Central and Peripheral Fatigue in Individuals With Parkinson's Disease - Evaluation and Training

NCT01971528 | Completed DMC

• 1 other identifier: 100-3167A3
• Study Type: interventional
• Target: 66
• Locations: 1 country
• Sites: 1

Brief Summary

Fatigue is one of the most common symptoms in individuals with Parkinson's Disease (PD). Past research indicated that more than half of the individuals with PD demonstrated fatigue symptom. The severity of fatigue was also correlated to the quality of life in individuals with PD. Finding the contributions of the central and the peripheral factors to fatigue and developing an effective training program for individuals with PD are very important. Fatigue can be categorized into peripheral or central causes. The central fatigue and voluntary activation failure originate from the decrease in motivation or the reduction of the conduction within corticospinal tracts. Long term activation failure and central fatigue will cause disuse of muscle and result in peripheral weakness and peripheral fatigue. Quantifying the weighting of central versus peripheral factors contributing to the fatigue in people with PD is important. Most of the conventional strength and endurance training programs were based on the researches of young groups. Almost no training program was design for enhancing the voluntary activation level and relief the central fatigue. Seeking an appropriate training program to enhance central activation is very important for individuals with PD who prone to fatigue. Previous studies have shown that increasing afferent input by peripheral electrical stimulation (ES) at sensory threshold enhanced the plasticity of contralateral primary sensory cortex, the excitability of corticospinal tracts, and the functional performance in young adults. Combining afferent input with strength training was more effective than strength training along. ES, which is easy to quantify the dose of afferent input, is a feasible method to provide such training. The purpose of this project is to investigate the effects of the combination of ES at sensory threshold and strength training on voluntary activation in the individuals with PD.

Conditions

Parkinson Disease(PD)

Keywords

Muscle strength, fatigue, electromyography (EMG), central fatigue, strength straining

Outcome Measures

Primary Outcomes (4)

• Muscle twitch force

  Measure of changes in muscle twitch force by interpolation twitch technique.

  baseline, 8 weeks.

• Muscle voluntary activity level

  Measure of changes in muscle voluntary activity level by interpolation twitch technique.

  Baseline,8 weeks

• Muscle strength test for lower extremities.

  Measure of changes in muscle strength test by clinical test.

  Baseline, 8 weeks

• The central activation and the excitability of motor cortex

  Measure of changes in the central activation and the excitability of motor cortex by Transcranial magnetic stimulation.

  Baseline,8 weeks

Study Arms (6)

Stage 1: Health control

NO INTERVENTION

pilot study: Establishing the central and peripheral contributing factors to the voluntary muscle strength loss during a fatiguing exercise in young and PD groups.

Stage 1: PD subjects

NO INTERVENTION

pilot study: Establishing the central and peripheral contributing factors to the voluntary muscle strength loss during a fatiguing exercise in young and PD groups.

Stage 2: Health subjects

NO INTERVENTION

pilot study: Finding optimal sensory stimulation parameters for PD individuals.

Stage 2: PD subjects

NO INTERVENTION

pilot study: Finding optimal sensory stimulation parameters for PD individuals.

Stage 3: PD subjects

EXPERIMENTAL

Investigating the long-term effects of combined sensory stimulating strengthening program on the activation level and central fatigue in PD individuals.

Device: Electronic muscle stimulator; Other: Muscle strength training

Stage 3: PD subjects (Control Subjects)

NO INTERVENTION

Investigating the long-term effects of combined sensory stimulating strengthening program on the activation level and central fatigue in PD individuals.

Interventions

Electronic muscle stimulator DEVICE

Participants will perform 8 weeks of electrical stimulation for Quadriceps muscle belly(30 minutes/time, 3 times/week).

Stage 3: PD subjects

Muscle strength training OTHER

Participants will perform 8 weeks of isotonic contraction muscle strength training for lower extremities.

Stage 3: PD subjects

Eligibility Criteria

• Age: 20 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may not qualify if:

• Musculoskeletal injuries for knee.
• Osteoporosis.
• Diabetes.
• PD subjects:
• Clinical diagnosis of Parkinson disease.
• Musculoskeletal injuries for knee.
• Osteoporosis.
• Diabetes.
• Any peripheral or central nervous system injury or disease patients.

Sponsors & Collaborators

• Chang Gung University: lead

Study Sites (1)

Chang Gung University

Taoyuan District, 333, Taiwan

Location

MeSH Terms

Conditions

Parkinson Disease; Fatigue

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: October 18, 2013
• First Posted: October 29, 2013
• Study Start: December 18, 2012
• Primary Completion: September 11, 2014
• Study Completion: May 10, 2015
• Last Updated: March 28, 2024

Record last verified: 2024-03

Locations

TW (1)