Prism Adaptation Treatment of Parkinson's Disease
Parkinson
About this trial
This is an interventional treatment trial for Parkinson focused on measuring problems of gait and balance
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of idiopathic Parkinson's Disease
- Referral for gait training
- Aged 40 -85
- If the subject is taking CNS-acting medications (benzodiazepines, hypnotics, antidepressants), regimen must be stable for 30 days prior to baseline visit
- Subjects with Stage 11.5 - Stage IV (Hoehn and Yahr scale) where stage II.5 is bilateral involvement with axial involvements, but without balance difficulty, to Stage IV where one has severe disability but is still able to walk or stand unassisted
- Subjects with any of the following abnormal scores (greater than 0) in the MDS-UPDRS Part III; a) Part III.10 Gait; b) Part III.11 Freezing of gait c) Part III.12 Postural Stability; subjects with Timed up and go test >12 seconds
- Right handed participants are preferred due to the cortical lateralization of functions related to sensorimotor adaptation and postural control.
- However, we will recruit left-handed participants if there are insufficient right-handed volunteers.
Exclusion Criteria:
- Subjects with a known psychiatric comorbidity that in the investigator's opinion would compromise participation in the study; subjects with a neurologic diagnosis, other than Parkinson's disease that can cause imbalance and gait impairment (e.g., multiple sclerosis, stroke, subdural hematoma, peripheral neuropathy)
- Injury or impairment to the right arm (other than that which is due to Parkinson's disease) that would affect pointing movements; subjects with normal score on UPDRS part III
- Classified as legally blind or lacking sufficient visual acuity to view the target and pointing hand during prism adaptation
- Lacking sufficient understanding of verbal and written information in English to complete any of the consent screening forms.
Sites / Locations
- Darmouth-Hitchcock Medical Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Sham Comparator
Prism adaptation
Sham adaptation
Patients will undergo twice daily adaptation to upward shifts in vision. Participants will be provided with goggles fitted with prismatic lenses that shift vision upward by 25 dioptres (about 17 degrees). While wearing the lenses, participants point to two 10cm-diameter visual targets positioned one above the other (about 20cm apart) on a wall, returning their pointing arm to their chest between each pointing movement. Participants make 50 pointing movements, as fast and as accurately as possible. Such a procedure induces a downward sensorimotor adaptation of pointing movements. Participants undergo this training twice a day (morning and evening) for two weeks in a self-guided fashion.
Participants undergo the same treatment protocol as described in the active comparator arm, with the exception that they wear goggles fitted with neutral lenses that do not induce sensorimotor adaptation.