Computer-based Cognitive Training for Parkinson Disease

Effects of Computer-based Cognitive Training on Gait Function in Individuals With Parkinson Disease

Parkinson's Disease (PD) is a neurodegenerative, progressive illness. It is a multi-system disease that influences not only the motor but also the cognitive and autonomic systems. The main cognitive impairment in individuals with PD is found in executive function (EF). EF is defined as a set of cognitive skills necessary for planning, monitoring and executing sequences of complex activities.

The primary study hypothesis is that computer-based training aimed at improving executive function will have a beneficial effect on gait functions.

Study Overview

• Status: Completed
• Conditions: Parkinson Disease; Gait
• Intervention / Treatment: Other: Computerized cognitive training

Detailed Description

Parkinson Disease (PD) is a neurodegenerative, progressive illness. It is a multi-system disease that influences not only the motor but also the cognitive and autonomic systems. The main cognitive impairment in individuals with PD is found in executive function (EF). EF is defined as a set of cognitive skills necessary for planning, monitoring and executing sequences of complex activities. Previous studies have revealed some relation between cognitive states and physical functions in healthy adults. Few studies have examined the effect of computer-based cognitive training on various populations. These studies showed a positive emotional-cognitive effect in those populations. This type of intervention plan was also applied to PD patients. However, there are no reports on the effect of intentional cognitive training on gait functions. The purpose of the study is to assess whether cognitive training, designed to improve EF ability, can also improve gait function in PD patients.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Israel
  • Haifa, Israel
    • Clalit Health Services, Haifa and Western Galilee District

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Idiopathic PD.
2. Aged 50-80, living in north region of Israel.
3. Receive regular medications for PD.
4. Not suffering from irregular cognitive disturbance or MMSE<25.
5. Measured 1-3 on the Hoehn & Yahr scale.
6. Have access to a computer and the ability to operate it.

Exclusion Criteria:

1. Brain operation, including DBS transplant.
2. History of orthopedic problems that can impair gait (hip/knee fractures and back problems).
3. Orthopedic operation on lower limbs performed no later than six months prior to the beginning of the study.
4. Unbalanced general health: uncontrolled diabetes or blood pressure, etc.
5. Inability to walk independently.
6. Immunodeficiency diseases, active cancer, ischemic diseases.
7. Vision impairment, partial/full blindness.
8. Having participated in similar research or cognitive assessment during the previous year.
9. Have received cognitive or gait training under physical therapy or other programs.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Computerized cognitive training; A 12 week computerized cognitive training	Other: Computerized cognitive training; A 12 week computerized cognitive training at home with the Attengo™ software program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gait Function	At enrollment eligible individuals will undergo a thorough baseline assessment using a predefined set of tests and performance measurements. Within a week after enrollment each individual will receive guided training on the use of the intervention tool, the Attengo™ software program. Thereafter they will train at their homes, at least three times a week, for a period of 12 weeks. Follow up assessments will be performed within a week of the end of the training period and 4 weeks thereafter to check for long-term cognitive and motor changes.	18 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Executive function	At enrollment eligible individuals will undergo a thorough baseline assessment using a predefined set of tests and performance measurements. Within a week after enrollment each individual will receive guided training on the use of the intervention tool, the Attengo™ software program. Thereafter they will train at their homes, at least three times a week, for a period of 12 weeks. Follow up assessments will be performed within a week of the end of the training period and 4 weeks thereafter to check for long-term cognitive and motor changes.	18 weeks
Quality of life.	At enrollment eligible individuals will undergo a thorough baseline assessment using a predefined set of tests and performance measurements. Within a week after enrollment each individual will receive guided training on the use of the intervention tool, the Attengo™ software program. Thereafter they will train at their homes, at least three times a week, for a period of 12 weeks. Follow up assessments will be performed within a week of the end of the training period and 4 weeks thereafter to check for long-run cognitive and motor changes.	18 weeks

Collaborators and Investigators

• Sponsor: Clalit Health Services
• Collaborators: Tel-Aviv Sourasky Medical Center
• Investigators: Principal Investigator: Uzi Milman, MD, Clalit health services; Principal Investigator: Anat Mirelman, Phd, Tel-Aviv Sourasky Medical Center; Principal Investigator: Hagit Atias, BA, Clalit health services

Publications and helpful links

General Publications

• Milman U, Atias H, Weiss A, Mirelman A, Hausdorff JM. Can cognitive remediation improve mobility in patients with Parkinson's disease? Findings from a 12 week pilot study. J Parkinsons Dis. 2014;4(1):37-44. doi: 10.3233/JPD-130321.

Study record dates

Study Major Dates

• Study Start: July 1, 2010
• Primary Completion (Actual): April 1, 2012
• Study Completion (Actual): April 1, 2012

Study Registration Dates

• First Submitted: May 10, 2010
• First Submitted That Met QC Criteria: May 10, 2010
• First Posted (Estimate): May 12, 2010

Study Record Updates

• Last Update Posted (Estimate): August 24, 2015
• Last Update Submitted That Met QC Criteria: August 21, 2015
• Last Verified: August 1, 2015

More Information

Terms related to this study

• Keywords: Quality of life; Executive Function; Computerized Cognitive training; Gait Function
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Parkinsonian Disorders; Basal Ganglia Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Parkinson Disease
• Other Study ID Numbers: K-10-0036-ctil