A Randomized Clinical Trial to Evaluate a Digital Therapeutic to Enhance Gait Function in Individuals With Parkinson's Disease.

Background: Postural instability and gait dysfunction (PIGD) is a cardinal symptom of Parkinson's disease (PD) and is exacerbated under dual-task conditions. Dual-task training (DTT), enhances gait performance, however it is time and cost intensive. Digitizing DTT via the Dual-task Augmented Reality...

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Publicado en:Neurorehabilitation & Neural Repair Vol. 37; no. 9; pp. 603 - 617
Autores principales: Alberts, Jay L., Kaya, Ryan D., Penko, Amanda L., Streicher, Matthew, Zimmerman, Eric M., Davidson, Sara, Walter, Benjamin L., Rosenfeldt, Anson B.
Formato: pictorial research tables/charts randomized controlled trial Journal Article
Publicado: Sage Publications Inc. Sep2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2023
      vid: 37
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: A Randomized Clinical Trial to Evaluate a Digital Therapeutic to Enhance Gait Function in Individuals With Parkinson's Disease.
      aug:
        au:
          Alberts, Jay L.
          Kaya, Ryan D.
          Penko, Amanda L.
          Streicher, Matthew
          Zimmerman, Eric M.
          Davidson, Sara
          Walter, Benjamin L.
          Rosenfeldt, Anson B.
        affil: Department of Biomedical Engineering, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, USA
      sug:
        subj:
          Parkinson Disease Therapy
          Digital Health
          Digital Technology
          Therapeutic Exercise
          Task Performance and Analysis
          Gait Disorders, Neurologic
          Balance, Postural Physiology
          Gait Physiology
          Human
          Male
          Randomized Controlled Trials
          Random Assignment
          Single-Blind Studies
          Descriptive Statistics
          Comparative Studies
          Functional Assessment
          Health Care Delivery
          Functional Status
          Funding Source
          Male
      ab: Background: Postural instability and gait dysfunction (PIGD) is a cardinal symptom of Parkinson's disease (PD) and is exacerbated under dual-task conditions. Dual-task training (DTT), enhances gait performance, however it is time and cost intensive. Digitizing DTT via the Dual-task Augmented Reality Treatment (DART) platform can expand the availability of an effective intervention to address PIGD. Objective: The aim of this project was to evaluate DART in the treatment of PIGD in people with PD compared to a Traditional DTT intervention. It was hypothesized that both groups would exhibit significant improvements in gait, and the improvements for the DART group would be non-inferior to Traditional DTT. Methods: A single-blind randomized controlled trial was conducted with 47 PD participants with PIGD. Both groups completed 16 therapeutic sessions over 8 weeks; the DART platform delivered DTT via the Microsoft HoloLens2. Primary outcomes included clinical ratings and single- and dual-task gait biomechanical outcomes. Results: Clinical measures of PD symptoms remained stable for DART and Traditional DTT groups. However, both groups exhibited a significant increase in gait velocity, cadence, and step length during single- and multiple dual-task conditions following the interventions. Improvements in gait velocity in the DART group were non-inferior to Traditional DTT under the majority of conditions. Conclusion: Non-inferior improvements in gait parameters across groups provides evidence of the DART platform being an effective digital therapeutic capable of improving PIGD. Effective digital delivery of DTT has the potential to increase use and accessibility to a promising, yet underutilized and difficult to administer, intervention for PIGD. Clinical Trial Registration: ClinicalTrials.gov Dual-task Augmented Reality Treatment for Parkinson's Disease (DART) NCT04634331; posted November 18, 2020.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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