None listed
Conditions
Brief summary
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique with the potential to improve function and learning in neurological conditions. However, evidence in PD is limited to three small pilot studies, all of which use sub-optimal tDCS protocols. Here we aim to undertake a preliminary trial to investigate the effect of tDCS coupled with dual task training on gait disturbances in PD. In addition we will examine the effect of tDCS on bradykinesia, motor function and learning. This novel and innovative research has the potential to improve the function and quality of life for over 4 million individuals living with PD.
Interventions
Nine one-hour sessions of walking training to improve step length whilst concurrently performing added cognitive or motor tasks will be undertaken in an outpatient rehabilitation setting with a physiotherapist over 3 weeks (3 sessions per week). Walking training will be one-on-one, progressed and include tasks such as walking, turning, and obstacle negotiation whilst concurrently performing added tasks such as conversation, mathematics, and route-finding. A home program of exercises and strategi
Nine one-hour sessions of walking training to improve step length whilst concurrently performing added cognitive or motor tasks will be undertaken in an outpatient rehabilitation setting with a physiotherapist over 3 weeks (3 sessions per week). Walking training will be one-on-one, progressed and include tasks such as walking, turning, and obstacle negotiation whilst concurrently performing added tasks such as conversation, mathematics, and route-finding. A home program of exercises and strategies will be provided. These will be customized to the individual. Examples include a walking program adding dual tasking (e.g. a 20 minute walk on a bike path with a carer, conversing for 5 minutes on and 5 minutes off) and postural exercises such as standing with back to a wall and holding an erect posture for 20 second holds. A diary will be used to record adherence to the home exercise protocol. Training will be combined with anodal transcranial direct current stimulation applied to the left primary motor cortex at 2mA for 20 minutes at the beginning of each training session.
Sponsors
Dr Siobhan Schabrun
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All participants will be aged over 18 years and have a diagnosis of idiopathic PD using the UK Brain Bank criteria. Additional inclusion criteria will comprise: being able to walk 100m independently with or without gait aids; rated stage I-IV on the Hoehn and Yahr disability scale (Hoehn and Yahr 1967); and report reduced step length or slowed gait speed, confirmed by clinical examination.
Exclusion criteria
Participants will be excluded if they have metal objects or stimulators in the head that might pose a hazard during tDCS; neurological conditions other than PD; musculoskeletal or cardiopulmonary conditions that affect the ability to safely walk; score < 24 on the Mini-Mental Status Examination (MMSE; Folstein et al 1975) or sensory system pathology affecting walking or communication (e.g. blindness, deafness).
Outcome results
None listed