Prism Adaptation Treatment of Parkinson's Disease
| Status: | Completed |
|---|---|
| Conditions: | Parkinsons Disease |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 40 - 85 |
| Updated: | 3/27/2019 |
| Start Date: | February 2015 |
| End Date: | November 30, 2017 |
Treatment of Gait Disturbance in Parkinson's Disease With Prism Adaptation
Subjects diagnosed with Idiopathic Parkinson's Disease, between ages of 40-85 inclusive, who
have been referred for gait training. Since there can be subtle differences in the brain
organization of left- and right-handed people that may influence some of the measurements,
right handed participants are preferred. However, a left handed participant may be
considered. Participants will be randomly assigned to one of two groups to undergo two weeks
of twice-daily sessions. Group A receiving goggles fitted with lenses that distort vision and
Group B patients receiving sham goggles
have been referred for gait training. Since there can be subtle differences in the brain
organization of left- and right-handed people that may influence some of the measurements,
right handed participants are preferred. However, a left handed participant may be
considered. Participants will be randomly assigned to one of two groups to undergo two weeks
of twice-daily sessions. Group A receiving goggles fitted with lenses that distort vision and
Group B patients receiving sham goggles
The participants will be trained to undergo two daily sessions of visual adaptation at home
for 14 consecutive days. For each adaptation session, subject will sit in a chair within
reaching distance of a wall or cabinet upon which two dime-sized targets will be placed (one
above the other, approximately ten inches apart). While wearing goggles, you will point
rapidly to one target then the next, bringing the hand back to his/her torso between each
pointing movement. They will be instructed to perform these movements "as quickly as
possible" for a total of 50 pointing movements in each treatment session. After performing
the 50 pointing movements, they will remove their goggles. Throughout the treatment period
they will be asked to keep a diary in which they will log the time and duration of each prism
adaptation session. At the first and second site visits, participants will be assessed for
posture, gait and activities of daily living which will include some questionnaires.
Questionnaires will be sent via mail after post-treatment at one week,1 month and 3 months.
for 14 consecutive days. For each adaptation session, subject will sit in a chair within
reaching distance of a wall or cabinet upon which two dime-sized targets will be placed (one
above the other, approximately ten inches apart). While wearing goggles, you will point
rapidly to one target then the next, bringing the hand back to his/her torso between each
pointing movement. They will be instructed to perform these movements "as quickly as
possible" for a total of 50 pointing movements in each treatment session. After performing
the 50 pointing movements, they will remove their goggles. Throughout the treatment period
they will be asked to keep a diary in which they will log the time and duration of each prism
adaptation session. At the first and second site visits, participants will be assessed for
posture, gait and activities of daily living which will include some questionnaires.
Questionnaires will be sent via mail after post-treatment at one week,1 month and 3 months.
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.
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