Treadmill Walking in Individuals With Dementia With Lewy Bodies and Huntington's Disease
Condition: Huntington Disease; Lewy Body Disease
MeSH terms: Dementia; Huntington Disease; Lewy Body Disease
Study type: Interventional

Summary: 
      Individuals with Dementia with Lewy Bodies (DLB) and Huntington's disease (HD) experience
      balance and walking problems that lead to falls. Treadmill walking has demonstrated
      improvements in balance and walking and fall risk in individuals with Parkinson's disease
      (PD), suggesting that it may be beneficial for individuals with DLB and HD. In PD subjects,
      changes in gait parameters have been noted after only one treadmill training session. The
      investigators propose a pilot study to investigate the safety, feasibility, and utility to
      improve mobility and fall risk of a single session of treadmill walking in individuals with
      DLB and HD.
    

Detailed description: 
      Several studies using HD animal models have shown that HD mice housed in enriched
      environments or in cages with running wheels that stimulated physical activity demonstrated a
      delayed onset and/or slowed decline in motor function compared to mice in non-enriched
      environments (van Dellen et al. 2000, 2008; Spires et al., 2004). Evidence suggests that
      aerobic exercise may have neuroprotective effects and helps the elderly and individuals with
      neurodegenerative diseases to maintain better cognitive and motor function than those who are
      inactive. More specifically, there is strong evidence from animal and human trials in
      neurological populations (i.e., Parkinson's Disease, spinal cord injury, and stroke) that
      treadmill training can improve walking and motor function. Immediate effects of a
      single-session of treadmill walking in the Parkinson's Disease population were improved
      over-ground gait measures (i.e., gait speed, stride length, double support percent, stride
      variability) and longer term treadmill training studies demonstrated additional improvements
      in Unified Parkinson Disease Rating Scale scores, fall risk, and health-related quality of
      life (Herman et al., 2008). This study builds upon foundational knowledge gained in animals
      and other neurologic populations to determine the feasibility, safety and possible immediate
      benefit of treadmill walking in individuals with HD.

      The primary purpose of this pilot study is to investigate the the safety, feasibility and
      utility of a single 20-minute session of treadmill walking to improve gait parameters in
      ambulatory individuals with DLB and HD. Secondarily we will explore the effects of treadmill
      walking on mobility, fall risk, and motor coordination. Based on previous studies utilizing a
      single-session of treadmill training in the PD population, we hypothesize that treadmill
      walking will improve overground spatiotemporal gait parameters (gait speed, stride length,
      double support percent, and stride-to-stride variations in gait) in individuals with DLB and
      HD (Pohl et al., 2003; Frenkel-Toledo et al., 2005; Bello et al., 2008).
    

Intervention name(s): Treadmill Walking
Intervention type(s): Other
Intervention description(s): Following instructions and familiarization with the treadmill, participants will walk on the treadmill for 20 minutes total with rest periods as needed. Treadmill speed will be set at each participant's overground comfortable walking speed for the first 5 minutes, provided that they can walk safely. If necessary the speed will be lowered until a safe gait is achieved. After 5 minutes the speed will be incrementally increased by10% each 5 minutes (3 times) as long as a safe gait (i.e., no abnormal vital signs, excessive effort, or loss of balance occurrences) can be maintained. If the gait pattern becomes unsafe or more abnormal the speed will revert to the previous safe speed and be maintained at this level until the end of training session.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Treadmill; Walking; Gait; Exercise