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Parkinson's DiseaseNCT02267785

Exercise Targeting Cognitive Impairment in Parkinson's Disease

A study testing Skill-Based Exercise, Aerobic Exercise and Social Contact in people with Parkinson's Disease, run by University of Southern California at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The aim of this application is to compare and elucidate the effects of skill-based versus aerobic exercise versus control on mild cognitive impairment (MCI) of the executive function (EF) subtype in Parkinson's disease (PD); we hypothesize that skill-based exercise will result in the greatest improvement in EF and… Read more about this study

Who is it for?
Ages 30 to 85 years
Conditions the study is for
Parkinson's Disease
What is being tested?
Skill-Based Exercise, Aerobic Exercise and Social Contact
Could I receive a placebo?
No, everyone receives an active treatment
How many people
25 participants
Where
1 siteUnited States
Study dates
Oct 2014to Dec 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 30 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • willing and able to provide informed consent
  • confirmed diagnosis of idiopathic PD based on the United Kingdom Brain Bank criteria
  • Mild cognitive impairment (Level II criteria Movement Disorder Task Force)
  • medically eligible for MRI imaging
  • able to provide a written medical clearance from their primary physician to participate in exercise
  • stable PD medications for 3 months

Who cannot join

  • a Hoehn \& Yahr staging greater than 2.5 at screening
  • severe cardiac disease (New York Heart Association classification IIIV)
  • history of an abnormal stress test
  • clinically significant medical or psychiatric illness
  • electrically, magnetically, or mechanically activated implant (such as cardiac pacemakers or intracerebral vascular clip)
  • metal in any part of the body including metal injury to the eye
Show all 18Show fewer
  • past history of brain lesions (such as stroke)
  • seizures or unexplained spells of loss of consciousness
  • family history of epilepsy
  • physical therapy within 6 months of the study
  • symptomatic orthostatic hypotension at the screening visit
  • orthopedic and other movement-influencing diseases such as arthritis or total hip joint replacement
  • requirement for central nervous system active therapies (e.g. hypnotics, antidepressants, anxiolytics)
  • moderate or severe depression or apathy using the Geriatric depression scale and Apathy scale
  • taking anticholinesterase inhibitors
  • taking anticholinergic medication
  • PD dementia
  • Colorblindness

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Southern California

    Los Angeles, California, 90033-4606

Other trials in United States

About this study

The aim of this application is to compare and elucidate the effects of skill-based versus aerobic exercise versus control on mild cognitive impairment (MCI) of the executive function (EF) subtype in Parkinson's disease (PD); we hypothesize that skill-based exercise will result in the greatest improvement in EF and lead to modification of underlying neural substrates.

Read the detailed description

Mild cognitive impairment (MCI), particularly of the executive function (EF) subtype, is common in Parkinson's disease (PD) and transitions to dementia, increased fall risk, and poor quality of life. EF is a set of processes that include mental flexibility and attention that are needed to learn and optimize performance of complex cognitive and motor skills. Such skills include the ability to generalize task performance under different conditions (context processing) and to perform two tasks simultaneously termed dual-task (DT) performance. Deficits in EF lead to problems in daily functioning and loss of independence and create psychosocial and economic burdens on patients and caregivers and stakeholders including health care providers. There is currently no effective treatment in PD to address EF deficits. Our animal and clinical studies in PD demonstrate that skilled exercise facilitates neuroplasticity of the basal ganglia (BG), a brain region sub-serving EF and supports the hypothesis that exercise will reverse EF deficits in PD. Furthermore, recent studies in healthy aging support that skill-based exercise that specifically promotes motor skill fitness (MSF), compared with aerobic exercise that promotes cardiovascular fitness (CF), has a greater impact on EF and related BG circuits. The aim of this application is to compare and elucidate the effects of skill-based versus aerobic exercise versus control on MCI of the EF subtype in PD; we hypothesize that skill-based exercise will result in the greatest improvement in EF and lead to modification of underlying neural substrates.

Being tested
Skill-Based Exercise, Aerobic Exercise, Social Contact
Keywords
exercise, mild cognitive impairment, Parkinson's Disease
Medical subject headings
Parkinson Disease, Motor Activity, Cognitive Dysfunction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Skill-Based ExerciseOther

    The skill-based exercise program is designed to improve skilled function, fine and gross- motor body coordination. The intervention will be focused on acquisition and improvement of complex movements for the whole body and include the following general categories of activities: (1) balance, (2) eye-hand coordination, (3) leg-arm coordination; 4) reaction time to moving objects/persons; (5) dynamic gait and 6) functional activity performance. The treating therapist will direct both general principles of progression and progression specific to each category.

  • Aerobic ExerciseOther

    The aerobic cardiovascular exercise will consist of 36 1-hour sessions performed 3 times weekly over 12 weeks. Aerobic exercise will consist of cycling on a recumbent stationary bicycle. Each session will begin and end with gentle stretching. Continuous cycling will be performed for 45-50 minutes, with the first and last 5 minutes designated as warm-up and cool-down periods. The intensity of the middle 30 minutes of cycling will be increased progressively from an initial target of 50% maximum heart rate (HR) during week 1 to 75% of maximum HR by week 12. The initial intensity will be set at 50% of maximum HR. Participants will be encouraged to cycle as fast as they can, with a goal of maintaining 90 revolutions per minute (RPM) throughout the middle 30-minute period. Pedaling resistance will be kept low throughout all sessions. Measures of heart rate via heart rate monitors, blood pressure, RPM, and rate of perceived exertion will be recorded at 5-minute intervals.

  • Social ContactOther

    The control Social Contact group will consist of an equal amount of social contact as the exercise group. Subjects will have weekly visits at the University of Southern California with the study coordinator. The goal is for 3 hours of social contact every week for a total of 36 hours over 12 weeks. Activities scheduled for the social contact visits will include: (1) support group interactions and (2) social outings such as a trip to a museum, local café for lunch or dinner; (3) book club; (4) sports event. Support group interaction can include discussions among patients and caregivers, presentations from experts in various aspects of PD. They will be instructed to continue with their usual level of activity but refrain from beginning new exercise activities during the study period.

Study groups in NCT02267785
Study groupRoleWhat they receive
Skill-Based ExerciseExperimentalParticipants assigned to this arm will complete the Skill-Based Exercise Intervention
Receives: Other: Skill-Based Exercise
Aerobic ExerciseExperimentalParticipants assigned to this arm will complete the Aerobic Exercise Intervention
Receives: Other: Aerobic Exercise
Social Contact GroupExperimentalParticipants assigned to this arm will complete the Social Contact Intervention
Receives: Other: Social Contact

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Context Dependent Motor Learning (CDML)

    All subjects from each group will undergo a finger sequence motor learning task to determine exercise effects on EF as evaluated through improvement in the transfer of a learned motor task from one contextual setting to another.

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  2. Change in Dual Task Performance and Functional Magnetic Resonance Imaging (fMRI)

    A subset of subjects (60 representing 20 per group) will be invited to undergo fMRI studies at University of California, Los Angeles. Patients will perform a learned single finger-sequencing task (a condition of the CDML) with an additional secondary dual task (DT) component during an fMRI scan.

    Measured: at Baseline, after 12 week intervention

  3. Change in D-KEFS Verbal Fluency Test

    The D-KEFS Verbal Fluency test will be used to evaluate executive function

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  4. Change in Tower of London Test

    The Tower of London test will be used to evaluate executive function

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  5. Change in Wisconsin Card Sorting Test

    The Wisconsin Card Sorting test will be used to evaluate executive function

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

Secondary outcomes (27)
  1. Change in Parkinson Disease Questionnaire-39 (PDQ-39)

    Parkinson Disease Questionnaire-39 (PDQ-39) will be used to indicate overall quality of life and frequency with which patients experience difficulties; high scores for the PDQ-39 reflect poorer quality of life.

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  2. Change in Evaluation of PD Motor Symptoms with Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS)

    The MDS-UPDRS is the established gold standard that is currently used for the vast majority of clinical settings and for scientific trials. This scale was developed in 1987 and is the most widely used tool in PD.

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  3. Change in Activity Specific Balance Confidence (ABC) Scale

    Activity Specific Balance Confidence (ABC) Scale is a 16-item self-report in which patients rate their balance confidence in performing several activities; high scores indicate greater balance confidence.

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  4. Change in Confidence in ability to maintain an exercise program (CONF)

    The CONF scale includes nine items, which assesses how sure subjects are that they would do exercise under different conditions or constraints, including when they are tired.

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  5. Change in Exercise Control Beliefs (BEL)

    The BEL, 6-item scale was developed to assess beliefs about control over exercise behavior.

