Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

Mental Practice Combined With Physical Practice to Improve the Gait Performance of People With Parkinson's Disease

17. september 2018 opdateret af: University of Sao Paulo General Hospital
Among the impairments associated to Parkinson's disease, gait disturbance is one of which that has the most negative impact on the independence in daily living activities and quality of life of people living with Parkinson's disease. Despite the considerable amount of research, we have no consensus about the most efficient physiotherapeutic approach to improve the gait disturbance. Mental practice is considered an efficient strategy to improve the motor performance in healthy individuals and people with stroke. However, there is scarce evidence about its therapeutic results to improve the gait performance in people living with Parkinson's disease. Thus, the aim of this study is to investigate the effects of gait mental practice associated to physical practice to improve the gait performance in people living with Parkinson's disease.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Background: Among the impairments associated to Parkinson's disease, the gait disturbance is one of which that has the most negative impact on the independence in daily living activities and quality of life of people living with Parkinson's disease. Despite the considerable amount of research, we have no consensus about the most efficient physiotherapeutic approach to improve the gait disturbance. Mental practice is considered an efficient strategy to improve the motor performance in healthy individuals and people with stroke. However, there is scarce evidence about its therapeutic results to improve the gait performance in people living with Parkinson's disease.

Objectives: To investigate the effects of mental gait practice associated with physical practice to improve the gait performance of people living with Parkinson's disease.

Design: Parallel, prospective, double-blind, multicentre randomized clinical trial.

Setting: Brazilian Parkinson Association.

Participants: Twenty-two people living with Parkinson's disease in stages 2-3 of disease evolution according to Hoehn and Yahr Classification.

Interventions: The participants will be randomly allocated in an experimental group and a control group. Both groups will perform 10 individual training sessions, two times per week, for five weeks. The training sessions consist of four blocks of mental practice intercalated with four blocks of physical practice of gait under different conditions. The only difference between the groups will be the content of mental practice blocks: the experimental group will perform mental practice of gait while the control group performs non-gait mental practice.

Randomization: Participants will be randomized by ClinStat software into one of two groups: Experimental Group (EG), which will perform gait mental practice; and Control Group (CG), which will perform the non-gait mental practice.

Statistical analysis: The training effects for each primary and secondary outcome measure will be analyzed for the two training conditions (i.e., control and experimental) at the four assessment time points (i.e., pre-intervention, 7 days post-completion and at 30 and 60-day follow-up) using a mixed-design ANOVA with training as the between-group factor and the assessment time point as the within-group factor. The effect sizes (ES) will be calculated for all comparisons at alpha = 0.05. A Tukey HSD post-hoc test will be used for multiple comparisons and p-values below 5 % will be considered as statistically significant.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

20

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Brasilien
      • São Paulo, Brasilien, 04142-092
        • Brazil Parkinson Association

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

65 år til 80 år (Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • diagnosis of Parkinson's disease according to the United Kingdom Brain Bank criteria;
  • in stage 2-3 of the disease evolution according to the Hoehn and Yahr;
  • treated with levodopa or its synergists;
  • capable to walk independently indoors without aid;
  • referring 5 years of education or more.

Exclusion Criteria:

  • presence of other neurological (excluding PD), orthopedic or cardiopulmonary problems;
  • visual and auditory deficiency uncorrected;
  • dementia [assessed by Montreal Cognitive Assessment (MoCA), cut-off 26];
  • depression [according to the Geriatric Depression Scale (GDS-15), cut-off 6];
  • declined imagery capacity [according to the Revised Movement Imagery Questionnaire (MIQ-R) cut-off 10].

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Eksperimentel gruppe (EG)
Den eksperimentelle træning (ET) består af 10 sessioner med 4 blokke af MP (GMP) interkaleret med 4 blokke af gang fysisk træning (GPP), under enkelt (ST) og dual-task (DT) forhold.
Adfærdsmæssigt: Eksperimentel træning

Hver blok MP består af 5 mentale gangforsøg med 10 forestillede trin. Deltagerne, der sidder behageligt med lukkede øjne, vil blive bedt om at forestille sig, at de går i et førstepersonsperspektiv, uden nogen åbenlys fysisk bevægelse, under fire forskellige forhold: sædvanlig hastighed, så hurtigt som muligt, overvinde forhindringer og huske et navn på en specifik medicin.

