Cortical Correlates of Gait Automaticity and Daily Life Mobility in Parkinson's Disease (cueing)
Parkinson Disease, Gait Disorders, Neurologic, Parkinsonian Disorders
About this trial
This is an interventional treatment trial for Parkinson Disease focused on measuring Fixed vibrotactile cueing, Personalized vibrotactile cueing, Balance
Eligibility Criteria
Inclusion Criteria: Diagnosis of idiopathic PD from movement disorders neurologist with the United Kingdom Brain Bank criteria of bradykinesia with 1 or more of the following - rest tremor, rigidity, and balance problems not from visual, vestibular, cerebellar or proprioceptive conditions Without musculoskeletal or peripheral or central nervous system disorders (other than PD) that could significantly affect their balance and gait All subjects will be capable of following directions for the protocols and to give informed consent. Hoehn & Yahr Levels II-III. Exclusion Criteria: Severe dyskinesia that may affect quality of fNIRS. Major musculoskeletal or neurological disorders, structural brain disease, epilepsy, acute illness or health history, other than PD, significantly affecting gait and turning i.e., peripheral neuropathy with proprioceptive deficits (detected as lack of toe proprioception assed during the neurological exam at Day 1), musculoskeletal disorders, vestibular problem, head injury, stroke. Montreal cognitive assessment (MoCA) <21 or dementia that precludes consent to participate or ability to follow testing procedures Inability to stand or walk for 2 minutes without an assistive device. Idiopathic PD exclusion criteria: Parkinson plus syndromes such as progressive supranuclear palsy, multiple system atrophy, or corticobasal syndrome or implanted electrodes for deep brain stimulation (DBS), possible vascular parkinsonism, current use of dopamine-blocking agents or cholinesterase inhibitor (as may affect PFC activity while walking).
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Personalized cueing
Fixed cueing
Personalized, step-synchronized tactile cueing, enhancing proprioceptive inputs, in the form of real-time, closed-loop tactile feedback signaling left and right stance times while walking
Tactile cueing at fixed intervals, enhancing proprioceptive inputs, in the form of open-loop tactile feedback (fixed rhythm) signaling left and right stance times while walking