasks and resulted in improvement of single or dual-task gait performance. However, previous studies less mentioned about combine cognitive and motor tasks simultaneously with gait training. While dual-task training with exergame and treadmill can include cognitive and motor tasks simultaneously while walking. Thus, whether dual-task training with exergame and treadmill can improve executive function and dual-task performance in individuals with PD and stroke is worth to investigate. Purposes: To investigate the effects of dual-task training with exergame and treadmill on executive function and dual-task performance in individuals with PD and stroke and discuss the correlation between the change values of executive function and dual-task performance after training. Besides, investigate cortical activation after training. Methods: This research will be implemented in two phases. First phase will include 50 subjects with PD and the second phase will include 50 subjects with stroke. After pre-test, subjects will be randomly assigned into either the experimental group or the control group. Subjects in the experimental group will receive 24 sessions dual-task training with exergame and treadmill in 8 weeks; while the control group will receive treadmill training only in same frequency. Each session lasts an hour. Primary outcomes include general cognitive performance, executive function, dual-task performance, dual-task effects and cortical activation. Secondary outcomes include single walking performance, functional walking and quality of life. Statistical analysis: Descriptive statistics will be generated for all variables. Intergroup differences among baseline characteristics will be evaluated by independent t test or χ2 analysis. Primary and secondary outcomes will be analyzed by two-way repeated measures ANOVA and post-hoc test. The correlation between change values of executive function and dual-task performance will be evaluated by Pearson correlation coefficient. Statistical significance will set at P\<0.05.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
28
Inclusion Criteria
  • Diagnosed as PD and Hoehn and Yahr stage between 1~3
  • Age between 50 to 80
  • Able to walk 10 m independently without an assistive device
  • A score of greater than or equal to 24 on the mini-mental state examination (MMSE)
  • In stable medical condition allowing participation in the testing protocol and intervention
Exclusion Criteria
  • Any comorbidity or disability other than PD that would preclude gait training
  • Any uncontrolled health condition for which exercise was contraindicated
  • Any neurological or orthopedic disease that might interfere with the study
  • Server freezing of gait, FOG questionnaire > 15

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Dual-task training groupDual-task trainingParticipants in dual-task training group will execute dual-task training via exer-game which combined with treadmill, 3 times per week, least 8 weeks.
Treadmill training groupTreadmill trainingParticipants in treadmill training group will do treadmill training only, 3 times per week, least 8 weeks.
Primary Outcome Measures
NameTimeMethod
Dual-task walking performanceChange from baseline at 8 weeks

To evaluate gait parameters while doing dual-task walking

Secondary Outcome Measures
NameTimeMethod
Timed up and go testChange from baseline at 8 weeks

To evaluate functional walking ability

Trail-making testChange from baseline at 8 weeks

To evaluate executive function

Functional near-infrared spectroscopyChange from baseline at 8 weeks

To evaluate the changes of blood perfusion in frontal lobe

Single walking performanceChange from baseline at 8 weeks

To evaluate gait parameters while doing single walking

Parkinson's Disease Questionnaire 39Change from baseline at 8 weeks

To evaluate the quality of life

Frontal lobe battery test-Chinese versionChange from baseline at 8 weeks

To evaluate executive function

Dual-task effects/ costs2 months

to compare the cost between doing dual task and single task

Verbal fluency test-Chinese versionChange from baseline at 8 weeks

To evaluate executive function

Stroop color and word test-Chinese versionChange from baseline at 8 weeks

To evaluate executive function

Digit span testChange from baseline at 8 weeks

To evaluate executive function

Trial Locations

Locations (1)

National Yang-Ming university

🇨🇳

Taipei, Taiwan

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