Fragile X Associated Tremor-ataxia SyndromeFXTASNCT04428567
Treadmill Training in Fragile X-associated Tremor/Ataxia Syndrome
A study testing Dual-Task Treadmill exercise + Cognitive Training in people with Fragile X Associated Tremor-ataxia Syndrome, run by Rush University Medical Center at 1 site in United States.
Trial summary
A pilot trial to determine the feasibility of treadmill training with dual training in patients with Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS). Read more about this study
- Who is it for?
- Ages 50 years and older
- Conditions the study is for
- Fragile X Associated Tremor-ataxia Syndrome
- What is being tested?
- Dual-Task Treadmill exercise + Cognitive Training
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 3 participants
- Where
- 1 siteUnited States
- Study dates
- 30 Jul 2019to 30 Mar 2020
- 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 50 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- A diagnosis of possible, probable or definite FXTAS
- Able to stand and walk without support for 2 minutes
Who cannot join
- Any neurologic or musculoskeletal problems
- History of traumatic brain injury
- Significant cardiopulmonary or cardiovascular disease
- Dementia or other significant cognitive impairment
- Unstable psychiatric disorders
Trial locations and contacts
1 site in 1 country.
United States1 site
Kellogg Building 1625 W. Harrison St. Room 235
Chicago, Illinois, 60612
About this study
Official title: A Pilot Dual-Task Treadmill Training to Improve Gait and Balance in Fragile X-Associated Tremor/Ataxia Syndrome
A pilot trial to determine the feasibility of treadmill training with dual training in patients with Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS).
Read the detailed description
There is substantial evidence that physical exercise can improve motor and cognitive function in individuals with Parkinson's Disease, traumatic brain injury or chronic stroke survivors. However, to the investigator's knowledge, no studies have explored the effect of treadmill training with or without a cognitive dual Task on gait, balance and cognition in Fragile X - Associated Tremor/Ataxia Syndrome (FXTAS), which is characterized by action tremor, cerebellar gait ataxia, parkinsonism, peripheral neuropathy and cognitive deficits, all of which increase the risk for falls and progressive disability. There are presently no medications or treatment interventions that have been shown to effectively manage the symptoms of FXTAS or delay disease progression, and it is currently not clear whether either the ST or Dual-Task treadmill training paradigms would be feasible or effective in FXTAS.
A total of 10 individuals with FXTAS will recruited from the Rush University Movement Disorders Clinic or the FXTAS Clinic Database at Rush University. The subjects will be assigned to either 6 weeks of dual-task treadmill exercise training combined with a cognitive task (intervention group) occurring 3 times weekly, or control group. The primary outcome measures will be feasibility, safety and patient adherence. The assessments will occur at baseline, week 3, week 6, 1 month \& 6 month post-training.
- Being tested
- Dual-Task Treadmill exercise + Cognitive Training
- Keywords
- Dual-task, feasibility, FXTAS, treadmill training
- Medical subject headings
- Fragile X Tremor Ataxia Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dual-Task Treadmill exercise + Cognitive TrainingBehavioural
The dual-task regimen will include treadmill exercise of 5-10 min warm-up and cool-down, 30 minutes of running towards target heart rate, combined with respond demands with the addition of cognitive tasks. The level of duration and intensity of treadmill exercise will progressively increase over the duration of 6 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Treadmill Exercise + Cognitive Training (Dual-Task) | Experimental | The Dual-Task group will be provided with treadmill training with added simultaneous cognitive training during treadmill exercise training. Receives: Behavioral: Dual-Task Treadmill exercise + Cognitive Training |
| Control Group | No intervention | The control group will be assessed as the intervention group at the same time intervals without the intervention. |
What is being measured
The primary outcome is the main question the study is designed to answer.
High levels of program attendance, and retention
At each study visit the subjects attend and revisit were taken down throughout the entire intervention period in an attendance/retention log book.
Measured: 6 weeks
High levels of satisfaction
At the end of the entire study a client satisfaction questionnaire was administered and interpreted based on a percent of satisfaction, ranging from zero to one hundred percent, on various satisfactory questions. Zero percent meaning highly unsatisfied and one hundred percent meaning highly satisfied.
Measured: 6 weeks
High levels of recruitment
Research subjects were recruited using a recruitment flyer for the study and tracked by the number of willing participants.
Measured: 6 months
Secondary outcomes (15)
Change in balance and mobility measured by Instrumented-SWAY (i-SWAY)
A test (not a scale) to assess balance and postural sway. Subjects will be asked to stand still with their hands across their chests and their feet positioned a set distance apart (scaled to their height) with a wearable sensor that records movements applied to the lumbar trunk. This sensor will record parameters including mean total sway area, path length, jerk, and sway distance in the mediolateral and anteroposterior directions.
Measured: 6 weeks
Change in functional mobility measured by Instrumented-WALK (i-WALK)
A test to examine fatigue over time and that will also allow more accurate calculation of gait variability indices by increasing the number of steps. The subject will walk 25 meters, turn and walk back, and repeat this until 2 minutes has elapsed.
Measured: 6 weeks
Change in balance and mobility measured by Mini-BEST balance scale
This is a shortened version of the Balance Evaluation systems Test (BESTest). It aims to target and identify 6 different balance control systems and has been used as a performance-based balance measure in many interventions and clinical trials. 1) The original BESTest 4 level (0-3) scoring was revised to 3 levels (0-2) due to redundancy. 2) Total Score = 28 points per test directions. 3) Two items have right and left assessment in which the lower score is used within the total score (directions specify which to use). 4) For research, many studies specify use of both left and right data, thus calculating data based on 32 (vs 28 points).
Measured: 6 weeks
Change in patient reported confidence in balance measured by Activities-Specific Balance Confidence Scale (ABC)
A 16-item self-report questionnaire in which patients rate their balance confidence for performing activities. Items are rated on a rating scale that ranges from 0 - 100. Score of zero represents no confidence, a score of 100 represents complete confidence. Overall score is calculated by adding item scores and then dividing by the total number of items.
Measured: baseline, week 6, post-training month 1 & month 6
Change in cognitive function measured by the Montreal Cognitive ASsessment (MoCa)
A screening instrument designed to help health professionals detect mild cognitive dysfunction. Subjects will answer questions to measure different areas of cognition including attention and concentration, executive functions, memory, language, visuo-constructional skills, conceptual thinking, calculations, and orientation. MoCA scores range between 0 and 30. A score of 26 or over is considered to be normal.
Measured: 6 months
Change in cognitive function measured by the Symbol Digit Modalities Test (SDMT)
A test for evaluating information processing speed, and the subject uses a reference key to pair specific numbers with given abstract geometric figures in 90 seconds. Scores are the correct number of pairs made in 90 seconds, with greater scores indicating greater cognitive abilities.
Measured: 6 weeks
Change in cognitive function measured by Controlled Oral Word Association Test (COWAT)
A phonemic test for verbal fluency and verbal memory. The COWAT uses the three letter set of C, F, and L to assess phonemic fluency. Subjects will be given 1 min to name as many words as possible beginning with one of the letters.
Measured: 6 weeks
Change in cognitive function measured by (STROOP)
A neuro-psychological test for attention and response inhibition the assess the ability to inhibit cognitive interference while processing a specific stimulus.
Measured: 6 weeks
Change in cognitive function measured by Digit Span forward and backward test
One of the oldest and most widely used test of short-term verbal and working memory. On each trial subjects will be presented with a series of digits appearing one at a time on a computer screen. Subjects will be tested in 2 variants; forward-span and backward-span. In the forward-span, the subject will be asked to recall the digits in the order they appeared. In the backward-span, subjects will be asked to recall the digits in the reverse order they appeared.
Measured: 6 weeks
Change in health related quality of life measured by the Neuro Quality of Life Survey
Neuro-QoL (Quality of Life in Neurological Disorders) is a measurement system that evaluates and monitors the physical, mental, and social effects experienced by adults and children living with neurological conditions. It is a self-report of health related quality of life in 17 domains and sub-domains for adults and 11 for children with neurological disorders. Raw scores are converted based on consistent metric (T-distribution) with data from the US general population with a t-score mean of 50 and standard deviation of 10. Adult Banks include 19-45 items. Items are scored on a 5-point scale that uses different language depending on assessment. the questions range from least (1) to most (5) based on frequency of behavior, amount of difficulty, or degree of agreement.
Measured: 6 months
Change in depression measured by the Center for Epidemiologic Studies Depression Scale (CES-D)
The CES-D is a brief self-report measure that assesses symptoms of depression in the general population. It is a 20-item, self-report measure designed to be used in the general population that assess current symptoms of depression (i.e. this week). The standard cut-off score suggesting depression >16.
Measured: 6 weeks
Change in quality of sleep measured by the Pittsburgh Sleep Quality Index (PSQI) questionnaire
The PSQI is an effective instrument used to measure the quality and patterns of sleep in adults. it differentiates "poor" from "good" sleep quality by measuring seven different areas over the last month; 19 self-reported items belongs to one of seven subcategories: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. Five additional questions rated by the respondent's roommate or bed partner are included for clinical purposes and are not scored.
