Neuromodulation on Motor Function in Parkinson's Disease
2014年9月24日 更新者：Adriana Carla Costa Ribeiro Clementino、Universidade Federal de Pernambuco
Transcranial Direct Current Stimulation (tDCS) Associated With Gait Training in Improving Motor Function in Parkinson's Disease
The aims of the present study was to analyze the effect of consecutive sessions of Transcranial direct current stimulation associated to kinesiotherapy about gait performance of Parkinson' s disease.
For this, the primary outcome was evaluation of gait performance by means of space and temporal parameters as speed (meter/second ), stride frequency (steps/min) and stride length (m).
The secondary outcome is motor cortex excitability which is analyzed by means of single pulse transcranial magnetic stimulation (TMS) intends to determine: motor evoked potential amplitude (MEP) and rest motor threshold (rMT).
調査の概要
状態
わからない
詳細な説明
This study consist by interventions involving screening followed by evaluation, where volunteers were subjected to the many tests: history, session III of the Unified Scale Modified Parkinson's Disease - Unified Parkinson 's Disease Rating Scale, Ten meters walk test - Walk Test 10 meters and shoot gait, (using Studio Version 8 software).
On the same day, the subjects underwent assessment of brain excitability to determine motor threshold and amplitude of the motor evoked potential (MEP).
The randomization of the volunteers was conducted by an external search through opaque envelopes ordered according to a random distribution.
The subjects were divided into two groups : control group , this group submitted to Transcranial Stimulation sessions a sham Continuous Current (sham tDCS) and gait training , and Experimental group, subjected to the stimulation by Transcranial Direct Current sessions (active tDCS ) and gait training.
研究の種類
介入
入学 (予想される)
24
段階
- 適用できない
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
40年～80年 (大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
Inclusion Criteria:
- Main eligibility criteria were idiopathic Parkinson's disease
- Both sex
- Hoehn and Yahr stage I to III
- Showing mild to severe gait disturbances
- Stable medication usage
- Age 40 to 80 years
- And absence of cognitive impairment and disorders interfering with participation in cueing therapy.
Exclusion Criteria:
- Presence of chronic disabling pathologies of lower limb
- Presence of pacemaker or severe cardiovascular conditions
- A history of tumor, prior neurosurgical brain
- Intervention, or severe cardiovascular conditions, including the presence of a pacemaker
- A diagnosis of epilepsy or major psychiatric disorders.
- Participants with other neurological, muscular, or psychiatric disorders (e.g. peripheral neuropathies, uncorrected visual problems, hearing problems, vestibular dysfunction, stroke, seizure, migraine, or frequent severe headaches) were excluded.
- Participants with surgical implants, significant postural tremor, dyskinesia, severe freezing or dementia were also excluded.
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：experimental group - tDCS
The tDCS intervention occur at 10 sessions of intervention where electrodes are connected to head specifically in supplementary motor area placed at 2 cm in front of vertex.
The clinical stimulator (NeuroConn, Germany) provided the direct current using two silicon-sponge electrodes with a surface area of 35 cm2 (5 × 7cm) embedded in a saline-soaked solution.
Immediately after 13 minutes of tDCS application, patient was submitted to gait training three times a week during 4 weeks with visuals cues.
The patients were asked to walk along at a 7 meters rubber carpet to at different speed, forward and backward gait, side walk during thirty minutes with three intervals of two minutes.
The patient may be at on state of drug administration and the training is applied by another physiotherapist.
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偽コンパレータ：Control group (tDCS sham)
The sham character is ensured by the stimulation time, once the device is programmed to turn off 30 seconds after the beginning of stimulation.
The current is switched in ascending ramp mode for 10 seconds until 2 mili ampere and a descending ramp similar also for 10 seconds will be used until the end of stimulation.
The sham stimulation is commonly perceived by the patient as the actual treatment and all procedures for the application of the technique should be similar to those adopted for the active stimulation.
Immediately after tDCS stimulation, the gait training consisting of a protocol based on sensory cues for 30 minutes is administered three times a week for four weeks.
Sham stimulation will be held for 30 seconds in order to mimic the perceived lowering effect of ramp current.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change on Bradykinesia
時間枠：This outcome will be measure before and after each session, before ten sessions, 1 and 2 months after ten session
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This outcome will be measure in three different moments of evaluation and at all interventions (sessions) days - before and after intervention.
Beyond these evaluations, the voluntairs will be evaluate at: T1- before ten sessions; T2- Immediately after ten sessions and T3- after a period of 1 month without intervention.
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This outcome will be measure before and after each session, before ten sessions, 1 and 2 months after ten session
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change on Cortical excitability
時間枠：The evaluation occur in 3 different moments: before and after each session, after a period of 1 month without intervention. This outcome will be measure at all intervention and evaluation days
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The secondary outcome measures will be done using amplitude of Motor Evoked Potential (MEP) and rest Motor Threshold (rMT) elicited by transcranial magnetic stimulation (TMS) by means of Neuro-MS device of Neurosoft.
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The evaluation occur in 3 different moments: before and after each session, after a period of 1 month without intervention. This outcome will be measure at all intervention and evaluation days
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change on Balance
時間枠：This outcome will be measure before ten sessions, 1 and 2 months after ten session
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Berg Balance scale (BBS) is measured asking to the patient for change posture in sit position for search balance during transferences and standing with one foot at single or double support, with open and closed eyes, narrow support base body, rotation around the own body axis; take up an object at floor and others.
This outcome is done using a scale with scores range from 0 to 56.
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This outcome will be measure before ten sessions, 1 and 2 months after ten session
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始
2013年9月1日
一次修了 (予想される)
2014年10月1日
研究の完了 (予想される)
2014年11月1日
試験登録日
最初に提出
2014年3月31日
QC基準を満たした最初の提出物
2014年9月24日
最初の投稿 (見積もり)
2014年9月26日
学習記録の更新
投稿された最後の更新 (見積もり)
2014年9月26日
QC基準を満たした最後の更新が送信されました
2014年9月24日
最終確認日
2014年7月1日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- Parkinson_tDCS_Gait_Impairment
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