Hver blok af PP består af 5 fysiske gangforsøg med 10 trin. Deltagerne vil blive bedt om at gå under 4 forskellige forhold: sædvanlig hastighed, så hurtigt som muligt, overvinde forhindringer og huske et navn på en specifik medicin.
Aktiv komparator: Control Group
The Control training (CT) consists of 10 sessions with 4 blocks of MP (nGMP) intercalated with 4 blocks of gait physical practice (GPP), under single (ST) and dual-task (DT) conditions.
Adfærdsmæssigt: Kontroltræning

Hver blok MP består af 5 mentale gangforsøg med 10 forestillede trin. Deltagerne, der sidder behageligt med lukkede øjne, vil blive bedt om at forestille sig, at de sætter pris på et smukt landskab i et førstepersonsperspektiv, uden nogen åbenlys fysisk bevægelse, i fire forskellige sammenhænge: i en vogn, i en luftballon, i en båd og i en zepelin.

Hver blok af PP består af 5 fysiske gangforsøg med 10 trin. Deltagerne vil blive bedt om at gå under 4 forskellige forhold: sædvanlig hastighed, så hurtigt som muligt, overvinde forhindringer og huske et navn på en specifik medicin.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Seks minutters gangtest
Tidsramme: op til 3 måneder
Seks-minutters gangtesten (6-MWT) er en timet anbefalet klinisk baseret test, hvor deltagerne bliver bedt om at gå i 6 minutter, i deres sædvanlige hastighed, så lang afstand som muligt. Afbrydelser til hvile er tilladt, hvis det er nødvendigt. 6-MWT har demonstreret tilstrækkelig test-gentest og interterrater-pålidelighed og minimal detekterbar ændring på 82 meter i PD. Det kan være en god forudsigelse for evnen til selvstændigt at gå sikkert udenfor.
op til 3 måneder
Postural Instability and Gait Difficulty Score
Tidsramme: up to 3 months
Postural Instability and Gait Difficulty Score (PIGD): This recommended rating scale for evaluation of gait alterations in PD is based on 5 Unified Parkinson's Disease Rating Scale (UPDRS) items relevant to gait and postural instability (items 13-15, 29, and 30). The 13-15 items are based on gait performance according to PPD perspective, while 29 and 30 items are based on the motor test. It is a recent rating scale that has been used in PD, evaluated independently, which has adequate clinimetric characteristics.
up to 3 months
Dynamic Gait Index
Tidsramme: up tp 3 months
The balance during the eight gait related activities is scored in this test. These include quality of walking speed change, going around and over obstacles and stair walking, as well as the number of steps required for a pivot turn.
up tp 3 months
30-second dual task gait
Tidsramme: up tp 3 months
It measures the maximal walking distance reached in 30 seconds under single task, i.e., without another concurrent task, and dual task, i.e., with a concurrent cognitive task. The cognitive task consists of speaking as many words as possible, starting with a specific character (F, S or A), presented at the beginning of test.
up tp 3 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Trail Making Test
Tidsramme: up to 3 months
This test is constituted with two-timed parts: Part A, which involves a visual-scanning task where the participant is required to draw lines sequentially connecting consecutively numbered circles (1-25) randomly arranged on a page as fast as possible. Part B, which assesses cognitive flexibility, where the participant is asked to connect the same number of circles in an alternating sequence of numbers and letters (1, A, 2, B, etc.).
up to 3 months
39-item Parkinson's Disease Questionnaire
Tidsramme: up to 3 months
This scale assesses the health-related quality of life, i.e., the impact of an illness and/or treatment on patients' perception of their status of health and on subjective well-being or satisfaction with life. It evaluates 39 parameters in eight groups of issues (mobility, ADL, emotional well-being, stigma of the disease, back in the next, cognitive, communication and bodily discomfort).
up to 3 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Sao Paulo General Hospital

Efterforskere

  • Ledende efterforsker: Maria Elisa P Piemonte, PhD, Department of Physioterapy , Communication Science&Disorders, Occupational Therapy, School of Medicine, University of São Paulo

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. marts 2015

Primær færdiggørelse (Faktiske)

1. oktober 2017

Studieafslutning (Faktiske)

1. december 2017

Datoer for studieregistrering

Først indsendt

9. september 2016

Først indsendt, der opfyldte QC-kriterier

13. september 2016

Først opslået (Skøn)

19. september 2016

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

19. september 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

17. september 2018

Sidst verificeret

1. september 2016

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • Pikel 01

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

UBESLUTET

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Parkinsons sygdom

Kliniske forsøg med Eksperimentel træning

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Angola

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner