Effect of Robot-assisted Gait Training on Freezing of Gait in Parkinson's Disease
Condition: Parkinson's Disease
MeSH terms: Parkinson Disease
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      Freezing of gait (FOG) is a common yet poorly understood motor symptom in persons with
      Parkinson's disease (PD). Previous studies have shown that bilateral uncoordinated gait and
      gait asymmetry are related to FOG, and that intensive treadmill training in PD patients can
      improve gait. However, no group has yet studied the effect of robot-assisted gait training
      (RAGT) on FOG. The primary aim of this study is to collect pilot data on the effect of
      robot-assisted gait training in reducing episodes of freezing in PD.

      Subjects with Parkinson's disease that experience freezing of gait will be recruited and
      enrolled following informed consent and screening for eligibility. Each of the 10 training
      session will last approximately one hour. Neurological evaluations, testing of gait
      parameters, and quality of life assessments will be conducted. Participants will also be
      asked to return for 1- and 3-month post-intervention assessments to see if the training has
      any lasting effects. Approximately 10-20 subjects will be enrolled, and the study will last
      up to 6 months.

      Robot-assisted gait training will be conducted with the Lokomat (a treadmill with
      supplemental robot-assistance for moving the hip and knee). We will monitor changes in
      freezing by conducting various assessments.

      There are approximately 1 million Americans with PD in the US. PD is a significant cause for
      reduced functional ability and quality of life, progressive disability. Patients with PD with
      FOG have indicated that this is one of their most disturbing symptoms, as there are no
      effective treatments. Therefore it is important that additional and alternative interventions
      for FOG be tested and developed.
    


Intervention name(s): Lokomat
Intervention type(s): Device
Intervention description(s): The Lokomat is a motor driven exoskeleton device that employs a body weight support suspension system and treadmill. Attached to the lower limbs, the Lokomat moves the subject's legs through position controlled trajectories that mimic normal human gait patterns. This is accomplished by utilizing high quality computer-controlled motors that are precisely synchronized with the speed of the treadmill. The hip and knee joint angles are controlled in real time by software to achieve kinematically correct stepping behaviors. Each of the four motor-driven joints is individually controlled to correspond precisely to the desired joint angle trajectories. This system assures a precise match between the speed of the limb trajectory and the treadmill. In addition, sensors in the motors provide an indirect indicator of the amount of effort the patient is generating to achieve walking in an upright posture.
Intervention model: Single Group Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Basic Science
Keywords: Robot; Treadmill; Rehabilitation; Freezing of gait