Self-controlled Practice on Motor Learning and Motivation in Parkinson's Disease

Официальное название

Effects of Self-controlled Practice on Motor Learning and Motivation in People With Parkinson's Disease

Обзор

People with Parkinson's disease have been known to have low motivation and motor learning impairment, which might limit the effectiveness of neurorehabilitation, exacerbate motor performance and quality of life, and increase the burden on caregivers. Therefore, enhancing motor learning ability and motivation is crucial for people with PD. According to the OPTIMAL theory, practice under self-controlled conditions has been shown to improve motivation and learning in healthy individuals. However, few studies have explored the effects of self-controlled practice on motor learning and motivation in people with PD and examined the underlying neurophysiological mechanisms. This study aims to investigate the effects of self-controlled practice on motor learning and motivation in people with PD, as well as the associated neurophysiological changes. People with PD and age-matched healthy controls without neurological disorders will be recruited. Participants will be pair-matched based on age, gender, and disease severity, and then assigned to either the self-controlled group or the yoked group. The participants will be required to visit the lab for a total of three times in one week: on Day 1 for baseline assessments, neurophysiological evaluation using transcranial magnetic stimulation (TMS), practice of the trajectory matching task, motivation evaluation, and exercise education; on Day 2 for additional trajectory matching task practice, motivation evaluation, immediate retention test of the task, neurophysiological evaluation using TMS, and exercise education; and on Day 7 for delayed retention and transfer tests and final TMS assessment. On Days 1 and 2, all participants will practice the trajectory matching task. At the beginning of each trial, a target trajectory will be shown, and participants will be asked to replicate it using a joystick. Feedback will be provided after each trial to indicate accuracy. The self-controlled group will be allowed to choose the story contents they prefer when practicing the task, and the exercise they would like to learn after the task. In contrast, yoked participants will receive the same story and exercise education as their matched counterparts in the self-controlled group. This study will help clarify the effects of self-controlled practice on motor learning and motivation in people with PD, offering a new perspective for clinical interventions and emphasizing the importance of patients actively participating in treatment planning.

Первичные конечные точки

• Root mean square error (RMSE) [Срок оценки: Day 1 (practice phase), day 2 (practice phase and immediate retention), and day 7 (delayed retention and transfer)]

Вторичные конечные точки (8)

• Error estimation (EE) test [Срок оценки: Day 2 (immediate retention) and day 7 (delayed retention and transfer)]
• Motivation evaluation [Срок оценки: Day 1 and 2]
• Transcranial magnetic stimulation (TMS) assessment [Срок оценки: Day 1, 2, and 7]
• Movement Disorder Society Unified Parkinson's Disease Rating Scale [Срок оценки: Day 1]
• Apathy Evaluation Scale [Срок оценки: Day 1]
• short-form Lille Apathy Rating Scale [Срок оценки: Day 1]
• Montreal Cognitive Assessment (MoCA) [Срок оценки: Day 1]
• Hospital Anxiety and Depression Scale (HADS) [Срок оценки: Day 1]

Критерии участия

Критерии включения

• age above 20-year-old
• able to follow instructions and the rules of the motor task
• do not have surgery or injury in their upper extremities in the past 6 months

Критерии исключения

• neurological disorders other than PD
• symptoms of severe tremor in upper extremities
• symptoms of anxiety and depression
• deep brain stimulator or pacemaker implanted in the body
• history of seizure or epilepsy
• unstable medical conditions
• migraines or tinnitus uncontrolled by medication
• pregnant

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Тайвань · 1 центр

• School and Graduate Institute of Physical Therapy — Taipei

Публикации

• Lewthwaite R, Chiviacowsky S, Drews R, Wulf G. Choose to move: The motivational impact of autonomy support on motor learning. Psychon Bull Rev. 2015 Oct;22(5):1383-8. doi: 10.3758/s13423-015-0814-7. PMID 25732095
• Wulf G, Lewthwaite R. Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning. Psychon Bull Rev. 2016 Oct;23(5):1382-1414. doi: 10.3758/s13423-015-0999-9. PMID 26833314
• Chiviacowsky S, Wulf G, Lewthwaite R, Campos T. Motor learning benefits of self-controlled practice in persons with Parkinson's disease. Gait Posture. 2012 Apr;35(4):601-5. doi: 10.1016/j.gaitpost.2011.12.003. Epub 2011 Dec 30. PMID 22209649

Идентификаторы

NCT: NCT07028515 · 202503040RINA

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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