Randomized controlled trial protocol: balance training with rhythmical cues to improve and maintain balance control in Parkinson’s disease
Identifieur interne : 000010 ( Main/Exploration ); précédent : 000009; suivant : 000011Randomized controlled trial protocol: balance training with rhythmical cues to improve and maintain balance control in Parkinson’s disease
Auteurs : Tamine Teixeira Da Costa Capato [Brésil] ; Juliana Tornai ; Patrícia Ávila ; Egberto Reis Barbosa [Brésil] ; Maria Elisa Pimentel Piemonte [Brésil]Source :
- BMC Neurology [ 1471-2377 ] ; 2015.
Abstract
Postural instability is a particularly incapacitating disorder, whose loss of motor independence by Parkinson´s Disease (PD) patients marks a significant stage of disease onset. Evidence suggests that deficits in automatic motor control, sensory integration and attention are associated with the lack of balance in PD. Physiotherapy together with medication play an important role in the treatment of this state, although no consensus has been reached on the best treatment modality. The aim of this randomized controlled trial protocol is to evaluate the effects of balance training with rhythmical (BRT), which is a motor program to improve balance associated with rhythmical auditory cues (RACs). This study is ongoing in the stage 1.
A total of 150 PD patients at H&Y stages II–III and asymptomatic for depression and dementia are enrolled in a single-blind randomized study. Randomization is achieved via a computer-generated random-sequence table. All patients should also present a fall history. They will be assigned into one of three groups, and their balance and gait will be assessed before and after 10 training sessions, and after 4 and 30 weeks subsequent to the end of the training. The BRT group will receive a motor program to improve balance associated with RACs, the MT group will perform motor training with the same aims as those in the BRT group but without RACs, and the control group (CG) will be trained only in orientations. The exercise program specific to balance is of 5 weeks’ duration with two sessions per week, 45 min each, and consists of general physiotherapy exercises. Each session will be divided into five warm-up minutes—30 min for the main part and 10 min for the cool down. The training progresses and intensifies each week depending on the individual’s performance. The subjects should be able to execute 10 repetitions of the exercise sequences correctly to progress to the next movement.
This randomized study protocol will evaluate the effects of a motor program designed to improve balance associated with RACs, and will also assess whether balance training leads to activation of balance reactions at the appropriate time. We hypothesize that if this motor program is maintained long-term, it will prevent falls.
Clinicaltrials.gov
The online version of this article (doi:10.1186/s12883-015-0418-x) contains supplementary material, which is available to authorized users.
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DOI: 10.1186/s12883-015-0418-x
PubMed: 26347052
PubMed Central: 4561447
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Randomized controlled trial protocol: balance training with rhythmical cues to improve and maintain balance control in Parkinson’s disease</title><author><name sortKey="Capato, Tamine Teixeira Da Costa" sort="Capato, Tamine Teixeira Da Costa" uniqKey="Capato T" first="Tamine Teixeira Da Costa" last="Capato">Tamine Teixeira Da Costa Capato</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Physicaltherapy, University of São Paulo, Av Dr Enéias de Aguiar, 255 – 05403.000 São Paulo, São Paulo Brazi</nlm:aff><orgName type="university">Université de São Paulo</orgName><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation><nlm:aff id="Aff2">PHYSICAL, Rua Cubatão 929 conj, 142 - 04013-043 São Paulo, São Paulo Brazil</nlm:aff><wicri:noCountry code="subfield">São Paulo Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Tornai, Juliana" sort="Tornai, Juliana" uniqKey="Tornai J" first="Juliana" last="Tornai">Juliana Tornai</name><affiliation><nlm:aff id="Aff2">PHYSICAL, Rua Cubatão 929 conj, 142 - 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04013-043 São Paulo, São Paulo Brazil</nlm:aff><wicri:noCountry code="subfield">São Paulo Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Tornai, Juliana" sort="Tornai, Juliana" uniqKey="Tornai J" first="Juliana" last="Tornai">Juliana Tornai</name><affiliation><nlm:aff id="Aff2">PHYSICAL, Rua Cubatão 929 conj, 142 - 04013-043 São Paulo, São Paulo Brazil</nlm:aff><wicri:noCountry code="subfield">São Paulo Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Avila, Patricia" sort="Avila, Patricia" uniqKey="Avila P" first="Patrícia" last="Ávila">Patrícia Ávila</name><affiliation><nlm:aff id="Aff2">PHYSICAL, Rua Cubatão 929 conj, 142 - 04013-043 São Paulo, São Paulo Brazil</nlm:aff><wicri:noCountry code="subfield">São Paulo Brazil</wicri:noCountry></affiliation></author><author><name sortKey="Barbosa, Egberto Reis" sort="Barbosa, Egberto Reis" uniqKey="Barbosa E" first="Egberto Reis" last="Barbosa">Egberto Reis Barbosa</name><affiliation wicri:level="4"><nlm:aff id="Aff3">Department of Neurology, University of São Paulo, Av Dr Enéias de Aguiar, 255 – 05403.000 São Paulo, São Paulo Brazil</nlm:aff><orgName type="university">Université de São Paulo</orgName><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Piemonte, Maria Elisa Pimentel" sort="Piemonte, Maria Elisa Pimentel" uniqKey="Piemonte M" first="Maria Elisa