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NCT Number: NCT04364152

Effects of Attentional Focus Strategy on Dual-task Walking Training in Patients With Parkinson's Disease

Walking deficits and altered brain capacity have been proved to be two of the main contributing factors in dual-task walking deficits in patients with Parkinson's disease (PD). In the past, patients with PD were usually suggested not to walk in dual-task conditions in order to concentrate on their walking performance better. However, since dual-task walking is really common in daily-life, this limitation usually lead to a decrease in quality of life for PD patients. In previous studies, effects of using attentional strategies in dual-task walking training remain unclear, while suitable attentional strategies and corresponded neuroplasticity for patients with and without freezing of gait have not been well discussed, either. Accordingly, this study is aimed to identify (1) whether internal or external attentional strategies is more ideal for PD patients with and without freezing of gait in dual-task walking training, and (2) changes in brain activity after receiving dual-task walking training with different attentional strategies in patients with or without freezing of gait. Our hypothesis are (1) patients with or without freezing of gait will react differently in dual-gait training with different attentional strategies, and (2) changes in brain activities will be different according to different attentional strategies given in the training.

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Key information

Age range

40 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

School and Graduate Institute of Physical Therapy, National Taiwan University

Taipei, 100, Taiwan

About this study

The hypothesis will be tested by gait performance, suprapostural tasks performance, relative power spectrum of EEG, and scales including MDS-UPDRS, ABC, BBS, and TUG.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

for PD patients:

  • (1) a diagnosis of idiopathic PD by a neurologist expert in movement disorders (2) onset age > 40 years old, (3) presence of gait disorders or freezing of gait (points on 3.10 in MDS-UPDRS>=1 or points on item 3 in NFOG-Q >0) (4) able to walk independently without an assistance device at least for 20 meters (5) without obvious action or postural tremor, according to the score of 3.15 and 3.16 (action and postural tremor of hands) in MDS-UPDRS

for healthy elders:

  • (1) without musculoskeletal of neurological diseases which may affect balance or walking performance (2) no medication that might influence their balance or cognition (3) MMSE> 26 points.

Exclusion criteria

for PD patients:

  • (1) with other neurological or musculoskeletal disease that might affect balance or walking (2) have a Mini-Mental State Examination (MMSE) < 27 points (3) have a history of brain surgery (4) have to modulate their medication for duration of the experiment.

Treatment and study plan

Dual-task walking training

Behavioral

Participants will be instructed to perform both motor and cognitive dual-task walking during exercise training. For example, for motor dual-task walking, the participants may be instructed to throw and catch a ball while walking. As for cognitive dual-task walking, the participants may be instructed to name animals or perform calculation while walking.

Primary outcomes

  1. Gait velocity from GAITRite

    Time frame: 60 minutes

    gait performance

  2. Cadence from GAITRite

    Time frame: 60 minutes

    gait performance

  3. Mean step length from GAITRite

    Time frame: 60 minutes

    gait performance

  4. Step-to-step variability from GAITRite

    Time frame: 60 minutes

    gait performance

  5. Amplitude from a triaxial accelerometer, X axes

    Time frame: 25 minutes

    motor suprapostural task performance

  6. Amplitude from a triaxial accelerometer, Y axes

    Time frame: 25 minutes

    motor suprapostural task performance

  7. Amplitude from a triaxial accelerometer, Z axes

    Time frame: 25 minutes

    motor suprapostural task performance

  8. Correct rate on working memory task

    Time frame: 25 minutes

    cognitive suprapostural task performance

Secondary outcomes

  1. EEG relative power in the delta band

    Time frame: 60 minutes

    brain activity under single, motor dual-task, and cognitive dual-task walking conditions

  2. EEG relative power in the theta band

    Time frame: 60 minutes

    brain activity under single, motor dual-task, and cognitive dual-task walking conditions

  3. EEG relative power in the alpha band

    Time frame: 60 minutes

    brain activity under single, motor dual-task, and cognitive dual-task walking conditions

  4. EEG relative power in the beta band

    Time frame: 60 minutes

    brain activity under single, motor dual-task, and cognitive dual-task walking conditions

  5. EEG relative power in the low gamma band

    Time frame: 60 minutes

    brain activity under single, motor dual-task, and cognitive dual-task walking conditions

Sponsors and collaborators

Lead sponsor

National Taiwan University Hospital

Other

Registry information

Official study title

Effects of Attentional Focus Strategy on Dual-task Walking Training in Parkinson's Disease With and Without Freezing of Gait

Important dates

Study start
2020
Primary completion
2021
Study completion
2023
First posted
Apr 27, 2020
Registry last updated
Sep 7, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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