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Dual-task Augmented Reality Treatment for Parkinson's Disease (DART)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04634331
Recruitment Status : Completed
First Posted : November 18, 2020
Last Update Posted : August 31, 2022
Sponsor:
Collaborator:
Michael J. Fox Foundation for Parkinson's Research
Information provided by (Responsible Party):
Jay Alberts, The Cleveland Clinic

Study Description
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Brief Summary:
Activities of daily living (ADL) frequently involve the simultaneous performance of two or more tasks, such as crossing the street while holding a conversation, commonly referred to as dual tasking. The simultaneous performance of a motor and a cognitive task increases postural instability, gait dysfunction, and may increase fall rates in Parkinson's disease (PD). The goal of this project is to evaluate the effectiveness of utilizing a digital therapeutic, Dual-task Augmented Reality Treatment (DART) protocol, for the treatment of postural instability and gait dysfunction (PIGD) in individuals with PD. A randomized controlled trial will be conducted at the Main Campus of the Cleveland Clinic (Cleveland, OH). A total of 50 individuals with Parkinson's disease will be randomized into 1) a traditional multi-modal training group, or 2) multi-modal training administered via an augmented reality headset. Multi-modal therapy is where the participant practices performing two things at once (i.e. marching while answering math questions). Augmented reality is a type of head-worn technology that allows the individual to see the real world and places holograms in the space. Both groups will exercise 2x/week for a total of 8 weeks. Assessments involving walking, balancing, and turning will be completed to assess the efficacy of the treatment.

Condition or disease Intervention/treatment Phase
Parkinson Disease Behavioral: Augmented Reality Multi-Modal Training Behavioral: Traditional Multi-Modal Training Phase 2

Detailed Description:
Individuals with Parkinson's disease who qualify for the study will come to the Cleveland Clinic for an informed consent visit. At the informed consent visit, the participant will receive an activity monitor and a fall diary. Following a 4-week period where activity and falls are monitored, the participant will come to the Cleveland Clinic for a comprehensive physical and cognitive assessment primarily using a virtual reality treadmill system. During that baseline assessment, the individual will be randomized to either 1) traditional multi-modal training, or 2) augmented reality multi-modal training. Regardless of group allocation, the participant will complete a total of 16 treatment sessions (2x/week for 8 weeks). The traditional multi-modal treatment will be administered 1:1 by a physical therapist. The augmented reality multi-modal training will be overseen by a physical therapist and administered via the Microsoft HoloLens 2 augmented reality device. Follow-up assessments will be conducted at the end of the 16 treatment sessions and 8 weeks after the treatment sessions have ceased. Falls and activity data will be monitored throughout the study.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 51 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: 50 individuals with Parkinson's disease will be randomized to either 1) traditional multi-modal training, or 2) augmented reality multi-modal training.
Masking: Single (Investigator)
Masking Description: The investigator performing the assessments will be blinded to group allocation.
Primary Purpose: Treatment
Official Title: Dual-task Augmented Reality Treatment for Parkinson's Disease (DART)
Actual Study Start Date : December 10, 2020
Actual Primary Completion Date : August 8, 2022
Actual Study Completion Date : August 8, 2022

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Active Comparator: Traditional Multi-Modal Training
A physical therapist will provide 1:1 multi-modal training. Multi-modal training is the simultaneous performance of a motor and a cognitive task (i.e. marching while answering math questions)
 Behavioral: Traditional Multi-Modal Training
Training administered via a 1:1 physical therapy session
Experimental: Augmented Reality Multi-Modal Training
Multi-modal training will be administered via the Microsoft HoloLens 2 augmented reality head set. Augmented reality allows user to see the real world, and inserts holograms into the environment. For example, the user could see boxes on the ground that they need to step around when walking. The boxes are not real, but rather a hologram that only the user can see. The augmented reality device will instruct the participant on the motor and cognitive task that should be performed simultaneously in a similar manner to the physical therapist in the traditional multi-modal training group. The intervention will be overseen by a physical therapist.
 Behavioral: Augmented Reality Multi-Modal Training
Training administered via an augmented reality headset.


Outcome Measures
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Primary Outcome Measures :
  1. Gait velocity [ Time Frame: From baseline assessment to the end of the 8-week training session ]
    Walking speed (m/s) on a self-paced treadmill during single and dual task conditions

  2. MDS-UPDRS III score [ Time Frame: From baseline assessment to the end of the 8-week training session ]
    Global score of motor function in Parkinson's disease; 18 items scored on a 0-4 scale; lower score indicates fewer PD motor symptoms

  3. Fall frequency [ Time Frame: From baseline assessment to the end of the 8-week training session ]
    number of falls in the previous 30 day period


Eligibility Criteria
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Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Adult with a diagnosis of idiopathic PD
  2. Self-reported gait or balance deficits
  3. Hoehn and Yahr stage I-III
  4. Ability to ambulate >10 minutes continuously

Exclusion Criteria:

  1. Diagnosis of dementia or any neurocognitive impairment that compromises the ability to provide informed consent
  2. >2 errors on the Short Portable Mental Status Questionnaire
  3. Implanted deep brain stimulation electrodes
  4. Musculoskeletal or cardiopulmonary issue that limits one's ability to engage in exercise
  5. Neurological disease other than Parkinson's disease that impacts motor or cognitive function
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04634331


Locations
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United States, Ohio
Cleveland Clinic
Cleveland, Ohio, United States, 44195
Sponsors and Collaborators
The Cleveland Clinic
Michael J. Fox Foundation for Parkinson's Research
Investigators
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Principal Investigator: Jay Alberts, PhD The Cleveland Clinic
More Information
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Responsible Party: Jay Alberts, Staff, Department of Biomedical Engineering, The Cleveland Clinic
ClinicalTrials.gov Identifier: NCT04634331    
Other Study ID Numbers: 20-207
First Posted: November 18, 2020    Key Record Dates
Last Update Posted: August 31, 2022
Last Verified: August 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Jay Alberts, The Cleveland Clinic:
Parkinson disease
dual task
postural instability
gait dysfunction
Additional relevant MeSH terms:
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Parkinson Disease
Parkinsonian Disorders
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases
 Nervous System Diseases
Movement Disorders
Synucleinopathies
Neurodegenerative Diseases