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Pragmatic Cyclical Lower Extremity Exercise Trial for Parkinson's Disease

Phase 2
Completed
Conditions
Parkinson Disease
Interventions
Other: High-Intensity Aerobic Exercise
Registration Number
NCT04000360
Lead Sponsor
The Cleveland Clinic
Brief Summary

Identification of an effective disease-modifying intervention (e.g. pharmaceutical, surgical or behavioral) is an unmet need in Parkinson's disease (PD). Increasing evidence indicates high intensity aerobic exercise is a candidate to alter PD progression. The primary aim of this study is to examine the disease-altering capabilities of a long-term, high-intensity aerobic exercise intervention. A multi-site pragmatic randomized controlled trial design has been selected. Individuals with PD will be randomized into 1) a home-based aerobic exercise program, or 2) a usual and customary care (UCC). Subjects in the home exercise group will receive an indoor stationary bicycle delivered to their home for a 12 month exercise period. Individuals in the UCC group will continue their current level of physical activity. Motor and non-motor assessments will be conducted at the main campus of the Cleveland Clinic or the University of Utah at enrollment, 6 months, and 12 months. Each assessment will last approximately one hour.

Detailed Description

Overview of Experimental Design: The study is a randomized controlled clinical trial designed to examine the disease-altering capabilities of a 12 month aerobic exercise program for individuals with PD. A total of 252 individuals with PD will be randomized into 1) a home-based aerobic exercise program, or 2) a usual and customary care (UCC). Subjects in the home exercise group will receive a commercially available Peloton indoor stationary bicycle delivered to their home for a 12 month exercise period. Individuals in the UCC group will continue their current level of physical activity. Both groups will undergo a series of motor and non-motor assessments at enrollment, 6 months, and 12 months to measure disease progression of the 12 month period. Additionally, data will be used to develop a prognostic model to predict 12-month change in Movement Disorder Society - Unified Parkinson's Disease Rating Scale III (MDS-UPDRS III) for patients participating in a home-based high-intensity aerobic exercise program.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
256
Inclusion Criteria
  • Adult with a diagnosis of idiopathic PD by a physician or physician extender
  • Hoehn and Yahr stage I-III
  • Demonstrate the ability to safely mount and dismount the Peloton stationary cycle
  • In-home wireless network (WiFi; required for Peloton system exercise data transmission)
Exclusion Criteria
  • Participation in pharmaceutical or behavioral disease modifying PD-related clinical trial or study
  • Diagnosis of dementia or any neurocognitive impairment that compromises one's ability to provide informed consent
  • Implanted deep brain stimulation electrodes
  • If the American College of Sports Medicine (ACSM) screen recommends medical clearance, the subject must obtain medical clearance by their health care provider prior to participation.
  • Any musculoskeletal issue that would limit one's ability to engage in exercise
  • Neurological disease other than Parkinson's disease (i.e. multiple sclerosis, stroke)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
High-Intensity Exercise GroupHigh-Intensity Aerobic ExerciseMild to moderate Parkinson's disease patients: The exercise group will be asked to cycle 3x/week for 12 months on a Peloton bicycle which will be delivered to their home.
Primary Outcome Measures
NameTimeMethod
MDS-UPDRS III Motor ScoreBaseline (on and off medications), 6 months (off medications), 12 months (off medication)

Change in MDS-UPDRS III Motor Score will be compared between the exercise arm and the UCC group . Administered by a blinded rater, used to examine global motor function and disease severity. The change in Motor Score from the MDS-UPDRS III will be utilized. A lower score indicates improvements in motor function.

Secondary Outcome Measures
NameTimeMethod
Nine Hole Peg TestBaseline (on and off medications), 6 months (off medications), 12 months (off medication)

Change in overall time for the Nine Hole Peg Test Score will be compared between exercise arm and UCC group. Faster time (measured in milliseconds) at the conclusion of the intervention indicates improvements in manual dexterity.

Trial Locations

Locations (1)

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

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