Clinical trial NCT02539446: Suprapostural Attention Focus and Postural Difficulty on H-reflex and Brain Activity: Aging and Parkinson's Disease
Official title: The Effects of Suprapostural Attention Focus and Postural Difficulty on H-reflex and Brain Activity: Aging and Parkinson's Disease
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Parkinson
Keywords: Aging
External focus
Internal focus
Attention
Posture balance
Parkinson's disease
Lead sponsor: National Taiwan University Hospital
Sponsor class: OTHER
First posted: 2015-09-03
Enrollment: 30
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: OTHER

Brief summary: Inherent with intricate allocation of brain resource and attention shift, postural-suprapostural task is defined as postural control takes place while the other concurrent task is being performed. Recent studies have indicated that attentional focusing alters attention allocation in the brain as well as motor performance of a postural-suprapostural task. Also, most studies have demonstrated benefits of inducing an external focus relative to internal focus for motor performance. However, postural difficulty might be a critical factor for choosing an appropriate focusing strategy, and the strategy used in a particular difficulty level do not always generalize to other difficulty levels. Besides, despite a lot of studies have been done, current findings are confined to behavioral observations in young healthy adults for lacking direct neural evidence. With the uses of H-reflex, event-related potential and behavioral measures, the purpose of the 3-year research project is to investigate the differences in performance quality and intrinsic neural mechanisms of a postural-suprapostural task for older adults and patients with Parkinson's disease, by adopting external and internal strategies for suprapostural task under different posture difficulties. In the first year, the investigators will characterize suprapostural focusing effect on reciprocity of a postural-suprapostural task, with a special focus on modulation of motoneuron excitability in sitting and standing posture for healthy young and older adults using H-reflex technique. In the second year, the adaptive selection of suprapostural focusing strategy will be investigated for patients with Parkinson's disease by varying the standing surface (stable/unstable surface). In the third year, the investigators will investigate suprapostural focusing effect on brain resource allocation for patients with Parkinson's disease, in light of event-related potential and movement-related potential. The present project is expected to have significant contributions not only to gain a better insight to neural correlates of concurrent postural and motor suprapostural tasks with internal/external focusing strategy under different posture difficulty, but to optimize treatment strategy for older adults and patients with Parkinson's disease with balance or multi-tasking disturbances.


Eligibility criteria: Inclusion criteria

* Independent standing balance on air pillow at least 20 sec
* No neurologic or orthopedic disorder

Exclusion criteria

* Had relative experience before
* Pregnant women

Primary outcomes:
measure: H-reflex analysis
timeFrame: 1 week
Secondary outcomes:
measure: EMG analysis
timeFrame: 1 week
measure: postural sway analysis
timeFrame: 1 week
Other outcomes:
Locations:
city: Taipei
country: Taiwan
facility: National Taiwan University Hospital
city: Taipei
country: Taiwan
facility: School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University
Study officials:
affiliation: National Taiwan University
name: Cheng-Ya Huang
role: PRINCIPAL_INVESTIGATOR
References:
citation: Yu SH, Wu RM, Huang CY. Attentional Resource Associated With Visual Feedback on a Postural Dual Task in Parkinson's Disease. Neurorehabil Neural Repair. 2020 Oct;34(10):891-903. doi: 10.1177/1545968320948071. Epub 2020 Aug 24.
citation: Huang CY, Chen YA, Hwang IS, Wu RM. Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease. Arch Phys Med Rehabil. 2018 Aug;99(8):1540-1546.e2. doi: 10.1016/j.apmr.2018.02.013. Epub 2018 Mar 31.