Clinical trial NCT03298503: Task-priority Effects on Postural-suprapostural Task in Patients With Parkinson's Disease
Official title: Effects of Task Prioritization on Postural-suprapostural Task and Brain Activity in Parkinson's Disease With Different Balance Ability: During Standing and Walking
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Parkinson Disease
Keywords: Parkinson's disease
posture balance
attention
Lead sponsor: National Taiwan University Hospital
Sponsor class: OTHER
First posted: 2017-10-02
Enrollment: 80
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: OTHER

Brief summary: Postural-suprapostural task is defined as postural control takes place while at least one other concurrent task is being performed. In a postural-suprapostural task, appropriate prioritization of is necessary to achieve task goals and maintain postural stability. Therefore, regarding to impose task prioritization in a postural-suprapostural task, the optimal task-priority strategy for PD patients is still an issue of debate. With the uses of EEG, EMG and behavioral measures, the purpose of this project is to investigate the differences in performance quality and intrinsic neural mechanisms of a postural-suprapostural task for PD patients, by adopting posture-focus and suprapostural-focus strategies during standing and walking. The present project is expected to have significant contributions not only to gain a better insight to neural correlates of concurrent postural and suprapostural tasks with different task prioritization under standing and walking, but to optimize treatment strategy for PD patients with balance or dual-tasking disturbances.

Detailed description: Postural-suprapostural task is defined as postural control takes place while at least one other concurrent task is being performed. In a postural-suprapostural task, appropriate prioritization of is necessary to achieve task goals and maintain postural stability. Some studies support that a "posture-first" strategy is favored by patients with Parkinson disease (PD) in order to secure stance stability, but this comes at the cost of reduced suprapostural performance. In addition, overemphasizing on postural task might deteriorate automatic control of posture resulting in increased postural instability, and the best task-priority strategy might vary with balance ability of PD patients. Therefore, regarding to impose task prioritization in a postural-suprapostural task, the optimal task-priority strategy for PD patients is still an issue of debate. With the uses of EEG, EMG and behavioral measures, the purpose of this 2-year research project is to investigate the differences in performance quality and intrinsic neural mechanisms of a postural-suprapostural task for PD patients, by adopting posture-focus and suprapostural-focus strategies during standing and walking. In the first year, we will characterize task prioritization effect on reciprocity of a postural-suprapostural task, with a special focus on modulation of brain and muscle activity patterns in standing posture for early stage (modified H \& Y: 1, 1.5 and 2) and moderate stage (modified H \& Y: 2.5 and 3) PD patients. In the second year, the appropriate task prioritization, walking automaticity and power/connectivity of brain areas will be investigated in walking for PD patients with/without freezing of gait. The present project is expected to have significant contributions not only to gain a better insight to neural correlates of concurrent postural and suprapostural tasks with different task prioritization under standing and walking, but to optimize treatment strategy for PD patients with balance or dual-tasking disturbances.

Eligibility criteria: inclusion criteria:

1. patients with Parkinson's Disease in H\&Y stage from stage 1 to stage 3
2. without other neurological disease with balance impairment
3. can stand and walk without aids for at least 30 seconds

exclusion criteria:

1. Mini-Mental State Examination \> 27
2. Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) \< 10
3. Hamilton Depression Rating Scale (HAM-D) \< 17
4. pregnancy

Primary outcomes:
measure: Electroencephalography (EEG)
timeFrame: about 30 seconds for each trial, total about 30 minutes
measure: Electromyography (EMG)
timeFrame: about 30 seconds for each trial, total about 30 minutes
Secondary outcomes:
measure: Gait parameters (GAITRite)
timeFrame: about 30 seconds for each trial, total about 30 minutes
measure: Center of pressure (COP)
timeFrame: about 30 seconds for each trial, total about 30 minutes
measure: Tilting angle of inclinometer
timeFrame: about 30 seconds for each trial, total about 30 minutes
Other outcomes:
Locations:
city: Taipei
country: Taiwan
facility: National Taiwan University Hospital
Study officials:
affiliation: School & Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University
name: Cheng-Ya Huang, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Hung YT, Chen LC, Wu RM, Huang CY. The Effects of Task Prioritization on Dual-Tasking Postural Control in Patients With Parkinson Disease Who Have Different Postural Impairments. Arch Phys Med Rehabil. 2020 Jul;101(7):1212-1219. doi: 10.1016/j.apmr.2020.02.014. Epub 2020 Mar 28.