Two Resistance Training Protocols to Reduce the Risk of Falls in Parkinson's Disease

NCT02476266 | Completed

• 1 other identifier: 3992
• Study Type: interventional
• Target: 53
• Locations: 1 country
• Sites: 1

Brief Summary

Parkinson's disease (PD) is a chronic neurodegenerative disorder that is characterized by a multitude of symptoms. Impairments in balance, muscle deficits and increased risk of falls are commonly experienced in PD.The purpose of this study is to investigate the effects of two different resistance training programs on improving balance and muscular strength to thereby reduce the risk of falls in those with PD. This study will randomize individuals to one of two groups, a power training group, or a strength training group. Both interventional groups will participate in 12 weeks of resistance training, two times per week for an hour each exercise session.

Conditions

Parkinson's Disease; Accidental Falls

Keywords

resistance training; strength training; balance; muscle strength

Outcome Measures

Primary Outcomes (3)

• Lean-and-Release Perturbation Technique.

  This measure will require participants to be in a forward static lean at a maximum lean angle of 20 degrees from the vertical. This measure will induce a fall like situation where participants will be required to respond to this "perturbation" as they would in a slip or a trip scenario in real life. Muscle activity will be collected through surface electromyography (sEMG) to measure muscular responses associated with the perturbation. Measurement of postural adjustments will be made on an electronic carpet. sEMG and postural adjustments will demonstrate participants' onset of muscular activation time, latency to stepping, movement speed, and stepping characteristics.

  Change in muscle activity, compensatory postural responses from baseline to 12 weeks.

• Lean-and-Release Perturbation Technique.

  Change in muscle activity, compensatory postural responses from 12 weeks to three month wash out

• Lean-and-Release Perturbation Technique.

  Change in muscle activity, compensatory postural responses from 12 weeks to six month wash out

Secondary Outcomes (18)

• Unified Parkinson's Disease Rating Scale Motor Subsection (UPDRS III)

  Change in motor severity from baseline to 12 weeks

• Unified Parkinson's Disease Rating Scale Motor Subsection (UPDRS III)

  Change in motor severity from 12 weeks to three month wash out

• Unified Parkinson's Disease Rating Scale Motor Subsection (UPDRS III)

  Change in motor severity from 12 weeks to six month wash out

• Gait Measurement

  Changes in gait measures from baseline to 12 weeks

• Gait Measurement

  Changes in gait measures from 12 weeks to three month wash out

Other Outcomes (4)

• Parkinson's disease Quality of Life Questionnaire (PDQ-39)

  Change in score from baseline to 12 weeks

• CHAMPS Questionnaire

  Changes in score from baseline to 12 weeks

• CHAMPS Questionnaire

  Changes in score from 12 weeks three month wash out

Study Arms (3)

Control

NO INTERVENTION

Participants randomized to this group will come in for testing at pre-intervention, post-intervention, three month wash out and six month wash out. Participants will be asked to continue their activities of daily living. To account for any physical activity changes over the length of the study the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire will be administered to all individuals. A control group is necessary to compare to show normal disease progression over the length of the study as well as to demonstrate that improvements in outcome measures are due to the interventions and not practice effects.

Strength Training

ACTIVE COMPARATOR

Individuals randomized to this program will complete three sets of eight to ten repetitions at 70% of their predicted 1-RM for each of the exercises mentioned above. The speed of the movements in this program will be two to three seconds each for the concentric and eccentric components. When participants are able to complete ten repetitions in their third set for two consecutive days, weight will be increased for the following session by 5% of the current weight that they are at in accordance with Canadian Society for Exercise Physiology (CSEP) and American College of Sports Medicine (ACSM) guidelines. Participants will complete a total of 24 sessions over the course of 12 weeks, two times per week for an hour each session.

Other: Resistance Training

Power Training

EXPERIMENTAL

Participants randomized to this program will complete three sets of 12 to 15 repetitions completed at 40% of predicted 1-RM for each exercises. The concentric part of the movement will be completed as fast as possible, whereas the eccentric component will be accomplished in two to three seconds. The load in this group is lower as it has been shown that by performing power training at lighter loads, the muscles are able to be activated, throughout the entire concentric component, while maintaining a consistent level of force. The progression will be determined through the same means as the conventional strength training group. Participants will complete a total of 24 sessions over 12 weeks, twice per week for an hour each session

Other: Resistance Training

Interventions

Resistance Training OTHER

Resistance training has been shown to improve balance and muscle weakness in those with PD as well as reducing the number of falls experienced, albeit not significantly. However to date no study has investigated forms of resistance training in the same study. To disentangle which form of resistance training might be more effective at reducing the risk of falls, improving balance and muscle strength, the proposed study will compare power training and conventional strength training.

Power Training; Strength Training

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diagnosed with idiopathic PD by a Neurologist
• Able to stand two minutes, unassisted
• Able to understand English instructions
• Signed Physical Activity Readiness Medical Examination (PARmed-X) by physician

You may not qualify if:

• a neurological disease other than PD
• peripheral neuropathy
• physical impairments that would prevent participation in the muscular strength testing
• uncontrolled hypertension

Sponsors & Collaborators

• Sun Life Financial Movement Disorders Research and Rehabilitation Centre: lead

Study Sites (1)

Sunlife Financial Movement Disorders Research and Rehabilitation Centre- Wilfrid Laurier University

Waterloo, Ontario, N2L 3C5, Canada

Location

Related Publications (6)

• Glendinning DS, Enoka RM. Motor unit behavior in Parkinson's disease. Phys Ther. 1994 Jan;74(1):61-70. doi: 10.1093/ptj/74.1.61.

  PMID: 8265729 BACKGROUND

• Stolze H, Klebe S, Baecker C, Zechlin C, Friege L, Pohle S, Deuschl G. Prevalence of gait disorders in hospitalized neurological patients. Mov Disord. 2005 Jan;20(1):89-94. doi: 10.1002/mds.20266.

  PMID: 15390043 BACKGROUND

• Wielinski CL, Erickson-Davis C, Wichmann R, Walde-Douglas M, Parashos SA. Falls and injuries resulting from falls among patients with Parkinson's disease and other parkinsonian syndromes. Mov Disord. 2005 Apr;20(4):410-415. doi: 10.1002/mds.20347.

  PMID: 15580552 BACKGROUND

• Newton RU, Murphy AJ, Humphries BJ, Wilson GJ, Kraemer WJ, Hakkinen K. Influence of load and stretch shortening cycle on the kinematics, kinetics and muscle activation that occurs during explosive upper-body movements. Eur J Appl Physiol Occup Physiol. 1997;75(4):333-42. doi: 10.1007/s004210050169.

  PMID: 9134365 BACKGROUND

• Ernst M, Folkerts AK, Gollan R, Lieker E, Caro-Valenzuela J, Adams A, Cryns N, Monsef I, Dresen A, Roheger M, Eggers C, Skoetz N, Kalbe E. Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev. 2024 Apr 8;4(4):CD013856. doi: 10.1002/14651858.CD013856.pub3.

  PMID: 38588457 DERIVED

• Ernst M, Folkerts AK, Gollan R, Lieker E, Caro-Valenzuela J, Adams A, Cryns N, Monsef I, Dresen A, Roheger M, Eggers C, Skoetz N, Kalbe E. Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev. 2023 Jan 5;1(1):CD013856. doi: 10.1002/14651858.CD013856.pub2.

  PMID: 36602886 DERIVED

MeSH Terms

Conditions

Parkinson Disease

Interventions

Resistance Training

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Physical Conditioning, Human; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Brittany Intzandt, BSc

  Wilfrid Laurier University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Graduate Student

Study Record Dates

• First Submitted: June 16, 2015
• First Posted: June 19, 2015
• Study Start: August 1, 2015
• Primary Completion: June 1, 2016
• Study Completion: September 1, 2016
• Last Updated: March 17, 2020

Record last verified: 2020-03

Locations

CA (1)