Clinical trial NCT06598891: PAS Balance Training for Parkinson Disease (PD)
Official title: Effect of Combined PAS Balance Training on Individuals With PD
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: PD - Parkinson's Disease
Keywords: Gait Initiation
Paired associative stimulation (PAS)
Balance training
Motor learning
Anticipatory postural adjustment (APA)
Lead sponsor: Chang Gung University
Sponsor class: OTHER
First posted: 2024-09-19
Enrollment: 60
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Gait initiation (GI) difficulty is a common problem in individuals with Parkinson's disease (PD), often linked to impaired anticipatory postural adjustments (APA). Currently, there are no targeted rehabilitation programs designed specifically for GI-related APA in PD patients. Research has shown that while motor learning deficits are common in PD, explicit learning is better preserved than implicit learning. Therefore, a GI-related APA training system using an explicit learning model could be particularly effective for this population.

During motor learning, long-term potentiation (LTP) increases the excitability of the primary motor cortex. Paired associative stimulation (PAS) has been demonstrated to induce LTP-like changes in the motor cortex, making it a potential priming method to enhance motor learning. However, the priming effect of PAS targeted at leg muscles and the motor cortex on motor learning related to GI-APA has not been previously studied.

The objectives of this study are:

1. To investigate the effects of explicit and implicit training on GI-related APA.
2. To evaluate the priming effect of PAS on GI-related APA training and the associated plasticity changes in the motor cortex.


Eligibility criteria: Inclusion Criteria:

- Clinical diagnosis of Parkinson disease.

Exclusion Criteria:

* Musculoskeletal injuries on legs
* Osteoporosis.
* Any peripheral or central nervous system injury or disease patients.

Primary outcomes:
measure: Balance Performance
timeFrame: Baseline, 4 weeks and 8 weeks
measure: COP Path Length in Balance Tasks
timeFrame: Baseline, 4 weeks and 8 weeks
measure: COP Displacement in Balance Tasks
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Motor Evoked Potentials (MEPs)
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Intracortical Facilitation (ICF)
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Intracortical Inhibition (ICI)
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Walking Speed
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Step Length
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Step Time
timeFrame: Baseline, 4 weeks and 8 weeks
Secondary outcomes:
measure: COP Velocity in Balance Tasks
timeFrame: Baseline, 4 weeks and 8 weeks
measure: COP Area in Balance Tasks
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Double Support Time
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Single Support Time
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Swing Time
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Stance Time
timeFrame: Baseline, 4 weeks and 8 weeks
measure: Cadence
timeFrame: Baseline, 4 weeks and 8 weeks
Other outcomes:
measure: Total UPDRS-III Score
timeFrame: Baseline
Locations:
city: Taoyuan
country: Taiwan
facility: Chang Gung University
Study officials:
References: