Task-priority Effects on Postural-suprapostural Task in Patients With Parkinson's Disease
29. desember 2017 oppdatert av: National Taiwan University Hospital
Effects of Task Prioritization on Postural-suprapostural Task and Brain Activity in Parkinson's Disease With Different Balance Ability: During Standing and Walking
Postural-suprapostural task is defined as postural control takes place while at least one other concurrent task is being performed.
In a postural-suprapostural task, appropriate prioritization of is necessary to achieve task goals and maintain postural stability.
Therefore, regarding to impose task prioritization in a postural-suprapostural task, the optimal task-priority strategy for PD patients is still an issue of debate.
With the uses of EEG, EMG and behavioral measures, the purpose of this project is to investigate the differences in performance quality and intrinsic neural mechanisms of a postural-suprapostural task for PD patients, by adopting posture-focus and suprapostural-focus strategies during standing and walking.
The present project is expected to have significant contributions not only to gain a better insight to neural correlates of concurrent postural and suprapostural tasks with different task prioritization under standing and walking, but to optimize treatment strategy for PD patients with balance or dual-tasking disturbances.
Studieoversikt
Detaljert beskrivelse
Postural-suprapostural task is defined as postural control takes place while at least one other concurrent task is being performed.
In a postural-suprapostural task, appropriate prioritization of is necessary to achieve task goals and maintain postural stability.
Some studies support that a "posture-first" strategy is favored by patients with Parkinson disease (PD) in order to secure stance stability, but this comes at the cost of reduced suprapostural performance.
In addition, overemphasizing on postural task might deteriorate automatic control of posture resulting in increased postural instability, and the best task-priority strategy might vary with balance ability of PD patients.
Therefore, regarding to impose task prioritization in a postural-suprapostural task, the optimal task-priority strategy for PD patients is still an issue of debate.
With the uses of EEG, EMG and behavioral measures, the purpose of this 2-year research project is to investigate the differences in performance quality and intrinsic neural mechanisms of a postural-suprapostural task for PD patients, by adopting posture-focus and suprapostural-focus strategies during standing and walking.
In the first year, we will characterize task prioritization effect on reciprocity of a postural-suprapostural task, with a special focus on modulation of brain and muscle activity patterns in standing posture for early stage (modified H & Y: 1, 1.5 and 2) and moderate stage (modified H & Y: 2.5 and 3) PD patients.
In the second year, the appropriate task prioritization, walking automaticity and power/connectivity of brain areas will be investigated in walking for PD patients with/without freezing of gait.
The present project is expected to have significant contributions not only to gain a better insight to neural correlates of concurrent postural and suprapostural tasks with different task prioritization under standing and walking, but to optimize treatment strategy for PD patients with balance or dual-tasking disturbances.
Studietype
Intervensjonell
Registrering (Forventet)
80
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
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Taipei, Taiwan, 10048
- Rekruttering
- National Taiwan University Hospital
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Ta kontakt med:
- Cheng-Ya Huang, Ph.D.
- Telefonnummer: +886-3366-8131
- E-post: rcyhuang@ntu.edu.tw
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
20 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
inclusion criteria:
- patients with Parkinson's Disease in H&Y stage from stage 1 to stage 3
- without other neurological disease with balance impairment
- can stand and walk without aids for at least 30 seconds
exclusion criteria:
- Mini-Mental State Examination > 27
- Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) < 10
- Hamilton Depression Rating Scale (HAM-D) < 17
- pregnancy
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Annen
- Tildeling: Ikke-randomisert
- Intervensjonsmodell: Crossover-oppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Aktiv komparator: early stage or non-freezers PD
early stage defined as modified Hoehn and Yahr scale 1, 1.5 and 2, means that symptoms involved unilateral or bilateral without impairment of balance. non-freezers defined as without freezing of gait, means that patients without transient inability to generate effective stepping. |
posture-focus strategy: when performing postural-suprapostural task (dual-task), the patient mainly focus on postural task (standing/walking). supraposture-focus strategy: when performing postural-suprapostural task (dual-task), the patient mainly focus on suprapostural task (stabilize the tray). |
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Eksperimentell: moderate stage or freezers PD
moderate stage defined as modified Hoehn and Yahr scale 2.5 and 3, means that symptoms involved unilateral or bilateral without impairment of balance. freezers defined as with freezing of gait, means that patients have transient inability to generate effective stepping. |
posture-focus strategy: when performing postural-suprapostural task (dual-task), the patient mainly focus on postural task (standing/walking). supraposture-focus strategy: when performing postural-suprapostural task (dual-task), the patient mainly focus on suprapostural task (stabilize the tray). |
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Electroencephalography (EEG)
Tidsramme: about 30 seconds for each trial, total about 30 minutes
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to collect the brain activity (unit: uV)
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about 30 seconds for each trial, total about 30 minutes
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Electromyography (EMG)
Tidsramme: about 30 seconds for each trial, total about 30 minutes
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to collect the muscle activity (unit: mV)
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about 30 seconds for each trial, total about 30 minutes
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Gait parameters (GAITRite)
Tidsramme: about 30 seconds for each trial, total about 30 minutes
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to know how the subjects walk during the trial
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about 30 seconds for each trial, total about 30 minutes
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Center of pressure (COP)
Tidsramme: about 30 seconds for each trial, total about 30 minutes
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to know how the subjects stand during the trial
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about 30 seconds for each trial, total about 30 minutes
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Tilting angle of inclinometer
Tidsramme: about 30 seconds for each trial, total about 30 minutes
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to know how the subjects perform the suprapostural task during the trial
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about 30 seconds for each trial, total about 30 minutes
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Etterforskere
- Hovedetterforsker: Cheng-Ya Huang, Ph.D., School & Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
- Peterson DS, Fling BW, Mancini M, Cohen RG, Nutt JG, Horak FB. Dual-task interference and brain structural connectivity in people with Parkinson's disease who freeze. J Neurol Neurosurg Psychiatry. 2015 Jul;86(7):786-92. doi: 10.1136/jnnp-2014-308840. Epub 2014 Sep 15.
- Kelly VE, Eusterbrock AJ, Shumway-Cook A. A review of dual-task walking deficits in people with Parkinson's disease: motor and cognitive contributions, mechanisms, and clinical implications. Parkinsons Dis. 2012;2012:918719. doi: 10.1155/2012/918719. Epub 2011 Oct 27.
- Shumway-Cook A, Woollacott M, Kerns KA, Baldwin M. The effects of two types of cognitive tasks on postural stability in older adults with and without a history of falls. J Gerontol A Biol Sci Med Sci. 1997 Jul;52(4):M232-40. doi: 10.1093/gerona/52a.4.m232.
- Beck EN, Ehgoetz Martens KA, Almeida QJ. Freezing of Gait in Parkinson's Disease: An Overload Problem? PLoS One. 2015 Dec 17;10(12):e0144986. doi: 10.1371/journal.pone.0144986. eCollection 2015.
- Mitra S, Fraizer EV. Effects of explicit sway-minimization on postural--suprapostural dual-task performance. Hum Mov Sci. 2004 Jun;23(1):1-20. doi: 10.1016/j.humov.2004.03.003.
- Vervoort G, Heremans E, Bengevoord A, Strouwen C, Nackaerts E, Vandenberghe W, Nieuwboer A. Dual-task-related neural connectivity changes in patients with Parkinson' disease. Neuroscience. 2016 Mar 11;317:36-46. doi: 10.1016/j.neuroscience.2015.12.056. Epub 2016 Jan 5.
- Knaepen K, Mierau A, Tellez HF, Lefeber D, Meeusen R. Temporal and spatial organization of gait-related electrocortical potentials. Neurosci Lett. 2015 Jul 10;599:75-80. doi: 10.1016/j.neulet.2015.05.036. Epub 2015 May 21.
- Hung YT, Chen LC, Wu RM, Huang CY. The Effects of Task Prioritization on Dual-Tasking Postural Control in Patients With Parkinson Disease Who Have Different Postural Impairments. Arch Phys Med Rehabil. 2020 Jul;101(7):1212-1219. doi: 10.1016/j.apmr.2020.02.014. Epub 2020 Mar 28.
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Faktiske)
5. desember 2017
Primær fullføring (Faktiske)
5. desember 2017
Studiet fullført (Forventet)
1. juli 2019
Datoer for studieregistrering
Først innsendt
4. mai 2017
Først innsendt som oppfylte QC-kriteriene
26. september 2017
Først lagt ut (Faktiske)
2. oktober 2017
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
2. januar 2018
Siste oppdatering sendt inn som oppfylte QC-kriteriene
29. desember 2017
Sist bekreftet
1. mai 2017
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- 201701080RINB
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Nei
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