The Learning Effects of Attentional Strategy on Dual-task Walking in Patients With Parkinson's Disease: Behavioral Performance and Neural Plasticity
Study Details
Study Description
Brief Summary
[year1]
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To compare the effects of dual-task training with two different task priority instruction in people with Parkinson's disease and healthy controls on dual-task weight shifting performances.
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Investigate the changes of brain activities and functional connectivity after dual-task training with different task priority instructions.
[year 2-3]
To investigate the learning effects of walking with internal/external focus on walking automaticity and brain plasticity in dual-task walking training for PD patients with/without freezing of gait.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Postural-suprapostural task is defined as postural control takes place while another concurrent task is being performed, belonging to dual-task paradigms. Effective dual-task training is important to patients with Parkinson disease (PD), because they often lose balance and fall in dual-task conditions. Attentional strategy includes 1) task-priority between postural and suprapostural tasks and 2) internal and external focus for the postural task, which is the critical factor for both dual-task control and motor learning. However, the appropriateness of attentional strategy has not been investigated in dual-task training in patients with PD. Besides, there is lack of neural evidence of brain plasticity for previous studies about dual-task training in patients with PD. With the uses of EEG, EMG and behavioral measures, the purpose of this 3-year research project is to investigate the differences in performance quality and intrinsic neural mechanisms of dual-task training in PD, by adopting task-priority strategy and internal/external strategy during weight-shifting and walking. In the first year, the investigators will characterize task-priority effect (posture-priority vs. supraposture-priority) on dual-task training, with a special focus on modulation of brain plasticity and muscle activity patterns in weight-shifting posture for patients with PD. In the second and third years, the learning effects of walking internal/external focus on walking automaticity and brain plasticity will be investigated in dual-task walking training for PD patients with/without freezing of gait. Besides, the transfer effects of dual-task learning will be also investigated on medication "off" state. The present project is expected to have significant contributions not only to gain a better insight to neural correlates of dual-task training with different attentional strategies under weight-shifting and walking, but to optimize treatment strategy for PD patients with balance or dual-tasking disturbances.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: [year1] PD group
|
Behavioral: [year1] dual-task training with task priority strategy
postural focus: focus mainly on postural performances while dual-tasking suprapostural focus: focus mainly on suprapostural performances while dual-tasking
|
| Active Comparator: [year1] healthy control group
|
Behavioral: [year1] dual-task training with task priority strategy
postural focus: focus mainly on postural performances while dual-tasking suprapostural focus: focus mainly on suprapostural performances while dual-tasking
|
| Experimental: [year2-3] freezer
|
Behavioral: [year2-3] dual-task training with internal and external focus
internal focus: focus mainly on body movements external focus: focus mainly on object in the environment
|
| Experimental: [year2-3] non-freezer
|
Behavioral: [year2-3] dual-task training with internal and external focus
internal focus: focus mainly on body movements external focus: focus mainly on object in the environment
|
Outcome Measures
Primary Outcome Measures
- postural performance [about 36 seconds for each trial for a total of 25 minutes]
measuring the amount of body weight shifting (unit: kg)
- suprapostural performance [about 36 seconds for each trial for a total of 25 minutes]
measuring the rotation angle of box on the hand (unit: degree)
- Walking speed [about 10-20 seconds for each trial]
collecting by using the GAITRite electronic walkway (CIR systems, Inc. ,USA) 24 inches(61cm) wide and 192 inches (488cm, 16ft) long, total 18,432 sensor (unit: m/s)
- Cadence [about 10-20 seconds for each trial]
collecting by using the GAITRite (unit: step/s)
- Gait symmetry [about 10-20 seconds for each trial]
collecting single leg supporting time of right and left leg by using the GAITRite
Secondary Outcome Measures
- electroencephalography (EEG) [about 36 seconds for each trial for a total of 25 minutes]
to collect the brain activity (unit: uV)
- electromyography (EMG) [about 36 seconds for each trial for a total of 25 minutes]
to collect the muscle activity (unit: mV)
Eligibility Criteria
Criteria
[year1]
Inclusion criteria:
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For people with Parkinson's disease
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modified Hoehn & Yahr stage 2-3
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without dementia and able to follow instructions
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For healthy controls
age and gender matched healthy subjects as control group
Exclusion criteria:
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MMSE < 26
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with other disease that may influence balance ability
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with marked action and postural tremor
[year2-3] inclusion criteria:
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idiopathic Parkinson's disease
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modified Hoehn & Yahr stage 2-3
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without marked action or postural tremor
exclusion criteria:
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MMSE < 26
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with other disease that may influence balance ability
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | National Taiwan University Hospital | Taipei | Taiwan | 10048 |
Sponsors and Collaborators
- National Taiwan University Hospital
Investigators
- Principal Investigator: Cheng-Ya Huang, School & Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 201812110RINC