Measured: 6 weeks
Change in perceived exertion on physical activity intensity measured by the Borg Rating Scale (Borg Rating of Perceived Exertion Scale)
The Borg Rating of Perceived Exertion Scale measures physical activity intensity felt by the participant based on the physical sensations a participant experiences during physical activity, including increased heart rate, increased respiration or breathing rate, increased sweating, and muscle fatigue.It is a 20-point scale with verbal descriptors to standardize perceived exertion across tasks and individuals. a score of 0 = nothing at all to 10 = very hard.
Measured: 6 weeks
Change in physical activity level measured step counts monitored by Fitbit wrist watch
The daily steps counts monitored by Fitbit wristband will be used as the measure of physical activity
Measured: 6 weeks
Change in anxiety measured by the Beck Anxiety Inventory (BAI).
The BAI is a self-report measure of anxiety that assesses anxiety symptoms and symptom severity. The BAI can discriminate anxiety from depression. 4-point Likert scale response for anxiety symptoms are severity within a week; the total score is calculated by calculating the sum of 21 items. Minimum score of 0 and a maximum score of 63. Score Interpretation: 0-7 = minimal anxiety; 8-15 = mild anxiety; 16-25 = moderate anxiety; 26-63 = severe anxiety
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Jun 2020
- Study start30 Jul 2019
- Primary completion30 Mar 2020
- Study completion30 Mar 2020
Why it stopped: Due to COVID 19, the recruitment was halted.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Fragile X Associated Tremor-ataxia SyndromeStudies of the same condition, open and under way.
- More trials run by Rush University Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Non-randomised
- Intervention model
- Parallel groups
- Model description
- The subjects will be randomly assigned to 2 groups: 1) treadmill training group with a cognitive task (Intervention group) 2) Control group. The entire intervention period is 6 weeks in both groups, with interventional training occurring 3 days per week for approximately 45 minutes per session. Evaluations will take place at baseline, 3 weeks, at the end of 6 weeks, and 1 month and 6 months after the intervention.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 3 participants (actual)
Sponsor and investigators
- Lead sponsor
- Rush University Medical Center
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Joan A O'Keefe, PhD, PT, Principal investigator, Rush University Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04428567
- Sponsor's protocol ID
- 18200205
- Acronym
- FXTAS
- Status last verified
- Oct 2021
- First submitted
- 1 Oct 2019
- Last updated
- 28 Oct 2021
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 28 Oct 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Pilot Dual-Task Treadmill Training to Improve Gait and Balance in Fragile X-Associated Tremor/Ataxia Syndrome
- ClinicalTrials.gov ID
- NCT04428567
- Acronym / sponsor ID
- FXTAS / 18200205
- Keywords
- Dual-task, feasibility, FXTAS, treadmill training
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Due to COVID 19, the recruitment was halted.
- Enrolment
- 3 participants (actual)
- Lead sponsor
- Rush University Medical CenterUniversity, hospital or other
- Study start
- 30 Jul 2019 (actual)
- Primary completion
- 30 Mar 2020 (actual)
- Study completion
- 30 Mar 2020 (actual)
- First posted
- 11 Jun 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A pilot trial to determine the feasibility of treadmill training with dual training in patients with Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS).
Detailed description
There is substantial evidence that physical exercise can improve motor and cognitive function in individuals with Parkinson's Disease, traumatic brain injury or chronic stroke survivors. However, to the investigator's knowledge, no studies have explored the effect of treadmill training with or without a cognitive dual Task on gait, balance and cognition in Fragile X - Associated Tremor/Ataxia Syndrome (FXTAS), which is characterized by action tremor, cerebellar gait ataxia, parkinsonism, peripheral neuropathy and cognitive deficits, all of which increase the risk for falls and progressive disability. There are presently no medications or treatment interventions that have been shown to effectively manage the symptoms of FXTAS or delay disease progression, and it is currently not clear whether either the ST or Dual-Task treadmill training paradigms would be feasible or effective in FXTAS.
