Freezing of Gait, Parkinson Disease
Conditions
Keywords
Split-Belt Treadmill, Training
Brief summary
Freezing of Gait (FOG) is a disabling symptom common in advanced Parkinson's Disease. FOG is an independent contributor to fall risk and is only partially relieved by medication. Parkinson's patients with FOG are known to have more difficulty with gait adaptation in their day to day environment. Further, asymmetry of gait has been implicated in FOG as these episodes are often elicited during asymmetric tasks such as turning. This study will examine the effect of a single session of split-belt treadmill walking on gait adaptation, gait symmetry and FOG as well as 24 hour retention of these effects.
Detailed description
In this proposal, the investigators will investigate whether adapting gait to modulations imposed by a split-belt treadmill, improves walking ability and reduces FOG. The investigators will test the hypothesis that motor adaptation deficits underlie FOG and that these problems are modifiable with training. To address these suppositions, the investigators propose a multi-centric study conducted in two research labs with expertise in split-belt gait analysis and FOG: University of Leuven (KUL) and Christian-Albrechts-University Kiel (CAUK). As freezers have been shown to have more difficulty with consolidation of motor learning, the investigators aim in study I (pilot phase) to first understand which split-belt parameters are optimal for training gait flexibility and lead to consolidated gains in daily walking. For this study, the investigators will recruit 60 freezers and 60 healthy controls, pooled across centers, and manipulate different split-belt conditions in one learning and retention session.
Interventions
BEHAVIORALSplit-Belt Treadmill Training
One session of 6 x 5 min with 1 min intervals.
Sponsors
University of Kiel
KU Leuven
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
Participants will randomly be assigned to 1 of 4 different split-belt treadmill paradigms. Assessments will be performed pre and post training on day 1 and once again on day 2.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Diagnosis of Parkinson's Disease as per the UK Parkinson's Disease Society Brain Bank Criteria * Classification as a Freezer with the New Freezing of Gait Questionnaire (score \> 0) * Ability to walk at least 5 min. without any aid * Stable anti-parkinsonian medication at least 1 month prior to participation
Exclusion criteria
* Neurologic diseases other than PD * Orthopedic injuries that could influence gait and balance * Participation in treadmill training more than once a week * Cognitive impairment (MMSE\<24) or inability to follow test instructions * Self-reported DBS-related postural or gait disturbances * Cardiovascular risk factors * Peripheral neuropathy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adaptation to Split/Tied Belt | 24 hours after training | Measured with 3D motion analysis system during treadmill walking. Patients will walk for 1.5 minutes on the treadmill that will switch from tied-to-split state and back to tied state. |
| Gait Asymmetry | 24 hours after training | Measured with 3D motion analysis system during straight line overground walking |
| Freezing Ratio | 24 hours after training | Measured with APDM sensors during 360 degree turns |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Medio-lateral Anticipatory Postural Adjustments | 24 hours after training | Measured with APDM sensors at gait initiation |
| Gait Speed during dual task walking | 24 hours after training | Measured with 3D motion analysis system during overground walking with an auditory Stroop task |
Countries
Belgium, Germany
Outcome results
None listed