RecruitingNot ApplicableNCT06104072

Effect of Adding Computerized Cognitive Training on Balance, Locomotion and Cognition in Parkinson's Disease

Adding Computer-based Cognitive Training to Conventional Rehabilitation Can Affect Postural Stability , Locomotion and Cognition in Parkinson's Disease Patients

Sponsor

Engy Badreldin Saleh Moustafa, PhD

Enrollment

70 participants

Start Date

May 23, 2024

Study Type

INTERVENTIONAL

Conditions

Parkinson Disease

Summary

BACKGROUND: Postural instability and gait abnormalities are cardinal features in Parkinson's disease (PD). It represents one of the most disabling symptoms in the advanced stages of the disease. The purpose of this study was to evaluate the immediate and long-term effects of adding computer-based cognitive training to physical therapy interventions on postural stability, locomotion, and cognitive performance in Parkinson's disease patients.

Eligibility

Min Age: 58 YearsMax Age: 70 Years

Inclusion Criteria7

Egyptian Parkinson's Disease patients of both sex , all patients fulfilled the U.K Parkinson's Disease Brain Bank Criteria for diagnosis of idiopathic PD.
The patients' age ranged from 58 to 68 years.
The duration of illness ranged from two to five years.
The severity of the disease ranged from mild to moderate disability according to UPDRS motor scores (part III) and Modified Hoehn and Yahr staging (stage 2.5\&3) .
Cognitive function ranged from 65 to 81 according to Parkinson's Disease-Cognitive Rating Scale (PD-CRS) that indicates mild cognitive impairment.
The patients with mild balance and gait impairments
Medically and psychologically stable patients and of adequate cardiac function to adhere to the protocol.

Exclusion Criteria11

Patients with secondary parkinsonism (Drug-induced, post traumatic, or post infectious) or atypical parkinsonism.
Patients with major language disturbance, severe physical, auditory or visual impairment affecting their ability to complete testing.
Patients with magnetic devices or any other implanted device (e.g., metallic implants such as pacemakers, surgical aneurysm clips…etc).
Patients with a history of seizure, head injury or brain surgery.
Complicating or unstable cardiovascular disease (unstable angina, recent myocardial infarction within the last three months, congestive heart failure, significant heart valve dysfunction, or unstable hypertension) or pulmonary disorders.
Patients with musculoskeletal disorders such as severe arthritis, knee surgery, total hip joint replacement, lower limb fractures or contractures of fixed deformity.
Patients with evidence from the history, physical examination, or special investigations for any concomitant medical or metabolic illness known to affect cognition e.g. cerebrovascular stroke, thyroid or parathyroid disease, hepatic or renal failure.
Patients receiving certain drugs known to improve cognition (e.g. rivastigmine, memantine…..etc).
Patients with current or prior history of major psychiatric disorder and/or current use of anxiolytic, neuroleptic, sedative medication or sleeping aids.
Uncooperative patients.
Illiterate patients.

Interventions

DEVICEREHACOM Software

It is a computer-based cognitive rehabilitation test that includes 32 cognition training tasks for attention/concentration, reaction behavior, memory , logical reasoning \& executive functioning with graded difficulty . It is composed of regular PC , 1G RAM , DVD drive, 100 GB hard drive with windows XP SP3, 128 MB RAM direct 3D graphic card , Screen at least 19" , regular PC keyboard or Rehacom panel \& printer .The Rehacom software version is (patientenpult (1990-1997) EN/ISO-13485-certified). * For each Cognitive training domain there is one hundred levels of difficulty. * Each patient is evaluated from level one(1) ang gradually increase the difficulty till we reach the level that will be used in the treatment sessions as the patient's performance improve we can proceed to the next level. * The period of the session was chosen to be maximum (60 minutes) for each patient with five minutes rest in between each level.

OTHERA Designed Physical Therapy Program

A designed physiotherapy program consisted of aerobic exercise on treadmill, stretching exercise, Proprioceptive neuromuscular facilitation (PNF) techniques, Graduated active exercises, postural correction, gait training, balance training on different base of supports using static and dynamic balance training with reciprocal and weight shifting exercises.