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| Name | Class |
|---|---|
| University of Kiel | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Split-Belt Treadmill Training 1:2 | Experimental | Split-Belt Training with a steady ratio of 1:2. |
|
| Split-Belt Treadmill Training 3:4 | Experimental | Split-Belt Training with a steady ratio of 3:4. |
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| Split-Belt Treadmill Training Changing | Experimental | Split-Belt Training with changing ratios between 3:4 to 1:2. |
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| Split-Belt Treadmill Training Tied-Belt | Active Comparator | Split-Belt Training with tied belts. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Split-Belt Treadmill Training | Behavioral | One session of 6 x 5 min with 1 min intervals. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Adaptation to Split/Tied Belt | 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. | 24 hours after training |
| Gait Asymmetry | Measured with 3D motion analysis system during straight line overground walking | 24 hours after training |
| Freezing Ratio | Measured with APDM sensors during 360 degree turns | 24 hours after training |
| Measure | Description | Time Frame |
|---|---|---|
| Medio-lateral Anticipatory Postural Adjustments | Measured with APDM sensors at gait initiation | 24 hours after training |
| Gait Speed during dual task walking | Measured with 3D motion analysis system during overground walking with an auditory Stroop task |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alice Nieuwboer, PhD | KU Leuven | Principal Investigator |
| Christian Schlenstedt, PhD | CAU Kiel | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Movement and Rehabilitation Sciences (FaBeR) | Leuven | 3001 | Belgium | |||
| University Hospital Schleswig-Holstein |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32940131 | Derived | Seuthe J, D'Cruz N, Ginis P, Becktepe JS, Weisser B, Nieuwboer A, Schlenstedt C. The Effect of One Session Split-Belt Treadmill Training on Gait Adaptation in People With Parkinson's Disease and Freezing of Gait. Neurorehabil Neural Repair. 2020 Oct;34(10):954-963. doi: 10.1177/1545968320953144. Epub 2020 Sep 17. |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Nov 14, 2017 | Feb 6, 2018 | Prot_000.pdf |
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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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.
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| 24 hours after training |
| Kiel |
| 24105 |
| Germany |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |