Home Exercise for Neurodegenerative Disease

Overseen By Jennifer L Keller, PT, MS

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Disqualifiers: Uncontrolled hypertension, diabetes, dementia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

30 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve walking ability in individuals with certain neurodegenerative diseases through a home exercise program, also known as resistance training, exercise therapy, or physical therapy. Each participant will receive a personalized exercise plan to follow at home. The trial seeks individuals diagnosed with conditions such as X-linked adrenoleukodystrophy, a confirmed DARS2 mutation, cerebellar ataxia, or other similar neurodegenerative diseases. Participants must be able to stand unassisted for 30 seconds and walk for two minutes, even with the use of a cane or walker. As an unphased trial, it provides a unique opportunity to contribute to research that could enhance daily living for many.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this home exercise program is safe for individuals with neurodegenerative diseases?

Research shows that home exercise programs are generally safe for people with brain diseases like Parkinson's and Alzheimer's. Studies have found these programs easy to manage and beneficial. One study found all types of exercise, including strength training, to be safe. Specifically, strength training improved participants' ability to perform daily activities. Thus, joining a home exercise program is likely safe and could enhance daily life. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about home exercise programs for neurodegenerative diseases because they offer a personalized and accessible approach to managing symptoms. Unlike standard treatments that often rely on medications or clinic-based therapies, these home exercise programs can be tailored to individual needs and performed in the comfort of one's home, making them more convenient and potentially more engaging. This personalized approach aims to improve quality of life and maintain physical function, which is crucial for individuals with neurodegenerative conditions. Additionally, the focus on regular, physical activity may provide benefits beyond what traditional treatments can offer, such as improved mood and cognitive function.

What evidence suggests that home exercise is effective for neurodegenerative disease?

Research has shown that exercising at home benefits people with diseases affecting the brain and nerves. Physical activity improves the brain's ability to change and adapt, enhancing thinking and memory. One study found that home exercise programs can help people with Parkinson's disease improve balance and coordination. Additionally, exercise links to better overall health and can slow disease progression. This trial will evaluate an individually designed home exercise program as a potential component in managing these conditions. ^{1 2 4 6 7}

Who Is on the Research Team?

Jennifer Keller, PT

Principal Investigator

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Are You a Good Fit for This Trial?

This trial is for individuals with specific neurodegenerative diseases like ataxia, leukodystrophy, or those with cerebellar damage due to stroke or tumor. Participants must have a confirmed genetic mutation related to their condition, be able to stand and walk with or without support, and not have other health issues that could interfere with the exercise program.

Inclusion Criteria

I am a female diagnosed with X-linked adrenoleukodystrophy.

Patients with other neurodegenerative diseases similar to these disorders as determined by chart review and clinical exam

I can stand and walk without much help.

Exclusion Criteria

Other medical or psychological conditions which in the clinical judgement of the investigator would interfere with acquiring the study information or performing the exercises safely including but not limited to uncontrolled hypertension, orthopedic conditions, diabetes, seizure disorder, peripheral vestibular loss, severe aphasia, dementia, pregnancy

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in an individually designed home exercise program to improve motor function and sleep quality

12 weeks

Remote supervision

Follow-up

Participants are monitored for changes in balance and walking post intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Home exercise

Trial Overview The study tests a home exercise regimen designed to improve walking abilities in people suffering from neurodegenerative diseases. It aims to create targeted therapeutic interventions tailored for these conditions.

How Is the Trial Designed?

Group I: Home exercise Experimental Treatment 1 Intervention

Individually designed home exercise program

Who Is Running the Clinical Trial?

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Lead Sponsor

Trials

93

Recruited

25,200+

Published Research Related to This Trial

Resistance exercise programs can positively impact muscle strength and functional mobility in individuals with Parkinson's disease, as shown in a systematic review of five studies, including three randomized controlled trials.

The studies indicated that resistance training leads to increases in fat-free mass, muscle strength, and endurance, suggesting it may be an effective strategy to delay or reverse functional decline in Parkinson's disease patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of resistance training for people with Parkinson's disease: a systematic review. Brienesse, LA., Emerson, MN.[2019]

A study involving 10 clients with Parkinson's disease and Huntington's disease, along with 8 physiotherapists, revealed that both groups identified significant barriers to participating in home exercise programs, including disease-specific impairments and safety concerns.

To improve participation, it is essential for therapists to collaborate with clients to tailor exercise programs that address individual barriers and preferences, ensuring the programs are both acceptable and feasible.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Client and therapist views on exercise programmes for early-mid stage Parkinson's disease and Huntington's disease. Quinn, L., Busse, M., Khalil, H., et al.[2022]

Resistance training (RT) significantly improves knee extension, knee flexion, and leg press strength in people with Parkinson's disease compared to control groups, based on a systematic review of nine studies.

