Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.
Grup de Recerca de Cures en Salut, Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain.
PLoS One. 2024 Jul 16;19(7):e0307304. doi: 10.1371/journal.pone.0307304. eCollection 2024.
Parkinson's Disease (PD) affects movement and cognition, and physiotherapy, particularly treadmill gait training, has potential in addressing movement dysfunctions in PD. However, treadmill training falls short in addressing cognitive aspects and adherence. Virtual reality (VR) and gamification can enhance motor and cognitive retraining and improve adherence. People with Parkinson's Disease (PWPD) have decreased motor skill learning efficiency, but tDCS can improve motor and cognitive learning.
78 participants with PD will be randomly allocated in a 1:1:1 ratio to one of three groups: (1) treadmill + Gamified Virtual Reality Environment (GVRE) + tDCS training group; (2) treadmill + GVRE training group or (3) treadmill training group. Participants will follow a 6-week, 12-session treadmill gait training plan, gradually increasing session duration from 20 to 45 minutes. Participants in (1) and (2) will undergo a GVRE training protocol, with (1) also receiving tDCS for the first 20 minutes of each session. Assessments will occur at baseline, post-intervention, and at a 6-week follow-up. The primary outcome measure will be gait speed during single and dual-task performance. Secondary measures will include additional gait parameters, executive tests for cognitive performance, and clinical outcomes for disease stage, cognitive status, and physical condition.
This randomized clinical trial presents an innovative neurorehabilitation protocol that aims to improve gait and cognition in PWPD. The study also examines how tDCS can enhance motor and cognitive training. Results could contribute to enhancing the motor and cognitive state of PWPD through a GVRE and tDCS-based neurorehabilitation protocol.
NCT05243394. 28/02/2024 -v3.2.
帕金森病（PD）影响运动和认知能力，而物理治疗，特别是跑步机步态训练，在解决 PD 运动功能障碍方面具有潜力。然而，跑步机训练在认知方面和依从性方面存在不足。虚拟现实（VR）和游戏化可以增强运动和认知再训练，并提高依从性。帕金森病患者（PWPD）的运动技能学习效率降低，但 tDCS 可以改善运动和认知学习。
78 名 PD 患者将被随机分配到三组之一，比例为 1:1:1：（1）跑步机+游戏化虚拟现实环境（GVRE）+ tDCS 训练组；（2）跑步机+ GVRE 训练组或（3）跑步机训练组。参与者将遵循 6 周 12 节跑步机步态训练计划，逐步将课程持续时间从 20 分钟增加到 45 分钟。（1）和（2）组将进行 GVRE 训练方案，（1）组还将在每次课程的前 20 分钟接受 tDCS。评估将在基线、干预后和 6 周随访时进行。主要结局测量指标是单任务和双任务表现时的步态速度。次要测量指标包括额外的步态参数、认知表现的执行测试，以及疾病阶段、认知状态和身体状况的临床结果。
这项随机临床试验提出了一种创新的神经康复方案，旨在改善 PWPD 的步态和认知能力。该研究还探讨了 tDCS 如何增强运动和认知训练。结果可能有助于通过基于 GVRE 和 tDCS 的神经康复方案改善 PWPD 的运动和认知状态。
NCT05243394。28/02/2024 -v3.2.
