Home-Based Exercise in Primary Progressive Aphasia (HEPPA)
- Conditions
- Neurodegenerative DiseasesLogopenic Progressive AphasiaSemantic DementiaNon-fluent AphasiaPrimary Progressive Aphasia
- Interventions
- Other: Home-based multicomponent exercise intervention program
- Registration Number
- NCT06181500
- Lead Sponsor
- Montreal Heart Institute
- Brief Summary
This pilot study aims to evaluate the feasibility of a novel home-based multicomponent exercise program in adults clinically diagnosed with Primary Progressive Aphasia
- Detailed Description
Exercise is known to induce changes in brain neuroplasticity in the elderly and is thought to have a protective effect against cognitive decline in patients already suffering from neurodegenerative diseases. While the benefits of exercise in the context of mild cognitive impairment and Alzheimer's disease have been extensively studied, little information is available on the potential benefits of exercise for other atypical neurodegenerative diseases, such as primary progressive aphasia (PPA). A multimodal exercise intervention (combination of aerobic and resistance exercises) could potentially slow overall cognitive decline in PPA, which is characterized by a gradual and isolated dissolution of language function, by promoting neurogenesis and neuroplasticity. In healthy but inactive older adults, exercise increases grey and white matter volume in prefrontal and temporal cortical regions, which are specifically impaired in PPA and play an important role in executive functions, episodic memory and language skills. Exercise could thus modulate certain executive, memory and language difficulties generally observed in this clinical population. This pilot study aims to evaluate the feasibility of a novel home-based multicomponent exercise program in adults clinically diagnosed with any of the three main variants of PPA (semantic, non-fluent/agrammatic or logopenic). The feasibility outcomes will be based on: 1) total recruitment and recruitment rate, 2) program completion rate, 3) compliance and 4) participants' ability to train at home with or without a caregivers' presence. A minimum of 12 participants will be recruited through McGill University's Douglas Research Institute and will complete a 6-month home-based multimodal intervention program. They will train two to three times a week for 45 minutes and be supervised via videoconference by a kinesiologist from the EPIC Center at the Montreal Heart Institute. If desired, participants will be accompanied by a partner, close friend, or relative to facilitate communication, especially if they have difficulty understanding instructions or expressing themselves. To assess changes in cognition, physical and psychological functions, participants will complete neuropsychological and functional assessments in-person at baseline. These assessments will also be completed at three and six months post-intervention. The knowledge gained from this pilot project will be used to assess the feasibility of a full randomized control trial aimed at assessing the effects of multimodal exercise intervention in PPA patients. Ultimately, an increased understanding of the potential beneficial effects of physical exercise in PPA will allow for more tailored rehabilitative approaches in this clinical population.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 13
- A clinical diagnosis of Primary Progressive Aphasia
- Fluent in French or English
- Able to read, understand and sign the information and consent form
- Have access to the internet
- Have access to a tablet (i.e. iPad or Android) or a computer
- Any absolute and relative contraindication to exercise testing and/or physical training (e.g., any severe musculoskeletal disease impairing their mobility)
- Any severe respiratory disease (e.g., asthma, COPD, COVID-19)
- Any severe exercise intolerance
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Home-based multicomponent exercise intervention program Home-based multicomponent exercise intervention program -
- Primary Outcome Measures
Name Time Method Evaluate the program completion rate of a 6-month exercise intervention in individuals with Primary Progressive Aphasia 6 months post-intervention Program completion rate (number of participants that completed their in-person evaluations as well as the home-based interventions after 6 months compared to the participants enrolled)
Evaluate the compliance rate of a 6-month exercise intervention in individuals with Primary Progressive Aphasia 6 months post-intervention Compliance (total number of in-person evaluations and home-based training sessions attended compared to the maximum possible)
Evaluate the total recruitment rate of a 6-month exercise intervention in individuals with Primary Progressive Aphasia 6 months post-intervention Total recruitment (number of participants screened compared to final enrollments)
Evaluate the satisfaction of a 6-month exercise intervention in individuals with Primary Progressive Aphasia 6 months post-intervention Satisfaction (feedback given by the participants and their caregivers will be considered using a satisfaction questionnaire and qualitative feedback). Ability to train at home with or without their caregivers' presence will also be taken into account.
