Self-controlled Practice on Motor Learning and Motivation in Parkinson's Disease

NCT07028515 | Recruiting

• 1 other identifier: 202503040RINA
• Study Type: observational
• Target: 72
• Locations: 1 country
• Sites: 1

Brief Summary

People with Parkinson's disease have been known to have low motivation and motor learning impairment, which might limit the effectiveness of neurorehabilitation, exacerbate motor performance and quality of life, and increase the burden on caregivers. Therefore, enhancing motor learning ability and motivation is crucial for people with PD. According to the OPTIMAL theory, practice under self-controlled conditions has been shown to improve motivation and learning in healthy individuals. However, few studies have explored the effects of self-controlled practice on motor learning and motivation in people with PD and examined the underlying neurophysiological mechanisms. This study aims to investigate the effects of self-controlled practice on motor learning and motivation in people with PD, as well as the associated neurophysiological changes. People with PD and age-matched healthy controls without neurological disorders will be recruited. Participants will be pair-matched based on age, gender, and disease severity, and then assigned to either the self-controlled group or the yoked group. The participants will be required to visit the lab for a total of three times in one week: on Day 1 for baseline assessments, neurophysiological evaluation using transcranial magnetic stimulation (TMS), practice of the trajectory matching task, motivation evaluation, and exercise education; on Day 2 for additional trajectory matching task practice, motivation evaluation, immediate retention test of the task, neurophysiological evaluation using TMS, and exercise education; and on Day 7 for delayed retention and transfer tests and final TMS assessment. On Days 1 and 2, all participants will practice the trajectory matching task. At the beginning of each trial, a target trajectory will be shown, and participants will be asked to replicate it using a joystick. Feedback will be provided after each trial to indicate accuracy. The self-controlled group will be allowed to choose the story contents they prefer when practicing the task, and the exercise they would like to learn after the task. In contrast, yoked participants will receive the same story and exercise education as their matched counterparts in the self-controlled group. This study will help clarify the effects of self-controlled practice on motor learning and motivation in people with PD, offering a new perspective for clinical interventions and emphasizing the importance of patients actively participating in treatment planning.

Conditions

Parkinson Disease

Keywords

Parkinson disease; motor learning; motivation; self-controlled practice

Outcome Measures

Primary Outcomes (1)

• Root mean square error (RMSE)

  The accuracy of the overall performance of the target waveform trajectory. The RMSE is the mean difference between the target waveform trajectory and the participant's performed waveform trajectory calculated over their actual movement time. Smaller RMSE value indicates better task performance. With a total of 144 trials practiced during the practice phase on D1 and D2, the RMSE will be averaged every 12 trials as a block for later data analysis and presentation, resulting in a total of 12 practice blocks (B1 to B12), 2 retention test blocks (imme-ret and delay-ret) and 1 transfer test block (xfer).

  Day 1 (practice phase), day 2 (practice phase and immediate retention), and day 7 (delayed retention and transfer)

Secondary Outcomes (8)

• Error estimation (EE) test

  Day 2 (immediate retention) and day 7 (delayed retention and transfer)

• Motivation evaluation

  Day 1 and 2

• Transcranial magnetic stimulation (TMS) assessment

  Day 1, 2, and 7

• Movement Disorder Society Unified Parkinson's Disease Rating Scale

  Day 1

• Apathy Evaluation Scale

  Day 1

Study Arms (4)

PD self-controlled group

PD participants in the choice condition

PD yoked group

PD participants in the no-choice condition

HC self-controlled group

Healthy controls in the choice condition

HC yoked group

Healthy controls in the no-choice condition

Eligibility Criteria

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

Study Population

Participants with PD are idiopathic PD diagnosed by a neurologist. Healthy controls are without any neurological disorders.

You may qualify if:

• age above 20-year-old
• able to follow instructions and the rules of the motor task
• do not have surgery or injury in their upper extremities in the past 6 months

You may not qualify if:

• neurological disorders other than PD
• symptoms of severe tremor in upper extremities
• symptoms of anxiety and depression
• deep brain stimulator or pacemaker implanted in the body
• history of seizure or epilepsy
• unstable medical conditions
• migraines or tinnitus uncontrolled by medication
• pregnant

Sponsors & Collaborators

• National Taiwan University Hospital: lead

Study Sites (1)

School and Graduate Institute of Physical Therapy

Taipei, Zhongzheng Dist., 100, Taiwan

RECRUITING

Related Publications (3)

• Lewthwaite R, Chiviacowsky S, Drews R, Wulf G. Choose to move: The motivational impact of autonomy support on motor learning. Psychon Bull Rev. 2015 Oct;22(5):1383-8. doi: 10.3758/s13423-015-0814-7.

  PMID: 25732095 BACKGROUND

• Wulf G, Lewthwaite R. Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning. Psychon Bull Rev. 2016 Oct;23(5):1382-1414. doi: 10.3758/s13423-015-0999-9.

  PMID: 26833314 BACKGROUND

• 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.

  PMID: 22209649 BACKGROUND

MeSH Terms

Conditions

Parkinson Disease

Condition Hierarchy (Ancestors)

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

Study Officials

• Graduate Institute of Physical Therapy

  National Taiwan University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Ya-Yun Lee, PhD

CONTACT

+886-2-33668155; yayunlee@ntu.edu.tw

Chiao-Rou Wang

CONTACT

+886-9-66766790; r13428003@ntu.edu.tw

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 8, 2025
• First Posted: June 19, 2025
• Study Start: July 8, 2025
• Primary Completion (Estimated): June 30, 2027
• Study Completion (Estimated): June 30, 2027
• Last Updated: August 27, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)