We aim to experimentally evoke FOG in patients walking on a motorised treadmill, using either expected or unexpected obstacles, or changes in visual feedback of gait
ID
Source
Brief title
Condition
- Movement disorders (incl parkinsonism)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Visual assessment of videotaped gait performance on the treadmill will be used
as gold clinical standard; primary outcome is occurence of freezing of gait.
Secondary outcome
We propose an elaborate and sophisticated battery of outcome measures to
optimise detection of subtle FOG manifestations. Measures in both experiments
will include kinematics of individual body segments, reactive forces under the
feet and telemetric (wireless) surface electromyography of eight muscles.
Background summary
Freezing of gait (FOG) is a common cause of falls in Parkinson*s disease (PD).
Optimal treatment requires timely and reliable recognition of FOG episodes, and
calls for a better understanding of the underlying pathophysiology.
Unfortunately, it proves difficult to reliably elicit FOG in clinical practice.
Here, we aim to *tackle* this problem by exploring two news ways to elicit FOG
in an experimental setting.
The first hypothesis is that a necessity to negotiate suddenly appearing
obstacles while walking on a motorised treadmill frequently elicits FOG. This
hypothesis is based on serendipitous observations made during a pilot study
where we noted that PD patients commonly froze when they had to avoid a
suddenly appearing obstacle on the floor. Gait in PD is dependent on visual
feedback, and improves with visual cueing; and FOG commonly occurs when
patients attempt to cross a narrow doorway.
Study objective
We aim to experimentally evoke FOG in patients walking on a motorised
treadmill, using either expected or unexpected obstacles, or changes in visual
feedback of gait
Study design
While walking on a motorised treadmill, FOG is measured in the following
conditions; undisturbed gait, gait with expected obstacles, gait with
unexpected obstacles, looking sideways, placing stripes on the treadmill and
virtual reality unexpected obstacles.
In the first experiment we will compare the degree of FOG during normal gait
and gait with expected and unexpected obstacles. We predict that unexpected
obstacles will induce FOG, while expected obstacles will decrease FOG.
In the second experiment we aim to evoke FOG in patients walking on a motorised
treadmill by changing visual feedback.
These experiments will be executed on two different days to be able to measure
patients on and off medication.
Study burden and risks
Subjects will be wearing a parachute harness attached to the ceiling to prevent
actual falls, without interfering with natural gait. Each condition lasts 10
minutes, and the total experiment lasts 2* hours, including preparation and
resting periods. This will be repeated in a second experiment on a different
day. Hence the experiment will be performed on two different days, once on and
once off medication.
Postbus 9101
6500 HB Nijmegen
Nederland
Postbus 9101
6500 HB Nijmegen
Nederland
Listed location countries
Age
Inclusion criteria
Parkinson's disease
Ability to walk without help for 10 minutes on a treadmill
Exclusion criteria
atypical hypokinetic rigid syndrome
cognitive impairment (Mini Mental State Examination (MMSE) score <24)
other cause of gait disorder (neurological, muscles, bones, visual, balance)
major psychiatric disease
major comorbidity
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL15383.091.06 |