The Effects of Dual Task Training in Individuals With Parkinson's Disease

Study Overview
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Brief Summary
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The primary aim of the proposed project is to characterize dual tasking (DT) deficits to improve motor, cognitive, and quality of life outcomes in individuals with Parkinson's disease (PD). Phase 1 of the intervention will involve an in-depth gait analysis on 15 individuals with PD. This gait analysis will utilize the Computer Assisted Rehabilitation Environment (CAREN) system, a virtual reality system with a fully integrated 3-D motion capture system. The purpose of Phase 1 is to generalize characteristics of gait and postural control during specific DT conditions. Phase 2 (N=20) involves the clinical translation of these findings. This phase will involve creating a clinical intervention based on the objective information gathered the CAREN system. The intervention will take place 3x/week for a total of 8 weeks. Interventional groups will include: 1) DT clinical group (N=10) and 2) Single task group (N=10). Outcome measures will be used at the beginning and end of the intervention to assess the feasibility and efficacy of the intervention.

Official Title
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The Effects of Dual Task Training on Motor and Non-Motor Function in Individuals With Parkinson's Disease

Conditions
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Parkinson's Disease

Intervention / Treatment
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* Behavioral: Dual Task Group
* Behavioral: Single Task Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of idiopathic PD Able to provide informed consent Ability to ambulate ≥ 300ft with or without an assistive device Hoehn and Yahr stage 2-4 Exclusion Criteria: Undergone any surgical procedure for the treatment of PD, such as deep brain stimulation Those who are considered to be high risk exercisers per American College of Sports Medicine exercise screening questionnaire Musculoskeletal injury or neurological injury other than PD that would restrict physical activity Inability to follow 2 step commands Significant cognitive impairment as designated by ≥ 3 errors on the Short Portable Mental Status Questionnaire
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dual Task Group<br>This group will complete an exercise intervention that involves performing dual tasking activities (simultaneously performing 2 things at once). This group will exercise 3x/wk for 8 weeks. | Behavioral: Dual Task Group<br>* Performing motor-motor or motor-cognitive tasks at the same time.<br>|
| Active Comparator: Single Task Group<br>This group will complete an exercise intervention that involves performing single task activities. The participant will perform motor tasks and cognitive tasks individually. This group will exercise 3x/wk for 8 weeks. | Behavioral: Single Task Group<br>* Performing motor or cognitive tasks alone.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Step Length During Gait | The average distance from heel strike of the less affected leg to heel strike of the more affected leg. Higher values indicate a longer step length. | Phase 1: baseline; Phase 2: baseline, end of treatment (8 weeks), and end of treatment +4 weeks | 
| Walking Speed During Gait | Average self-selected walking speed without dual tasking. | Phase 1: baseline; Phase 2: baseline, end of treatment (8 weeks), and end of treatment +4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 2 Minute Walk Test | A functional endurance assessment, reporting total distance traveled over a 2 minute period. Higher values indicate better functional endurance. | Phase 1: baseline; Phase 2: baseline, end of treatment (8 weeks), and end of treatment +4 weeks | 
| Quality of Life in Neurological Disorders Questionnaire | Quality of life questionnaire. Reported here is T-Score for the Lower Extremity domain. A T-score of 50 is the mean of the reference population, with higher scores indicating a better outcome. | Phase 2: baseline, end of treatment (8 weeks), and end of treatment +4 weeks | 
| Activities-specific Balance Confidence Scale | Balance questionnaire. Scores range from 0-100, with higher scores indicating greater balance confidence. | Phase 2: baseline, end of treatment (8 weeks), and end of treatment +4 weeks | 
| Trail Making Test | Cognitive task where the participant connects 25 dots in numerical order. Lower scores indicate better cognitive function. Reported here is total time to complete the task. | Phase 2: baseline, end of treatment (8 weeks), and end of treatment +4 weeks | 
| Reaction Time | Average time taken to react to a choice of two stimuli. Lower scores indicate better reaction time. | Phase 2: baseline, end of treatment (8 weeks), and end of treatment +4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dual tasking