Pimentel" last="Piemonte">Maria Elisa Pimentel Piemonte</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Department of Physicaltherapy, University of São Paulo, Av Dr Enéias de Aguiar, 255 – 05403.000 São Paulo, São Paulo Brazi</nlm:aff><orgName type="university">Université de São Paulo</orgName><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author></analytic><series><title level="j">BMC Neurology</title><idno type="eISSN">1471-2377</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Postural instability is a particularly incapacitating disorder, whose loss of motor independence by Parkinson´s Disease (PD) patients marks a significant stage of disease onset. Evidence suggests that deficits in automatic motor control, sensory integration and attention are associated with the lack of balance in PD. Physiotherapy together with medication play an important role in the treatment of this state, although no consensus has been reached on the best treatment modality. The aim of this randomized controlled trial protocol is to evaluate the effects of balance training with rhythmical (BRT), which is a motor program to improve balance associated with rhythmical auditory cues (RACs). This study is ongoing in the stage 1.</p></sec><sec><title>Methods and design</title><p>A total of 150 PD patients at H&Y stages II–III and asymptomatic for depression and dementia are enrolled in a single-blind randomized study. Randomization is achieved via a computer-generated random-sequence table. All patients should also present a fall history. They will be assigned into one of three groups, and their balance and gait will be assessed before and after 10 training sessions, and after 4 and 30 weeks subsequent to the end of the training. The BRT group will receive a motor program to improve balance associated with RACs, the MT group will perform motor training with the same aims as those in the BRT group but without RACs, and the control group (CG) will be trained only in orientations. The exercise program specific to balance is of 5 weeks’ duration with two sessions per week, 45 min each, and consists of general physiotherapy exercises. Each session will be divided into five warm-up minutes—30 min for the main part and 10 min for the cool down. The training progresses and intensifies each week depending on the individual’s performance. The subjects should be able to execute 10 repetitions of the exercise sequences correctly to progress to the next movement.</p></sec><sec><title>Discussion</title><p>This randomized study protocol will evaluate the effects of a motor program designed to improve balance associated with RACs, and will also assess whether balance training leads to activation of balance reactions at the appropriate time. We hypothesize that if this motor program is maintained long-term, it will prevent falls.</p></sec><sec><title>Trial registration</title><p>Clinicaltrials.gov <ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NTC02488265">NCT02488265</ext-link>; Ethics Committee of the University of São Paulo Faculty of Medicine Clinics Hospital 1.102.464.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s12883-015-0418-x) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Bloem, Br" uniqKey="Bloem B">BR Bloem</name></author><author><name sortKey="Hausdorff, Jm" uniqKey="Hausdorff J">JM Hausdorff</name></author><author><name sortKey="Visser, Je" uniqKey="Visser J">JE Visser</name></author><author><name sortKey="Giladi, N" uniqKey="Giladi N">N 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sortKey="Yardley, L" uniqKey="Yardley L">L Yardley</name></author><author><name sortKey="Beyer, N" uniqKey="Beyer N">N Beyer</name></author><author><name sortKey="Hauer, K" uniqKey="Hauer K">K Hauer</name></author><author><name sortKey="Kempen, G" uniqKey="Kempen G">G Kempen</name></author><author><name sortKey="Piot Ziegler, C" uniqKey="Piot Ziegler C">C Piot-Ziegler</name></author><author><name sortKey="Todd, C" uniqKey="Todd C">C Todd</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Capato, T" uniqKey="Capato T">T Capato</name></author><author><name sortKey="Souto, P" uniqKey="Souto P">P Souto</name></author><author><name sortKey="Zan, T" uniqKey="Zan T">T Zan</name></author><author><name sortKey="Barbosa, Er" uniqKey="Barbosa E">ER Barbosa</name></author><author><name sortKey="Piemonte, Mep" uniqKey="Piemonte M">MEP Piemonte</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Brésil</li></country><region><li>État de São Paulo</li></region><settlement><li>São Paulo</li></settlement><orgName><li>Université de São Paulo</li></orgName></list><tree><noCountry><name sortKey="Avila, Patricia" sort="Avila, Patricia" uniqKey="Avila P" first="Patrícia" last="Ávila">Patrícia Ávila</name><name sortKey="Tornai, Juliana" sort="Tornai, Juliana" uniqKey="Tornai J" first="Juliana" last="Tornai">Juliana Tornai</name></noCountry><country name="Brésil"><region name="État de São Paulo"><name sortKey="Capato, Tamine Teixeira Da Costa" sort="Capato, Tamine Teixeira Da Costa" uniqKey="Capato T" first="Tamine Teixeira Da Costa" last="Capato">Tamine Teixeira Da Costa Capato</name></region><name sortKey="Barbosa, Egberto Reis" sort="Barbosa, Egberto Reis" uniqKey="Barbosa E" first="Egberto Reis" last="Barbosa">Egberto Reis Barbosa</name><name sortKey="Piemonte, Maria Elisa Pimentel" sort="Piemonte, Maria Elisa Pimentel" uniqKey="Piemonte M" first="Maria Elisa Pimentel" last="Piemonte">Maria Elisa Pimentel Piemonte</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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