A total of 10 individuals with FXTAS will recruited from the Rush University Movement Disorders Clinic or the FXTAS Clinic Database at Rush University. The subjects will be assigned to either 6 weeks of dual-task treadmill exercise training combined with a cognitive task (intervention group) occurring 3 times weekly, or control group. The primary outcome measures will be feasibility, safety and patient adherence. The assessments will occur at baseline, week 3, week 6, 1 month \& 6 month post-training.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- The subjects will be randomly assigned to 2 groups: 1) treadmill training group with a cognitive task (Intervention group) 2) Control group. The entire intervention period is 6 weeks in both groups, with interventional training occurring 3 days per week for approximately 45 minutes per session. Evaluations will take place at baseline, 3 weeks, at the end of 6 weeks, and 1 month and 6 months after the intervention.
| Arm | Type | Receives |
|---|---|---|
| Treadmill Exercise + Cognitive Training (Dual-Task) | Experimental | Behavioral: Dual-Task Treadmill exercise + Cognitive TrainingThe Dual-Task group will be provided with treadmill training with added simultaneous cognitive training during treadmill exercise training. |
| Control Group | No intervention | –The control group will be assessed as the intervention group at the same time intervals without the intervention. |
Who may qualify
- Ages
- 50 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- A diagnosis of possible, probable or definite FXTAS
- Able to stand and walk without support for 2 minutes
Key exclusion criteria (5 listed)
- Any neurologic or musculoskeletal problems
- History of traumatic brain injury
- Significant cardiopulmonary or cardiovascular disease
- Dementia or other significant cognitive impairment
- Unstable psychiatric disorders
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Dual-Task Treadmill exercise + Cognitive TrainingThe dual-task regimen will include treadmill exercise of 5-10 min warm-up and cool-down, 30 minutes of running towards target heart rate, combined with respond demands with the addition of cognitive tasks. The level of duration and intensity of treadmill exercise will progressively increase over the duration of 6 weeks. | Behavioural | Treadmill Exercise + Cognitive Training (Dual-Task) |
Primary outcome
High levels of program attendance, and retention
Time frame: 6 weeks
At each study visit the subjects attend and revisit were taken down throughout the entire intervention period in an attendance/retention log book.
High levels of satisfaction
Time frame: 6 weeks
At the end of the entire study a client satisfaction questionnaire was administered and interpreted based on a percent of satisfaction, ranging from zero to one hundred percent, on various satisfactory questions. Zero percent meaning highly unsatisfied and one hundred percent meaning highly satisfied.
High levels of recruitment
Time frame: 6 months
Research subjects were recruited using a recruitment flyer for the study and tracked by the number of willing participants.
15 secondary outcomes
Change in balance and mobility measured by Instrumented-SWAY (i-SWAY)
Time frame: 6 weeks
Change in functional mobility measured by Instrumented-WALK (i-WALK)
Time frame: 6 weeks
Change in balance and mobility measured by Mini-BEST balance scale
Time frame: 6 weeks
Change in patient reported confidence in balance measured by Activities-Specific Balance Confidence Scale (ABC)
Time frame: baseline, week 6, post-training month 1 & month 6
Change in cognitive function measured by the Montreal Cognitive ASsessment (MoCa)
Time frame: 6 months
Change in cognitive function measured by the Symbol Digit Modalities Test (SDMT)
Time frame: 6 weeks
Change in cognitive function measured by Controlled Oral Word Association Test (COWAT)
Time frame: 6 weeks
Change in cognitive function measured by (STROOP)
Time frame: 6 weeks
Change in cognitive function measured by Digit Span forward and backward test
Time frame: 6 weeks
Change in health related quality of life measured by the Neuro Quality of Life Survey
Time frame: 6 months
Change in depression measured by the Center for Epidemiologic Studies Depression Scale (CES-D)
Time frame: 6 weeks
Change in quality of sleep measured by the Pittsburgh Sleep Quality Index (PSQI) questionnaire
Time frame: 6 weeks
Change in perceived exertion on physical activity intensity measured by the Borg Rating Scale (Borg Rating of Perceived Exertion Scale)
Time frame: 6 weeks
Change in physical activity level measured step counts monitored by Fitbit wrist watch
Time frame: 6 weeks
Change in anxiety measured by the Beck Anxiety Inventory (BAI).
Time frame: 6 weeks
Results and safety
The study was stopped early (reason given: Due to COVID 19, the recruitment was halted.). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Oct 2021.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Joan A O'Keefe, PhD, PT principal investigator
Rush University Medical Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Dual-Task Treadmill exercise + Cognitive Training in people with Fragile X Associated Tremor-ataxia Syndrome, run by Rush University Medical Center 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 2 inclusion and 5 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: stopped early, as of the sponsor's last update on 28 Oct 2021. 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?
The study was stopped early (reason given: Due to COVID 19, the recruitment was halted.). 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?
High levels of program attendance, and retention (time frame: 6 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 28 Oct 2021.