Evaluate the recruitment rate of a 6-month exercise intervention in individuals with Primary Progressive Aphasia 6 months post-intervention Recruitment rate (number of participants that can be enrolled per month)
- Secondary Outcome Measures
Name Time Method Document changes in nonverbal fluency Baseline and 6 months post-intervention Participants will complete the Ruff figure fluency test (scores are based on the total number of figures drawn, with a higher number indicating a better score).
Document changes in writing ability Baseline and 6 months post-intervention Participants will complete the Bernard Croisile dictation task (scores range from 0-18, with a higher score indicating better writing ability).
Document changes in reading comprehension Baseline and 6 months post-intervention Participants will complete the Chapman-Cook (scores range from 0-30, with a higher score indicating better reading comprehension).
Document change in upper limb muscle strength Baseline and 6 months post-intervention Upper limb muscle strength will be assessed with a grip strength test (scores are measured with the maximum force/tension generated by one's forearm muscles, with a higher kilogram indicating a better score).
Document change in lower limb muscle strength Baseline and 6 months post-intervention Lower limb muscle strength will be assessed with a timed Sit-to-Stand test (scores are measured in seconds, with a lower time indicating a better score).
Document changes in walking speed Baseline and 6 months post-intervention Walking speed will be assessed with a 10-meter walking test (scores are measured in seconds, with a lower time indicating a better score).
Document changes in general cognitive functioning Baseline and 6 months post-intervention Participants will complete the Montreal Cognitive Assessment (scores range from 0-28, with a higher score indicating better cognitive functioning).
Document changes in verbal working memory Baseline and 6 months post-intervention Participants will complete the forward and backward digit span subtasks of the Wechsler Adult Intelligence Scale-IV (scores range from 0-32, with a higher number indicating a better score).
Document changes in oral expression Baseline and 6 months post-intervention Participants will complete the word/sentence repetition subtasks from the Boston Diagnostic Aphasia Examination (BDAE) (scores range from 0-14, with higher scores indicating better oral expression).
Document changes in executive functions and processing speed Baseline and 6 months post-intervention Participants will complete validated neuropsychological tests and iPad tests (scores are measured in milliseconds, with lower reaction times indicating faster processing speeds).
Document changes in cardiorespiratory fitness Baseline and 6 months post-intervention Cardiorespiratory fitness will be assessed with the Matthews cardiorespiratory fitness questionnaire (the score is an estimation of individual VO2 max (ml.kg.min) and ranges from 15-50, with a higher score indicating a higher VO2max).
Document changes in auditory long-term memory Baseline and 6 months post-intervention Participants will complete the Rey auditory verbal learning test (scores range from 0-15, with a higher score indicating a better auditory long-term memory).
Document changes in visual working memory Baseline and 6 months post-intervention Participants will complete the spatial span subtask of the Wechsler Memory Scale-III (scores range from 0-32, with a higher number indicating a better score).
Document changes in verbal fluency Baseline and 6 months post-intervention Participants will complete phonemic and semantic fluency tasks (scores are based on the total number of words given, with a higher number indicating a better score).
Document changes in lexical retrieval Baseline and 6 months post-intervention Participants will complete the Boston Naming Test (scores range from 0-30, with a higher score indicating better lexical retrieval).
Document change in balance performance Baseline and 6 months post-intervention Balance performance will be assessed with a timed one-leg standing test (scores are measured in seconds, with a higher time indicating a better score).
Document changes functional mobility Baseline and 6 months post-intervention Functional mobility will be assessed with the Timed up and Go test (scores are measured in seconds, with a lower time indicating a better score).
Document changes in endurance Baseline and 6 months post-intervention Endurance will be assessed with a 6 min walking test (scores are measured in the number of meters walked, with a higher number of meters indicating a better score).
Document changes in visual long-term memory Baseline and 6 months post-intervention Participants will complete the Rey-Osterrieth complex figure test (scores range from 0-36, with a higher score indicating a better visual long-term memory).
Document changes in auditory comprehension Baseline and 6 months post-intervention Participants will complete the Boston Diagnostic Aphasia Examination (BDAE) subtasks: word, body part, commands, story comprehension, and the word-picture matching (scores range from 0-36, with higher scores indicating better auditory comprehension).
Trial Locations
- Locations (2)
Preventive medicine and physical activity centre (centre EPIC), Montreal Heart Institute
🇨🇦Montréal, Quebec, Canada
McGill University Research Centre for Studies in Aging (MCSA)
🇨🇦Montréal, Quebec, Canada