Facilitating Motor Skill Learning in Parkinson's Disease

Study Overview
=================
Brief Summary
-----------------
The study is designed to assess the effects of aerobic exercise on motor learning in Parkinson patients. Specifically, the investigators examine whether a single bout of moderate intensity aerobic exercise, performed immediately before task practice, facilitates the acquisition and retention of a motor skill. In a cross-over design, participants will be randomly allocated to either the intervention group (aerobic exercise before motor learning) or control group (rest before motor learning).

Detailed Description
-----------------
Parkinson's disease is a progressive neurodegenerative disorder that is characterized by motor control impairments, such as gait disturbances and postural instability. Beneficial effects of exercise are attributed to mechanisms of neuroplasticity, and task-specific motor training is consequently considered to be a motor learning process. While motor learning is preserved in persons with Parkinson's disease, slower acquisition rates and reduced retention have been reported compared to healthy individuals. Thus, it is crucial to identify strategies to enhance motor learning in people with Parkinson's disease. Recent studies have accumulated evidence to show that aerobic exercise can facilitate motor skill learning. However, these observations are limited to healthy individuals and have not been addressed in individuals with neurologic conditions. The present study is designed to assess the effects of a single bout of moderate intensity aerobic exercise on a motor skill learning task in patients with Parkinson's disease. In a cross-over design, participants will be randomly allocated to one of two groups. Both groups will practice balancing on a specific stability platform (motor learning task). The experimental group will additionally perform a bout of aerobic exercise (cycle ergometer) immediately before the motor learning task, while the control group will rest before practice. Subsequently, the acquisition and one-day retention of the motor learning task will be examined.

Official Title
-----------------
Facilitating Motor Skill Learning by Aerobic Training in Parkinson's Disease

Conditions
-----------------
Parkinson Disease

Intervention / Treatment
-----------------
* Behavioral: aerobic exercise
* Behavioral: rest
* Behavioral: motor learning


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Parkinson's disease stage 1-3 on Hoehn & Yahr scale Ability to stand unaided and walk without an assistive device Stable medication during the study period Exclusion Criteria: On-off and wearing-off phenomena Unstable medical or psychiatric illness Clinically relevant cardiovascular or orthopaedic disease Severe polyneuropathy Cognitive impairment Smoking > 10 cigarettes/day Caffeine > 6 cups of coffee/day Alcohol > 50 g (two glasses)/day

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: aerobic exercise + motor skill practice<br>acute bout of aerobic exercise before motor learning | Behavioral: aerobic exercise<br>* Single-bout of moderate intensity aerobic exercise on a cycle ergometer before motor learning<br>Behavioral: motor learning<br>* Motor learning task on a stability platform (Stabilometer). Participants try to keep the tiltable platform in an horizontal position.<br>|
| Active Comparator: rest + motor skill practice<br>seated rest before motor learning | Behavioral: rest<br>* Seated rest before motor learning<br>Behavioral: motor learning<br>* Motor learning task on a stability platform (Stabilometer). Participants try to keep the tiltable platform in an horizontal position.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Motor Learning (Precision) | Change from baseline in time in balance (±5° from horizontal) during balancing task. | Baseline (first trial of practice day 1), 1 day (last trial of practice day 1), and 7 days (first trial of 7-day retention session). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Motor Learning (Variability) | Change from baseline in mean standard deviation (root mean square error) of platform deflection (in degree). | Baseline (first trial of practice day 1), 1 day (last trial of practice day 1), and 7 days (first trial of 7-day retention session). | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Parkinson's Disease, motor learning, aerobic exercise, cardiovascular exercise, balance, postural instability, motor skill