Gait-initiation Related APA Training in Individuals With Parkinson Disease -Explicit Training and Paired Associative Stimulation(PAS) Priming
试验速览
- 阶段
- 不适用
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- Intracortical Inhibition (ICI)
研究概览
简要总结
Our research focused on understanding the interplay between brain excitability and balance function in patients with Parkinson's disease (PD), alongside evaluating effective physical therapy methods. It highlights the prevalence of non-motor disorders and cognitive impairments among PD patients, including balance and postural issues, cognitive function decline, and gait instability. Additionally, it notes that PD patients exhibit abnormal electrophysiological responses, indicating altered central excitability.
详细描述
Research on Brain Excitability and Balance Function Performance in Patients with Parkinson's Disease and Related Physical Therapy Methods
Research indicates that non-motor disorders and cognitive impairments are prevalent in most patients with Parkinson's disease. These include balance issues, postural instability, impaired cognitive functions like working memory and executive functions, and gait instability. Additionally, electrophysiological phenomena in Parkinson's disease patients reveal abnormal central excitatory and inhibitory responses compared to healthy individuals.
This experiment seeks to investigate the link between motor performance and brain excitability in patients with Parkinson's disease. Previous studies suggest that associative electrical stimulation, used to regulate sensorimotor information integration, can enhance brain excitability in both healthy individuals and those with Parkinson's disease. However, the optimal parameters for this stimulation remain uncertain.
Furthermore, balance exercise training can improve motor performance in Parkinson's disease patients. This study aims to determine if various designs of associative electrical stimulation parameters can help these patients achieve optimal brain excitability regulation. The combined approach of this stimulation and balance exercise training aims to maintain and improve the patients' functional performance, thereby enhancing the safety of their daily activities.
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
- 是
入选标准
- •Health subjects:
排除标准
- •Musculoskeletal injuries on legs.
- •Osteoporosis.
- •PD subjects:
- •Inclusion Criteria:
- •- Clinical diagnosis of Parkinson disease.
- •Exclusion Criteria:
- •Musculoskeletal injuries on legs
- •Osteoporosis.
- •Any peripheral or central nervous system injury or disease patients.
研究组 & 干预措施
Stage 1:Healthy people
To establish PAS baseline and reliability.
干预措施: Paired associative stimulation (Procedure)
Stage 2:PD people
To establish stage 3 training protocol.
干预措施: Paired associative stimulation (Procedure)
Stage 3:PD people
Control group.
Stage 3: PD APA training group
Weight shift training and APA feedback.
干预措施: Weight shift training and APA feedback (Other)
Stage 3:PD PAS group
Using PAS to regulate brain plasticity
干预措施: Paired associative stimulation (Procedure)
结局指标
主要结局
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.
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.
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.
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).
Balance Performance
时间窗: Baseline, 4 weeks and 8 weeks.
Measured by the duration the stance can be maintained. Unit：seconds(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. Unit：millimeters(mm)
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：millimeters(mm)
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)
Step Length
时间窗: Baseline, 4 weeks and 8 weeks.
The linear distance between the two ankles, typically expressed in centimeter(cm).
次要结局
- COP Velocity in Balance Tasks(Baseline, 4 weeks and 8 weeks.)
- Double Support Time(Baseline, 4 weeks and 8 weeks.)
- Swing Time(Baseline, 4 weeks and 8 weeks.)
- Cadence(Baseline, 4 weeks and 8 weeks.)
- COP Area in Balance Tasks(Baseline, 4 weeks and 8 weeks.)
- Single Support Time(Baseline, 4 weeks and 8 weeks.)
- Stance Time(Baseline, 4 weeks and 8 weeks.)
研究者
Ya-Ju Chang
Professor
Chang Gung University