- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04608604
Mobility in Atypical Parkinsonism: a Trial of Physiotherapy (Mobility_APP)
Mobility in Atypical Parkinsonism: a Randomized Trial of Physiotherapy
Patients with atypical parkinsonism often show gait and mobility impairment manifesting in early disease stages.
In order to maintain mobility and physical autonomy as long as possible for these patients, we will examine the effect of two types of physiotherapy in patients with multiple system atrophy (MSA), progressive supranuclear gaze palsy (PSP) and idiopathic Parkinson's disease (IPD).
The study is divided into an ambulant daily in-patient physiotherapy phase, followed by a home-based training phase. At the beginning and the end of the study, the patients daily activity will be recorded for one week using Physical Activity Monitoring (PAM) sensors.
The aim of this double-blind, randomized-controlled study is to determine effective physiotherapy in patients with atypical parkinsonian syndromes in order to maintain mobility for as long as possible.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Patients with Parkinson's disease often show gait impairment and reduced mobility over the disease course. Rare atypical forms of parkinsonism, like multiple system atrophy (MSA) or progressive supranuclear gaze palsy (PSP) develop these features in early disease stages. The reduced mobility and increased time spent in sitting or lying posture leads to loss of physical independence and increased mortality. Since MSA and PSP can currently only be treated symptomatically, a long lasting independence and mobility is therefore of great importance.
A positive effect has already been shown in a few studies on specific physiotherapy in patients with idiopathic Parkinson's disease (IPD), and some small studies also give us an evidence that physiotherapy in atypical parkinsonism can improve mobility.
The Mobility_APP study examines the effect of two types of physiotherapy in patients with MSA, PSP and IPD. The participants are initially assigned to a type of therapy and they learn specific exercises with a physiotherapist every day for two weeks. These exercises will then be continued independently at home for another five weeks. Regular checks in the study center ensure a precise examination of the physical condition, quality of life and gait pattern. The latter will be objectively analyzed with the help of sensors that are worn on the participant's shoes. In addition, before the start and at the end of the study, the participants are also monitored for one week at home using shoe sensors in order to reflect the natural conditions of the patients.
During the entire study, neither the participant nor the study investigator knows what type of therapy is being used in order to guarantee an unbiased analysis (double blinding).
The aim of this double-blind, randomized-controlled study is to determine effective physiotherapy in patients with atypical parkinsonian syndromes in order to maintain mobility for as long as possible. If the exercises learned during physiotherapy can be continued regularly at home and can improve mobility, this means a big step towards autonomous therapy. Frequent visits to therapists can be reduced and sufficient and effective independent therapy can still be carried out during times of crisis or phases with increased motor impairment.
The project is kindly supported by the Fund for the Promotion of Scientific Research (FWF). Together with the German Research Foundation (DFG) and Swiss National Science Foundation (SNF) in Switzerland this project can be carried out internationally in cooperation with renowned centers for neurological and sensor-based research.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Gregor Wenning, MD
- Phone Number: +4351250481811
- Email: gregor.wenning@i-med.ac.at
Study Locations
-
-
Tirol
-
Innsbruck, Tirol, Austria, 6020
- Recruiting
- Medical University Innsbruck
-
Contact:
- Gregor Wenning, Prof
- Phone Number: +43 50 504 81811
- Email: gregor.wenning@tirol-kliniken.at
-
Contact:
- Cecilia Raccagni, MD
- Email: cecilia.raccagni@tirol-kliniken.at
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- The subject is willing and able to give written informed consent
- The patient is able to tolerate all study visits including daily physiotherapy and home training.
- Patients similar with regard to age and sex with probable/possible MSA-P according to rev. Gilman criteria OR probable/possible PSP-RS according to MDS-PSP criteria OR PD according to MDS-PD criteria.
- Stable antiparkinsonian and Anti-OH medication 4 weeks prior to study entry.
Exclusion Criteria:
- Co-morbidities that influence the clinical presentation of parkinsonian symptoms (as judged by the enrolling investigator).
- Participation in other clinical trials that might influence the impact of the trial intervention (as judged by the enrolling investigator)
- H&Y Staging score greater than or equal to 4
- Change of antiparkinsonian and anti-OH medication 4 weeks prior to the interventional trial.
- Secondary cause of autonomic failure or parkinsonism (e.g. diabetic autonomic neuropathy, bladder surgery, drug-induced or vascular parkinsonism, etc.)
- Dementia according to DSM-V.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Physiotherapy 1
|
Patients will be randomized in either physiotherapy 1 or physiotherapy 2. Physiotherapy programs are individually tailored based on a structured standardized series.
In order to not unblind potential participants, detailed description of both interventions will be provided after recruitment has been finished.
|
Active Comparator: Physiotherapy 2
|
Patients will be randomized in either physiotherapy 1 or physiotherapy 2. Physiotherapy programs are individually tailored based on a structured standardized series.
In order to not unblind potential participants, detailed description of both interventions will be provided after recruitment has been finished.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sensor-based analysis
Time Frame: Baseline to week 7
|
Gait speed
|
Baseline to week 7
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical Rating scale
Time Frame: Baseline to week 7
|
MDS-UPDRS
|
Baseline to week 7
|
Sensor-based analysis
Time Frame: Baseline to week 7
|
Stride length
|
Baseline to week 7
|
PAM Secondary outcome
Time Frame: Baseline to week 7
|
Number of steps per day
|
Baseline to week 7
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Eye Diseases
- Neurologic Manifestations
- Basal Ganglia Diseases
- Movement Disorders
- Synucleinopathies
- Neurodegenerative Diseases
- Tauopathies
- Cranial Nerve Diseases
- Autonomic Nervous System Diseases
- Ocular Motility Disorders
- Paralysis
- Primary Dysautonomias
- Hypotension
- Ophthalmoplegia
- Parkinson Disease
- Multiple System Atrophy
- Shy-Drager Syndrome
- Parkinsonian Disorders
- Supranuclear Palsy, Progressive
Other Study ID Numbers
- 1290/2020
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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