Combining RT with other forms of exercise, such as aerobic or balance training, leads to even greater improvements in strength, although RT alone may not always outperform other exercise types for certain muscle groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Resistance Training on Measures of Muscular Strength in People with Parkinson's Disease: A Systematic Review and Meta-Analysis. Roeder, L., Costello, JT., Smith, SS., et al.[2018]

A home-based multimodal exercise program for 40 older adults with mild to moderate Alzheimer's disease is expected to improve muscle strength, balance, cognition, and overall functioning after 16 weeks of training.

The study aims to provide a foundation for future clinical interventions and health promotion strategies tailored for older individuals with Alzheimer's, highlighting the potential benefits of at-home exercise for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home-based multimodal exercise program in older people with Alzheimer disease: Randomized controlled trial protocol. Cezar, NOC., Ansai, JH., de Andrade, LP.[2021]

A home-based exercise program for patients with Alzheimer's Disease (AD) showed good adherence and a trend towards improved functional performance, particularly in hand function and lower extremity strength, after 6 and 12 weeks.

Despite the positive trends in functional performance, there were also indications of worse depression and lower quality of life ratings among participants, suggesting the need for further research to optimize the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a home-based exercise program in the treatment of Alzheimer's disease: the Maximizing Independence in Dementia (MIND) study. Steinberg, M., Leoutsakos, JM., Podewils, LJ., et al.[2022]

A 2-month home exercise program for 10 patients with Parkinson's disease led to significant improvements in flexibility and muscle strength, indicating that guided exercise can enhance physical function.

The intervention also resulted in a reduction in the time spent lying down and an increase in sitting time, suggesting that it may help patients become more active in their daily lives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of home exercise on physical function and activity in home care patients with Parkinson's disease. Nakae, H., Tsushima, H.[2020]

Treadmill training is feasible and safe for individuals with Lewy body dementia (LBD) and Huntington's disease (HD), as no adverse events were reported during the sessions.

However, the study found that participants with LBD and HD did not show significant improvements in gait measures or motor function after treadmill training, suggesting that longer and more frequent sessions may be necessary to achieve beneficial effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Immediate effects of treadmill walking in individuals with Lewy body dementia and Huntington's disease. Kegelmeyer, DA., Kostyk, SK., Fritz, NE., et al.[2021]

Resistance training (RT) significantly improves muscle strength, motor impairment, mobility, balance, and quality of life in patients with Parkinson's disease, based on a meta-analysis of 18 randomized controlled trials.

While RT shows large effects compared to passive control groups, it does not demonstrate superior benefits over other physically active interventions, suggesting that any form of exercise is beneficial for Parkinson's patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Resistance Training on Motor- and Non-Motor Symptoms in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. Gollan, R., Ernst, M., Lieker, E., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11906675/

Physical activity and neuroplasticity in neurodegenerative ... PA significantly enhances neuroplasticity and cognitive function in neurodegenerative disorders through various mechanisms. Aerobic exercise, ...

2. withpower.com withpower.com/trial/phase-neurodegenerative-diseases-6-2022-501c1

Home Exercise for Neurodegenerative Disease What data supports the effectiveness of the treatment Home exercise, Resistance training, Exercise therapy, Physical therapy for neurodegenerative diseases?

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10250655/

Physical activity and lifestyle modifications in the treatment of ... Epidemiological and clinical studies of physical activity and exercise in rare neurodegenerative diseases. Study type, country, year, Sample size, disease ...

4. sciencedirect.com sciencedirect.com/science/article/pii/S1836955319300906

Home-based prescribed exercise improves balance ... Parkinson's disease is a chronic, progressive, neurodegenerative disorder. ... effectiveness of home-based prescribed exercise for people with Parkinson's disease ...

5. germanjournalsportsmedicine.com germanjournalsportsmedicine.com/archive/archive-2024/issue-7/physical-activity-and-neurodegenerative-diseases-potential-role-in-prevention-and-therapy/

Physical Activity and Neurodegenerative Diseases In this clinical review, we summarize the potential role of physical activity and exercise in prevention and therapy of neurodegenerative disease.

6. clinicaltrials.gov clinicaltrials.gov/study/NCT02510833

Study Details | Effects of Home Therapeutic Exercises ... To investigate the knowledge, attitudes and practice about home therapeutic exercises oriented in the study population;; Identify adhesion and barriers related ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT05443906?cond=(LEUKOENCEPHALOPATHY%20WITH%20BRAINSTEM%20SPINAL%20CORD%20INVOLVEMENT%20LACTATE%20ELEVATION)%20OR%20(dorsi)&checkSpell=&rank=3

Study Details | Home Exercise for Individuals with ... A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.