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  6. Change in Self-efficacy for Exercise Scale (EFFIC)

    The EFFIC scale is a self-efficacy barriers to exercise measure, a 13-item instrument that focuses on self-efficacy expectations related to the ability to continue exercising in the face of barriers to exercise.

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  7. Change in Frontal Systems Behavior Scale (FrSBe)

    The FrSBe assesses changes in behavior dysfunction and disturbances associated with frontal-subcortical damage, which is the circuitry involved with executive functioning

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  8. Change in Motor Skill Fitness

    An individual's Motor skill fitness will be a composite score of their Physical Performance Test (PPT) and their Timed Up and Go (TUG).

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  9. Change in Cardiovascular Fitness

    Subjects will participate in testing designed to determine their level of cardiovascular fitness by estimating maximal oxygen uptake (V02max) known as the Balke treadmill submaximal fitness test and has been optimized for use in samples of elderly adults.

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  10. Change in Lifetime Total Physical Activity Questionnaire (LTPAQ)

    The LPAQ measures the time spent in physical activity over the lifetime of the subject

    Measured: at Baseline

  11. Change in Global Physical Activity Questionnaire (GPAQ)

    The GPAQ measures the time spent in physical activity during a normal week

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  12. Change in Body Mass Index

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  13. Change in Body Fat Percentage

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  14. Change in Mattis Dementia Rating Scale

    The Mattis Dementia Rating Scale will be used to differentiate between study subjects with mild cognitive impairment and dementia

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  15. Change in Geriatric Depression Scale

    The Geriatric Depression Scale will be used to evaluate study subjects for depression

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  16. Change in Geriatric Anxiety Inventory

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  17. Change in Apathy Scale

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  18. Change in Revised Activities of Daily Living Scale

    The Revised Activities of Daily Living Scale will be used to evaluate independent living skills

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  19. Change in the Frontal Systems Behavior Scale (FrSBe)

    The FrSBe will be used to evaluate frontal systems behavior

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  20. Change in Adaptive Digit Ordering Test

    The Adaptive Digit Ordering Test will be used to evaluate attention and working memory

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  21. Change in Hooper Visual Organization Test

    The Hooper Visual Organization Test will be used to evaluate visuospatial function

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  22. Change in Benton's Judgment of Line Orientation

    The Benton's Judgment of Line Orientation test will be used to evaluate visuospatial function

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  23. Change in D-KEFS Color Word Interference Test

    The D-KEFS Color Word Interference Test will be used to evaluate attention, working memory and executive function

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  24. Change in California Verbal Learning Test- 2nd Edition (CVLT-II)

    The CVLT-II will be used to evaluate memory function

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  25. Change in WMS-II Visual Reproduction Test

    The WMS-II Visual Reproduction Test will be used to evaluate memory function

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  26. Change in WAIS-IV Similarities Test

    The WAIS-IV Similarities test will be used to evaluate language function

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

  27. Change in Boston Naming Test

    The Boston Naming Test will be used to evaluate language function

    Measured: at Baseline, after 12 week intervention, and at 12 week follow up visit

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Oct 2014 (estimated)
  2. Study startOct 2014
  3. Primary completionDec 2019 (estimated)
  4. Study completionDec 2019 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
25 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02267785
Sponsor's protocol ID
HS-14-00422
Status last verified
May 2019
First submitted
14 Oct 2014
Last updated
31 May 2019
Results posted
No
Data monitoring committee
No

Publications

  • Ernst M, Folkerts AK, Gollan R, Lieker E, Caro-Valenzuela J, Adams A, Cryns N, Monsef I, Dresen A, Roheger M, Eggers C, Skoetz N, Kalbe E. Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev. 2024 Apr 8;4(4):CD013856. doi: 10.1002/14651858.CD013856.pub3.

    PubMed 38588457
  • Ernst M, Folkerts AK, Gollan R, Lieker E, Caro-Valenzuela J, Adams A, Cryns N, Monsef I, Dresen A, Roheger M, Eggers C, Skoetz N, Kalbe E. Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev. 2023 Jan 5;1(1):CD013856. doi: 10.1002/14651858.CD013856.pub2.

    PubMed 36602886

Questions about this trial

What is this clinical trial studying?

A study testing Skill-Based Exercise, Aerobic Exercise and Social Contact in people with Parkinson's Disease, run by University of Southern California at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 31 May 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Context Dependent Motor Learning (CDML) (time frame: at Baseline, after 12 week intervention, and at 12 week follow up visit). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02267785, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 May 2019.

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