Effects of Combined rTMS and Treadmill Training in People With Parkinson's Disease
Parkinson's Disease
About this trial
This is an interventional treatment trial for Parkinson's Disease focused on measuring Transcranial Magnetic Stimulation, metaplasticity, gait training
Eligibility Criteria
Inclusion Criteria:
- Diagnosed with idiopathic Parkinson's disease by a neurologist
- had been stable on anti-Parkinsonian medication
- able to walk independently for 30 meters
Exclusion Criteria:
- severe co-morbidity that may interfere with their ability to participate including significant orthopaedic or rheumatological conditions or disorders of peripheral nervous systems that may interfere with mobility or balance performance
- a diagnosis of neurological disease other than PD
- a history of psychiatric disorders
- the impossibility of inducing motor evoked potentials (MEPs)
- a score of less than 24 on the Mini-Mental State Examination
- contraindication to TMS including personal or family history of seizure disorder, metal in the head, implants of medical devices such as cardiac pacemakers or medical pumps, females subjects who are pregnant, a history of neurosurgery
- subjects with irrepressible tremor and / or dyskinesia
Sites / Locations
- Rehabilitation Sciences
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Sham Comparator
25Hz-TT
1Hz-TT
Sham-TT
Participants will receive 4s train of 25-Hz rTMS pulses with 50s inter-train interval, with an intensity of 80% resting motor threshold (RMT). Participant will receive a total of 600 rTMS pulses in 6 minutes for each hemisphere and a total of 1200 pulses followed by 30 minutes of treadmill training.
Participants will receive a total of 600 1-Hz rTMS pulses in 10 minutes for each hemisphere and a total of 1200 pulses ,with an intensity of 80% RMT, followed by 30 minutes of treadmill training.
Sham rTMS will be applied over the same site as for real rTMS, however, with the cable of the coil disconnected. Another figure-of-eight coil using the same stimulation parameters (intensity, time, and frequency) as per 25Hz-TT group will be placed posterior to the subject's neck with the handle pointing backward to produce the same clicking sound effect. Sham rTMS will be followed by 30 minutes of treadmill training.