Active clinical trials for "Movement Disorders"

The goal of this protocol is to identify families with inherited movement disorders and evaluate disease manifestations to establish an accurate clinical diagnosis by using newest technological advances and investigate the underlying molecular mechanisms. Studies of inherited movement disorders in large families with good genealogical records are especially valuable. Patients with diseases of known molecular basis will be genotyped in order to investigate phenotype/genotype correlation. Patients with disease of unknown or incomplete genetic characterization will be studied with a hope of contributing to the identification of specific disease-causing genes and genetic mechanisms responsible for a specific disorder.

The purpose of this research study is to develop a protocol using a fully wearable, portable lower-limb exoskeleton for improving leg and walking function in people with movement disorders. The study investigates the effects of wearing the device during a set of experiments including leg stretching, treadmill walking and overground walking in muscle activity, joint motion, and gait performance. The goal is to develop an effective lower-limb strategy to restore lost leg function (e.g., range of motion) and gait ability, and improve quality of life in people with movement deficits following a neurological disorder.

The purpose of this study is to determine which method is most effective for teaching the kettlebell swing: verbal cueing, physical constraints, or a combination of the two.

Veterans with mid to later stage Parkinson's disease (PD) may not be able to work out as hard as they need to, to prevent brain cell loss. Maybe they could work out longer and more frequently to make up for this during their good times and good weeks and then rest during the bad weeks. We will compare how effective working out a lot one week per month with a break of three weeks is to continuously exercising weekly with no breaks in people with mid stage PD. We will look at how fast they walk per minute, whether they become more physically active, the biochemicals in their blood, and at how stiff their blood vessels are before and after the exercise.

The purpose of this study is to clinically validate new measures of the Personal KinetiGraph® (PKG®).

Training prescription is planned considering recovery periods to enhance performance. To assess recovery, a complexity model can be used, in which the main variable would correspond to a fractal of performance. To assess the effectiveness of post-exercise massage and cold-water immersion under a new prism of recovery by means of muscle stiffness and movement variability analysis regarding the sport-specific gesture and an experimental task of shoulder elevation in swimmers.

To explore the pathogenesis underlying tremor in essential tremor (ET) and parkinson disease (PD) as well as the mechanisms of tremor suppression after Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy through multi-model MRI study, and to identify imaging biomarkers for triaging patients for the suitability of MRgFUS thalamotomy and predicting the treatment effectiveness. Essential tremor (ET) and Parkinson disease (PD) are the most prevalent tremor disorders. ET, considered as a pure tremor disease, is characterized by upper limb intention or postural tremor, while PD is characterized by a variety of motor and nonmotor symptoms, among them rest tremor. A number of studies have demonstrated that Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is a minimally invasive and effective procedure suitable for medication-refractory tremor in patients with ET and patients with PD. However, the treatment effectiveness is variable among individuals. Therefore, it is important to clarify the pathogenesis of tremor in both ET and PD and the mechanisms of tremor arrest produced by MRgFUS thalamotomy to triage suitable candidates for MRgFUS thalamotomy and predict clinical outcomes. In addition, localization precision and individualized treatment remain to be improved.

The goal of this clinical trial is effect of terminal visual feedback therapy following the use of immersive virtual reality(VRi) effects on pain,kinesiophobia, fear of pain, disability, self-efficacy, grip strength and range of motion in motion in people with chronic shoulder pain compare with just VRi. The main question[s] it aims to answer are: Can terminal visual feedback therapy following the use of immersive virtual reality software decrease movement-evoked pain in patients with chronic shoulder pain compared with just VRi? Can terminal visual feedback therapy following the use of immersive virtual reality software increase shoulder flexion range of motion in patients with chronic shoulder pain compared with just VRi? Participants will use a visual feedback therapy following the use of immersive virtual reality software compared with just specific VRi software

The purpose of this protocol is to create an active natural history cohort of patients with degenerative movement disorders, tracked in a clinical setting with clinical rating scales and neuroimaging. The overarching rationale is that neurodegenerative diseases may be heterogeneous, complex disorders. A new way of performing clinical trials in these patients may be in order and this protocol aims to build a longitudinally tracked clinical trial-ready cohort of patients. The purpose of this protocol is to establish an active natural history cohort of patients with neurodegenerative movement disorders who are deeply phenotyped and "clinical trial ready" across Mass General Brigham. After a thorough clinical diagnostic evaluation (this may include clinically indicated testing, for example MRI, FDG-PET, MIBG scan, polysomnography, genetic testing, autonomic function tests, inflammatory tests, skin biopsy) the investigators aim to achieve this through: Longitudinal tracking of clinical progression through use of clinical scales including at the present time: UMSARS, BARS, MoCA and UPSIT, PROM, MDS-NMS, UPDRS, and SARA Longitudinal tracking of disease progression through use of neuroimaging including at the present time: TSPO-PET and 3D MRI (see section 1.3) This is a pilot study designed to track patients with neurodegenerative movement disorders across Mass General Brigham through MRI and PET imaging modalities and clinical measures. Figure 5 represents the study design in detail. In short, subjects will be asked to visit Mass General Brigham every 6-9 months over the course of 18 months for imaging and clinical evaluation.

Inherited movement disorders are rare conditions, whose cumulative prevalence are in the order of 5-10/100,000 inhabitants, in most cases progressive and can lead to a significant loss of autonomy after one or more decades of evolution. They include spinocerebellar ataxias and hyperkinetic disorders (dystonias, choreas, tremor, parkinsonism and myoclonus with variable combination of those, or more complex alteration of movements). The existence of the National Reference Centre (CMR) for Rare Diseases (CMR Neurogenetics, devoted to ataxias and spastic paraparesis, dystonia and rare movement disorders and CMR Huntington, devoted to Huntington Disease) has allowed a more integrated vision of these diseases. This is illustrated, in the same family, by the occurrence of different clinical expressions of spinocerebellar ataxias and hyperkinetic disorders that share the same genetic background. Conversely, different causal mutations within the same gene may have very different ages at onset and a wide range of clinical expression, and the spectrum of new phenotypes linked to a single gene is still expanding . Many ataxia and dystonia genes are involved in similar pathways. There are numerous arguments supporting a share pathogenesis including synaptic transmission and neurodevelopment . BIOMOV project aims to : establish the clinical spectrum and natural history of these diseases, understand the role of genetic and familial factors on the phenotype, elucidate the molecular basis of these disorders and evaluate diagnostic strategies involving molecular tools for clinical and genetic management, develop multimodal biomarkers both for physiopathological studies and for accurate measures of disease progression, develop trial ready cohorts of well characterized genetic patients, test new therapies either symptomatic or based on pathophysiological mechanisms.