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The goal of this clinical trial is to explore the benefits of autonomy supported learning in patients with Parkinson's disease. The main questions to answer are:
Participants will be recruited into two groups (Self-control group, SC; and yoked group, YK) to learn a finger-pressing trajectory matching task
Autonomy is the sense of learner to actively participate in determining their own behaviour. The present study aims to investigate whether an autonomy supported practice (with self-controlled feedback) would benefit adults with Parkinson's disease (PD), along with increased intrinsic motivation, information processing and cortical excitability. Two groups of healthy adults and two groups of PD patients will be recruited to learn a finger-pressing trajectory matching task. Participants will be allocated in either a self-control group (choice over feedback schedule), or a yoked group (receive feedback with no-choice). Learning will be assessed on the second day and one week later, along with an error estimation of learners' own performance to represent their information processing ability. Cortical excitability and inhibition will be assessed via transcranial magnetic stimulation as indicators of cortical plasticity. Questionnaire regarding motivation will be assessed before and after practice trials. Study hypothesized that individual with PD would benefit from autonomy supported learning, with better performance, enhanced motivation and information processing, associates with change of cortical excitability
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Self-control group | Experimental | Participants will be able to choose over feedback schedule when practicing finger-pressing trajectory matching task. |
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| Yoked group | Active Comparator | Participants will receive feedback, which was determined by their counterpart in self-control group, with no-choice when practicing finger-pressing trajectory matching task. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Autonomy supported learning | Behavioral | The ability of learners to participate in determining their own behaviour, which is the feedback schedule regarding their practice performance in this study. |
| Measure | Description | Time Frame |
|---|---|---|
| Performance accuracy | Overall performance accuracy relative to the target waveform was assessed using root mean square error (RMSE), which is the mean difference between the target waveform and the participant's movement trajectory calculated over their actual movement time. | up to day 7 |
| Measure | Description | Time Frame |
|---|---|---|
| Intrinsic Motivation Inventory | A questionnaire with subscales of perceived competence and autonomy. Questions were either taken directly or modified from the IMI, regarding to the participants subjective motivation after completing their practice trials. | day 1, day 2, day 7 |
| Error Estimation |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| YA-YUN LEE, PhD | Contact | +886-2-33668155 | yayunlee@ntu.edu.tw | |
| DE-JUN LIM, Bachelor | Contact | +886-9-66716146 | R11428011@ntu.edu.tw |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Taiwan University Hospital | Recruiting | Taipei | 100229 | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28224481 | Result | Carter MJ, Ste-Marie DM. Not all choices are created equal: Task-relevant choices enhance motor learning compared to task-irrelevant choices. Psychon Bull Rev. 2017 Dec;24(6):1879-1888. doi: 10.3758/s13423-017-1250-7. | |
| 22209649 | Result | Chiviacowsky S, Wulf G, Lewthwaite R, Campos T. Motor learning benefits of self-controlled practice in persons with Parkinson's disease. Gait Posture. 2012 Apr;35(4):601-5. doi: 10.1016/j.gaitpost.2011.12.003. Epub 2011 Dec 30. |
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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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| Practice with predetermined feedback | Behavioral | Learners practice the motor task, while the feedback is provided according to their counterpartner |
|
Participants will be instructed to estimate their error in RMSE after completing each trial in retention and transfer test. Error estimation is used to assess the cognitive processing of participants during the trials. |
| day 2, day 7 |
| Cortical excitability changes | Transcranial magnetic stimulation (TMS) device (The Magstim Company Ltd, Whitland, UK) will be used to determine the neurophysiological changes of corticomotor excitability before and after the acquisition phase. | Baseline, day 2, day 7 |
| 41992310 | Derived | Lim DJ, Tai CH, Chen SY, Huang CY, Lee YY. Self-Controlled Feedback on Motor Learning and Neuroplastic Changes in People With Parkinson Disease. J Neurol Phys Ther. 2026 Jul 1;50(3):166-173. doi: 10.1097/NPT.0000000000000553. Epub 2026 Apr 17. |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |