Comparing the Effects of Instability Resistance Training Versus Aerobic Training on Cognitive and Motor Improvements Found in Parkinson's Disease Participants

NCT03711955 | Unknown

• 1 other identifier: Sunlife1
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

This study will be looking at the effects that instability resistance training and aerobic training, individually, have on the improvement of various motor and cognitive impairments present in individuals with Parkinson' disease. There will be 25-30 participants in this study (all of whom have Parkinson's disease). Once passing the eligibility criteria, participants will complete as series of baseline/pre-tests and then be randomly assigned to either the aerobic training group or the instability training group, where they will participate in every training session that occurs in the next 8 consecutive weeks. There will be 3 training sessions a week occurring on non-consecutive days (ex. Monday, Wednesday, Friday) for both training groups (3 aerobic training sessions, 3 instability resistance training sessions). Once the 8 week training intervention has been completed, a series of post-tests will occur exactly once week after (same tests used as in the pre-tests)

Conditions

Exercise; Parkinson Disease

Outcome Measures

Primary Outcomes (8)

• executive function (memory, language and concentration)

  memory, language and concentration will be measured using Montreal Cognitive Assessment test

  change from baseline executive functions tested after 8 weeks of intervention (post-test measured on consecutive week after last week of intervention)

• executive function (selective attention, cognitive flexibility)

  selective attention, cognitive flexibility will be measured using the Delis-Kaplan Executive Function System test

  change from baseline executive functions tested after 8 weeks of intervention (post-test measured on consecutive week after last week of intervention)

• executive function (visual attention and task switching)

  visual attention and task switching ability will be measured using the Trail Making Test

  change from baseline executive functions tested after 8 weeks of intervention (post-test measured on consecutive week after last week of intervention)

• executive function (attention, working memory and recall verbal memory)

  sustained attention, working memory, and immediate and delayed free recall verbal memory is measured using the Parkinson's Disease Cognitive Rating Scale (score total out of 134-the perfect score. The closer to 134, the the better results)

  change from baseline executive functions tested after 8 weeks of intervention (post-test measured on consecutive week after last week of intervention)

• gait variability

  gait variability will be measured using the the Protokinetic Gait-walk test

  change from baseline gait functions tested after 8 weeks of intervention (post-test measured on consecutive week after last week of intervention)

• muscular strength

  muscular strength will be measured using the grip strength test (jamar dynamometer tool)

  change from baseline muscular strength tested after 8 weeks of intervention (post-test measured on consecutive week after last week of intervention)

• gait (static and dynamic balance)

  static and dynamic balance will be measured using Timed Up and Go Test

  change from baseline gait functions tested after 8 weeks of intervention (post-test measured on consecutive week after last week of intervention)

• assessing comprehensive motor and non-motor symptoms

  assess non-motor experiences of daily living, motor experiences of daily living, motor examination, and motor complications symptoms will be assessed through the Unified Parkinson's Disease Rating Scale (0-4 rating scale, where 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe)

  change from baseline motor and non-motor functions tested after 8 weeks of intervention (post-test measured on consecutive week after last week of intervention)

Study Arms (2)

Aerobic training group (AET)

EXPERIMENTAL

Each AET sessions are to last one hour, with 40 minutes being allocated to the aerobic exercise training component, 10 minutes allocated to warm-ups, 5 minutes allocated to cool-downs, and one 5 minute rest period between the 20 minutes spent on each machine (20 minutes of cycling, 5 minute rest, 20 minutes seated row). The AET program consists of 20 minutes of cycling on the stationary bicycle and 20 minutes of seated row on the kinesis Technogym machine. This is to be preceded by 10 minutes of static stretching during warm up, and 5 minutes of post-exercise recovery (dynamic stretches).

Other: Exercise

Instability training group (IRT)

EXPERIMENTAL

Each IRT sessions are to last one hour, with time being allocated to a 10 minute warm up, consisting of static stretches, a 5 minute cool down, consisting of dynamic stretches, and a series of IRT exercises performed in a circuit setting over the duration of 40 minutes. In the sessions, five resistance exercises will be performed. A linear periodization will occur, in which the training load will progress from high-volume low-intensity to low-volume high-intensity loads over the duration of eight weeks to maximize training adaptations. Additionally, there will be a progressive increase in load/resistance by 1-2 lbs and the degree of instability of each exercise during the course of the eight week program. Unstable devices will be changed from the least unstable to the most unstable device throughout the program, but only when participants showed a considerable decrease in body sway/movement and force production increased when performing exercises.

Other: Exercise

Interventions

Exercise OTHER

Two types of training exercises, AET and IRT, will be used as the interventions in this study. Participants will either be assigned to the AET group or the IRT group, where they will participate in the respective training intervention group for 8 consecutive weeks.

Aerobic training group (AET); Instability training group (IRT)

Eligibility Criteria

• Age: 50 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Parkinson's disease participants aged between 50 to 80 years old
• Has idiopathic Parkinson's disease
• On stable medication (dopaminergic medication)
• Hoehn and Yahr stage between 2 and 3
• Does not present other neurological disorder other than Parkinson's disease)
• Does not have significant arthritis, cardiovascular disease, and cognitive impairment by Mini-Mental State Examination (score \<23)
• Has normal or corrected vision in at one eye in order to carry out exercise)
• Able to comply to scheduled visits, treatments, and other trial procedures
• Must be in sufficient health to participate in study's training program as determined through the use of Physical Activity Readiness Questionnaire-Plus (PARQ+) screening tool, coupled with evaluation by a certified exercise physiologist/physician for clearance to participate in training program

You may not qualify if:

• has uncontrolled hypertension and/or diabetes
• Is currently participating in any form of physical activity/exercise program that involves AET or RT two or more times a week in the last six months
• presence of dementia which is determined by having a score of 13 or less on the MoCa test.
• has significant arthritis, cardiovascular disease, and cognitive impairment by Mini-Mental State Examination (score \<23)

Sponsors & Collaborators

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

Study Sites (1)

Movement Disorder Research and Rehabilitation Centre

Waterloo, Ontario, N2L 3J4, Canada

RECRUITING

Related Publications (2)

• 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

Related Links

• synergic trail
• balance and fear of falling in subjects with Parkinson's disease is improved after exercises with motor complexities
• resistance training with instability for patients with Parkinson's disease
• symptom and gait changes after sensory attention focused exercise vs aerobic training in Parkinson's disease

MeSH Terms

Conditions

Motor Activity; Parkinson Disease

Interventions

Exercise

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Alisha Mistry

  Movement Disorder Research and Rehabilitation Center

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Alisha Mistry

CONTACT

4164002909; mist4750@mylaurier.ca

Qunicy Almeida

CONTACT

qalmeida@wlu.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Masking Details: Investigator will not engage in the 8 week training program occurring, a leading supervisor will lead every training session so that the primary investigator (myself) will be blinded to the participants and their performance throughout the 8 week training interventions. Participants from the opposite training groups will have separate training session times. In this way, no participant from the opposite training group will have contact with each other (ex. aerobic training group's session is at 12pm; instability resistance training group's session is at 4pm).
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Primary Investigator

Model Details: Participants will be randomly assigned to either the aerobic training group/intervention or the instability resistance training group/intervention

Study Record Dates

• First Submitted: October 11, 2018
• First Posted: October 19, 2018
• Study Start: February 18, 2019
• Primary Completion: October 1, 2020
• Study Completion: October 31, 2020
• Last Updated: September 23, 2019

Record last verified: 2019-09

Locations

CA (1)