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Status unknownNCT06363071Updated Apr 12, 2024

APA and PAS Training for Gait Initiation in Parkinson's Disease

An interventional study of Weight shift training and APA feedback and Paired associative stimulation in Parkinson Disease, sponsored by Chang Gung University. Status unknown at 1 site in Taiwan. Open to participants aged 20 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-04-12.

Sponsored by Chang Gung University · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Apr 2024), so the status shown — last known as Recruiting — may be out of date.

From the registry’s dates

  • Registered 1 year 9 months after the study started (first participant enrolled Jun 2022, registered Mar 2024).
Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
20 Years and older
Sex
All
01

Study summary

Our research focused on understanding the interplay between brain excitability and balance function in patients with Parkinson's disease (PD), alongside evaluating effective physical therapy methods. It highlights the prevalence of non-motor disorders and cognitive impairments among PD patients, including balance and postural issues, cognitive function decline, and gait instability. Additionally, it notes that PD patients exhibit abnormal electrophysiological responses, indicating altered central excitability.

Read the detailed description

Research on Brain Excitability and Balance Function Performance in Patients with Parkinson's Disease and Related Physical Therapy Methods

Research indicates that non-motor disorders and cognitive impairments are prevalent in most patients with Parkinson's disease. These include balance issues, postural instability, impaired cognitive functions like working memory and executive functions, and gait instability. Additionally, electrophysiological phenomena in Parkinson's disease patients reveal abnormal central excitatory and inhibitory responses compared to healthy individuals.

This experiment seeks to investigate the link between motor performance and brain excitability in patients with Parkinson's disease. Previous studies suggest that associative electrical stimulation, used to regulate sensorimotor information integration, can enhance brain excitability in both healthy individuals and those with Parkinson's disease. However, the optimal parameters for this stimulation remain uncertain.

Furthermore, balance exercise training can improve motor performance in Parkinson's disease patients. This study aims to determine if various designs of associative electrical stimulation parameters can help these patients achieve optimal brain excitability regulation. The combined approach of this stimulation and balance exercise training aims to maintain and improve the patients' functional performance, thereby enhancing the safety of their daily activities.

02

Conditions studied

  • Parkinson Disease

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Keywords

  • Gait Initiation
  • Balance training
  • Anticipatory postural adjustments
  • Paired associative stimulation (PAS)
  • Transcranial magnetic stimulation (TMS)
03

In context

Parkinson Disease

4,583 studies on the registry are indexed under Parkinson Disease; 1,097 are open to participants now.

This study's planned enrollment of 100 is above the median of 40 across 3,365 interventional studies indexed under Parkinson Disease.

Browse Parkinson Disease studies →

Lead sponsor

Chang Gung University is the lead sponsor of 66 studies on the registry; 13 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
20 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Eligibility criteria

Health subjects:

Exclusion Criteria:

  • Musculoskeletal injuries on legs.
  • Osteoporosis.

PD subjects:

Inclusion Criteria:

- Clinical diagnosis of Parkinson disease.

Exclusion Criteria:

  • Musculoskeletal injuries on legs
  • Osteoporosis.
  • Any peripheral or central nervous system injury or disease patients.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
100 participants (estimated)

Study arms

  • Experimental
    Stage 1:Healthy people

    To establish PAS baseline and reliability.

    Procedure: Paired associative stimulation

  • Experimental
    Stage 2:PD people

    To establish stage 3 training protocol.

    Procedure: Paired associative stimulation

  • No intervention
    Stage 3:PD people

    Control group.

  • Experimental
    Stage 3: PD APA training group

    Weight shift training and APA feedback.

    Other: Weight shift training and APA feedback

  • Experimental
    Stage 3:PD PAS group

    Using PAS to regulate brain plasticity

    Procedure: Paired associative stimulation

Interventions

  • OtherWeight shift training and APA feedback

    Use COP trajectory to train weight shift on force plate. To give APA visual feedback for subjects after weight shift training.

    Also known as: • APA training group

  • ProcedurePaired associative stimulation

    Use TMS combine ES to stimulate TA nerve and M1 cortical

    Also known as: PAS group

06

What researchers measure

Primary outcomes

  1. Balance Performance

    Measured by the duration the stance can be maintained. Unit:seconds(s)

    Time frame: Baseline, 4 weeks and 8 weeks.

  2. COP Path Length in Balance Tasks

    The total distance traveled by the COP over a specified period. Longer path lengths can indicate increased effort to maintain balance or greater instability. Unit:millimeters(mm)

    Time frame: Baseline, 4 weeks and 8 weeks.

  3. COP Displacement in Balance Tasks

    Measures of COP movement in the anterior-posterior (AP) and medial-lateral (ML) directions, offering insights into the directional tendencies of balance control. Unit:millimeters(mm)

    Time frame: Baseline, 4 weeks and 8 weeks.

  4. Motor Evoked Potentials (MEPs)

    MEPs are the electrical responses recorded from muscles following stimulation of the motor cortex. They reflect the efficiency of neural transmission from the cortex to the muscle. Unit:millivolts (mV)

    Time frame: Baseline, 4 weeks and 8 weeks.

  5. Intracortical Facilitation (ICF)

    ICF is measured by applying a pair of TMS pulses with a short interval (e.g., 8-15 ms) where the first (subthreshold) pulse is followed by a second (suprathreshold) pulse, leading to an increased amplitude of the MEP.

    Time frame: Baseline, 4 weeks and 8 weeks.

  6. Intracortical Inhibition (ICI)

    ICI is measured similarly to ICF but with a shorter inter-stimulus interval (e.g., 1-5 ms), resulting in a suppressed MEP amplitude. This suppression reflects inhibitory processes within the cortex.

    Time frame: Baseline, 4 weeks and 8 weeks.

  7. Walking Speed

    The time taken by participants to walk a standardized distance, typically expressed in centimeters per second (cm/s).

    Time frame: Baseline, 4 weeks and 8 weeks.

  8. Step Length

    The linear distance between the two ankles, typically expressed in centimeter(cm).

    Time frame: Baseline, 4 weeks and 8 weeks.

  9. Step Time

    The duration taken for one complete step, measuring from foot-off of one foot to the next foot-off of the same foot, usually expressed in seconds.

    Time frame: Baseline, 4 weeks and 8 weeks.

Secondary outcomes

  1. COP Velocity in Balance Tasks

    The speed at which the COP moves, calculated over the duration of the balance task. Higher velocities may reflect more dynamic balance adjustments or instability. Unit:millimeters per second(mm/s)

    Time frame: Baseline, 4 weeks and 8 weeks.

  2. COP Area in Balance Tasks

    The area covered by the COP trajectory during the balance task, providing an estimate of the sway envelope. A larger area might indicate poorer balance control. Unit:square millimeters(mm\^2)

    Time frame: Baseline, 4 weeks and 8 weeks.

  3. Double Support Time

    The portion of the gait cycle where both feet are in contact with the ground, indicating the transition phase between steps, expressed as a percentage of the gait cycle or in seconds.

    Time frame: Baseline, 4 weeks and 8 weeks.

  4. Single Support Time

    The duration within the gait cycle when only one foot is in contact with the ground, typically measured in seconds or as a percentage of the total gait cycle.

    Time frame: Baseline, 4 weeks and 8 weeks.

  5. Swing Time

    The portion of the gait cycle where the foot is not in contact with the ground, moving forward to the next step. It is usually expressed as a percentage of the total gait cycle or in seconds.

    Time frame: Baseline, 4 weeks and 8 weeks.

  6. Stance Time

    The portion of the gait cycle when the foot is in contact with the ground, supporting body weight. It's typically expressed as a percentage of the total gait cycle or in seconds

    Time frame: Baseline, 4 weeks and 8 weeks.

  7. Cadence

    The number of steps an individual takes per minute, providing an overview of gait speed and rhythm, , expressed as steps per minute.

    Time frame: Baseline, 4 weeks and 8 weeks.

07

Study locations

1 of 1 sites recruiting
  • Chang Gung University
    Taoyuan, 333, Taiwan
    Recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jun 2022 (actual). Primary completion is estimated for Mar 2025, 33 months after the start.

Of 1,296 non-industry interventional studies with no phase under Parkinson Disease, half reached primary completion within 24 months of starting (the median), counting those still running; a quarter within 11 and three quarters within 45. This study's planned 33 months is above that.

Counting every sponsor, half of 1,369 studies reached it within 24 months; a quarter within 11 and three quarters within 44.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 28, 2024
First posted
Apr 12, 2024
StartActual
Jun 13, 2022
Primary completionEst.
Mar 31, 2025
CompletionEst.
May 31, 2025
Last update
Apr 12, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 12, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06363071
Lead sponsor
Chang Gung University
Responsible party
Ya-Ju Chang (Professor, Chang Gung University) — Principal investigator
First posted
Apr 12, 2024
Start date
Jun 13, 2022
Primary completion
Mar 31, 2025 (estimated)
Completion
May 31, 2025 (estimated)
Last update
Apr 12, 2024

Study contacts

Ya-Ju Chang, PhD
Contact
yjchang@mail.cgu.edu.tw
+88632118800 ext. 5515

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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