Facilitating Motor Skill Learning in Parkinson's Disease II (FaST-PD II)

Study Overview
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Brief Summary
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The study is designed to assess the effects of cardiovascular (aerobic) exercise on motor skill learning in Parkinson patients. Specifically, the investigators examine whether a single bout of moderate-intense aerobic exercise, performed immediately following motor skill practice, facilitates motor memory consolidation. In this experimental trial, participants will be randomly allocated to either an intervention group (motor skill practice + aerobic exercise) or control group (motor skill practice + seated rest).

Detailed Description
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Parkinson's disease (PD) 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 (repeated practice of a skill) is consequently considered to be a motor learning process. Importantly, the formation (acquisition) and consolidation of motor memories is impaired in PD compared to healthy individuals of similar age. Thus, it is crucial to identify strategies to enhance motor learning in people with PD. Recent studies have accumulated evidence to show that acute (single bouts of) cardiovascular exercise can facilitate motor skill learning. However, this evidence is mainly derived from studying healthy individuals. In a first study including PD patients, we recently found improved motor memory consolidation, but not skill acquisition, when practice was preceded by a single bout of cardiovascular exercise. These results suggest that acute exercise may enhance motor memory formation processes, but could potentially interfere with motor skill acquisition when performed prior to practice. Consequently, the present study investigates whether performing a single bout of cardiovascular exercise immediately following skill practice will enhance motor memory consolidation without affecting skill acquisition in PD. In an experimental trial, participants will be randomly allocated to one of two groups. Both groups will practice balancing on a stability platform (motor learning task). The experimental group will additionally perform a bout of aerobic exercise (cycle ergometer) immediately following motor practice, while the control group will rest. Subsequently, motor skill retention will be tested after 24 hour and seven-days.

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

Conditions
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Parkinson Disease

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


Participation Criteria
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Eligibility Criteria
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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 Unfamiliar to the motor learning task 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
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Minimum Age: 18 Years

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: None (Open Label)


Arms and Interventions

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

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time in balance | Motor memory consolidation: Change of time in balance (angular displacement ±5° from horizontal) from skill practice (last block of skill acquisition) to 24-hour and seven-day retention test. | Day 1: performance at end of skill acquisition (last practice block), Day 2: 24-hour retention performance, Day 3: seven-day retention performance | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Root mean square error (RMSE) | Memory consolidation: Change of root mean square error (average angular deviation from horizontal) from skill practice (last block of skill acquisition) to one-day and seven-day retention test. | Day 1: performance at end of skill acquisition (last practice block), Day 2: 24-hour retention performance, Day 3: seven-day retention performance | 

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