Parkinson Disease, Rhythm
Conditions
Keywords
musicokinetic education, rhythm, dance, anxiety, gait, walking kinematics, walking kinetics, DLPFC hemodynamics
Brief summary
The aim of the present study is to examine the acute effects of a specially designed musicokinetic (MSK) program for patients with Parkinson's disease (PD) on a) anxiety levels b) select kinematic and kinetic parameters, and c) frontal cortex hemodynamic responses, during gait initiation and steady-state walking.
Detailed description
This is a blind cross over randomized control trial (RCT) in which 13 volunteers with PD will attend a 45 min MSK program under the following conditions: a) synchronous learning format, b) asynchronous remote video- based, and c) control conditions. Changes in gait biomechanics and frontal cortex hemodynamic responses will be examined using a 10-camera 3D motion analysis (Vicon T-series, Oxford, UK), and a functional near-infrared spectroscopy (f-NIRS - Portalite, Artinis, NL) system, respectively, while anxiety levels will be evaluated using the Hamilton Anxiety Rating Scale.
Interventions
OTHERMusicokinetic Training
The intervention protocols are either a) synchronous learning format, b) asynchronous remote video- based, and c) control.
Sponsors
University of Thessaly
National and Kapodistrian University of Athens
Federal University of Rio Grande do Sul
Karolinska Institutet
University of Wolverhampton
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Masking description
Participants will be randomly (randomizer.org) assigned by a researcher blinded to the study either to start with the synchronous intervention or with the asynchronous remote video-based intervention. Two evaluators also blinded to the scope of the study will take all measurements before and after interventions. It will be not possible to blind participants as the delivery of the class will reveal their allocation
Intervention model description
Volunteers will be asked to attend three conditions in a randomized order, separated by at least a week of washing out period. Levels of anxiety, kinematic, and DLPFC hemodynamic activity data will be collected before and after the two different interventions, while, on a third occasion, control data will be collected at the same time-points but without any intervention
Eligibility
Sex/Gender
ALL
Age
No minimum to 75 Years
Healthy volunteers
No
Inclusion criteria
* Hoehn and Yahr (H&Y) Parkinson disease scale I-III * No restriction on disease duration, * No restriction on type of drug therapy * Stable antiparkinsonian medication of at least 6 months * Data collections will be on medication * No participation to any other exercise program for at least 2 months * 100% attendance of the session.
Exclusion criteria
* Dementia * Deep brain stimulation, * Cancer, * Cardiovascular diseases * Poor visual capability * Poor or auditory capability * Musculoskeletal problems * No stable antiparkinsonian therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Anxiety | 1-2 hours before the intervention arms and within 2 hours after the completion of the intervention arms | Hamilton Anxiety rating scale. Scores of 17 or less indicates mild anxiety severity, 18 to 24 indicates mild to moderate anxiety severity, and 25 to 30 indicates a moderate to severe anxiety severity. |
| Dorsolateral pre-frontal cortex (DLPFC) blood markers during gait | 2 hours before the intervention arms and within 2 hours after the completion of the intervention arms | A portable fNIRS system (Portalite, Artinis Medical Solutions, Netherlands) will be applied to monitor concentration changes (mM), of O2Hb, HHb and total hemoglobin (tHb) and the difference between O2Hb and HHb \[Hbdiff = O2Hb -HHb\] of the dorsal lateral prefrontal cortex (DLPFC). To correct for scattering of photons in the tissue, a differential path-length factor (DPF) of 4.0 will be used, for the calculation of absolute concentration changes at a sample frequency of 10Hz. The NIRS probe will be placed in the Brodmann 46 region on the right DLPFC, which has been proposed to be more involved in regulating muscle fatigue and activation. Subsequently, the NIRS probe will be fixed with adhesive tape and a dark elastic bandage around the head to avoid external light and artifacts. The O2Hb, HHb and tHb will be used as an indicator of DLPFC total activity, while the Hbdiff (i.e., oxygen supply vs demand) will be used as a marker of oxygenation in the DLPFC. |
| Gait initiation - balance | 2 hours before the intervention arms and within 2 hours after the completion of the intervention arms | Using two force plates in line the participant stands on the first, adapting a quite bipedal stance and after a verbal command, starts ambulating forwarding one leg and stepping on the second plate. GRFs are calculated from both force plates, to evaluate the balance ability single leg stance (Fy+Fx) |
| Gait initiation - acceleration | 2 hours before the intervention arms and within 2 hours after the completion of the intervention arms | Using two force plates in line the participant stands on the first, adapting a quite bipedal stance and after a verbal command, starts ambulating forwarding one leg and stepping on the second plate. GRFs are calculated from both force plates, to evaluate foot clear force (FZ) respectively (leg .1) |
| Walking kinematic parameters - stride length | 2 hours before the intervention arms and within 2 hours after the completion of the intervention arms | Ground reaction force (GRF) data captured at 1000 Hz for the right and left leg by the force platforms will be synchronized with the kinematic data obtained by the Vicon motion analysis system at 1000 Hz. Kinematic data will focus on stride length and time and shoulder-pelvis association. |
| Walking kinematic parameters - shoulder-pelvis association | 2 hours before the intervention arms and within 2 hours after the completion of the intervention arms | Kinematic data obtained by the Vicon motion analysis system at 1000 Hz will focus on shoulder-pelvis association. |
| Walking kinematic parameters - gait velocity | 2 hours before the intervention arms and within 2 hours after the completion of the intervention arms | Kinematic data obtained by the Vicon motion analysis system at 1000 Hz and will focus on gait velocity. |
| Walking kinetic parameters - medio-lateral ground reaction forces | 2 hours before the intervention arms and within 2 hours after the completion of the intervention arms | GRFs are calculated from both force plates, to evaluate the medio-lateral movement during the stance phase of walking (Fy+Fx) |
| Walking kinetic parameters- foot strike | 2 hours before the intervention arms and within 2 hours after the completion of the intervention arms | GRFs are calculated from both force plates, to evaluate the strike forces during landing (Fz) |
Countries
United Kingdom
Outcome results
None listed