Motor Control Evaluation for Parkinson's Disease

Overseen By Hyosub Kim, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Delaware

Must be taking: Dopaminergic, Dopamine agonists

Disqualifiers: Musculoskeletal conditions, Seizure disorders, others

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

Compensation: Varies

Number of Visits: Unknown

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to understand how people with Parkinson's disease control their arm movements, especially during sudden environmental changes. Participants will perform reaching tasks in a virtual reality setting to help researchers learn more about motor control in Parkinson's. Suitable candidates have Parkinson's disease, take specific medication for it, and can reach about 8 inches with their arms.

As an unphased trial, this study allows participants to contribute to foundational research that could lead to better understanding and treatment of Parkinson's disease.

Will I have to stop taking my current medications?

The trial requires participants with Parkinson's to be currently taking dopaminergic or dopamine agonist medications, so you will not need to stop these medications.

What prior data suggests that this motor control assessment is safe for participants?

Research has shown that smart devices can safely monitor and assess movement in people with Parkinson's disease. These devices provide continuous and accurate information, tracking movement without causing harm. Studies also indicate that physical exercise is generally safe and beneficial for improving movement in Parkinson's patients.

The tools used in these assessments are non-invasive, meaning they don't physically touch or enter the body. This makes them easy to use, with no reports of serious side effects. While this trial focuses on understanding movement control through virtual reality, similar studies using digital devices have demonstrated their safety for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Motor Control Assessment for Parkinson's Disease because it offers a fresh approach to understanding and managing the condition. Unlike standard treatments that primarily focus on medication to manage symptoms, this assessment emphasizes evaluating and improving motor control through behavioral testing. This method aims to provide deeper insights into the specific motor challenges faced by patients, potentially leading to more personalized and effective strategies for managing Parkinson's Disease. By focusing on motor control, researchers hope to enhance quality of life beyond what current medications achieve.

What evidence suggests that this motor control assessment is effective for evaluating Parkinson's disease?

Research has shown that studying motor control aids in understanding movement problems in Parkinson's disease. In this trial, participants will undergo behavioral testing to evaluate motor control. One test, the PD-FUNC, monitors disease progression and medication effectiveness. Virtual reality allows these tests to assess how individuals with Parkinson's handle various movement challenges. This testing provides important insights into how the disease affects daily movements. Understanding these patterns may help individuals manage Parkinson's symptoms more effectively. ^{3 4 6 7 8}

Who Is on the Research Team?

Hyosub Kim, PhD

Principal Investigator

University of Delaware

Are You a Good Fit for This Trial?

This trial is for people aged 18-85 with Parkinson's Disease who can make reaching movements and are on Parkinson's medication. They must have a good level of mental function (MMSE score ≥ 26/30) and be able to attend all test sessions.

Inclusion Criteria

MMSE score ≥ 26/30

I can reach out about 8 inches.

I can attend all required testing sessions.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants perform reaching movements in a virtual reality setup with visual and force perturbations applied

4-6 weeks

Multiple sessions (in-person)

Follow-up

Participants are monitored for safety and effectiveness after intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Motor Control Assessment

Trial Overview The study focuses on understanding motor control in Parkinson's patients by observing their responses to changes while they reach for things in virtual reality.

How Is the Trial Designed?

Group I: Behavioral testing Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

University of Delaware

Lead Sponsor

Trials

167

Recruited

25,700+

National Institutes of Health (NIH)

Collaborator

Trials

2,896

Recruited

8,053,000+

Published Research Related to This Trial

The oral combination of melevodopa/carbidopa has been shown to improve motor fluctuations in over 743 Parkinson's disease patients, with a faster absorption and more effective delivery compared to standard levodopa formulations.

Treatment with melevodopa/carbidopa does not increase the risk of adverse effects or levodopa-induced dyskinesias, suggesting it is a safe alternative for managing motor symptoms in Parkinson's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review on the clinical experience with melevodopa/carbidopa fixed combination in patients with Parkinson disease. Stocchi, F., Vacca, L.[2020]

Quantitative measures of motor performance, such as movement time and reaction time, can detect early signs of Parkinson's disease in patients with symptoms lasting less than 2 years, indicating their potential for early diagnosis.

Tests focusing on bradykinesia were found to be the most sensitive for detecting early Parkinson's disease, while rest tremor detection was the most specific, suggesting these tests could be useful for screening at-risk individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Electrophysiologic analysis of early Parkinson's disease. Watts, RL., Mandir, AS., Ahn, KJ., et al.[2019]

The MLS motor performance test, which includes assessing 'tapping' regularity, provides a reliable method for evaluating motor dexterity in patients with Parkinson's disease, addressing issues of low interrater reliability found in traditional clinical scores.

This test allows for objective evaluation of therapeutic success by comparing motor performance results before and after treatment, making it a practical tool for therapy control in multicenter studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment of symptoms of Parkinson's disease by apparative methods. Kraus, PH., Klotz, P., Fischer, A., et al.[2004]

The Advanced Sensing for Assessment of Parkinson's disease (ASAP) protocol provides a quantitative and reliable way to measure motor impairment in individuals with early to moderate Parkinson's disease, using grip force tracking under varying cognitive loads.

In a study of 30 participants, the ASAP protocol was able to predict scores on the Unified Parkinson Disease Rating Scale (UPDRS) with a mean prediction error of about 3.5 points, accounting for 76% of the variability, indicating its potential to track changes in motor symptoms over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Application of modified regression techniques to a quantitative assessment for the motor signs of Parkinson's disease. Brewer, BR., Pradhan, S., Carvell, G., et al.[2021]

Motor fluctuations and dyskinesias are common and debilitating complications in Parkinson's disease patients within the first few years of treatment, significantly impacting their quality of life.

New therapeutic options, such as subcutaneous apomorphine and deep-brain stimulation, are available for patients who continue to experience motor complications despite optimal medical management, potentially improving both motor and nonmotor symptoms of the disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Management of motor complications in Parkinson disease: current and emerging therapies. Espay, AJ.[2013]

A new measurement system using a digitizing tablet effectively evaluates motor block (MB) during hand movements in patients with Parkinson's disease, providing objective data on this condition.

The results from the digitizing tablet correlated well with traditional assessments of freezing in the Unified Parkinson's Disease Rating Scale, suggesting that this low-cost tool could enhance clinical evaluations of motor block in PD patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A method to assess hand motor blocks in Parkinson's disease with digitizing tablet. Popovic, MB., Dzoljic, E., Kostic, V.[2019]

The review identified eight rating scales for assessing drug-induced dyskinesia in Parkinson's disease, with the Abnormal Involuntary Movement Scale (AIMS) and the Rush Dyskinesia Rating Scale being the only ones currently recommended for use, albeit with weak support.

The newer scales, PDYS-26 and UDysRS, show excellent clinimetric properties and could become recommended tools if validated in broader clinical settings, highlighting the need for further testing before introducing new scales.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Task force report on scales to assess dyskinesia in Parkinson's disease: critique and recommendations. Colosimo, C., Martínez-Martín, P., Fabbrini, G., et al.[2022]

Levodopa remains the most effective treatment for Parkinson's disease, but its long-term use can lead to motor fluctuations and dyskinesias, prompting clinicians to consider alternative therapies like MAO-B inhibitors and dopamine agonists as first-line treatments.

Despite advances in treatment options, there is currently no therapy available that can alter the progression of Parkinson's disease, highlighting the need for ongoing research into new drugs that are safe, effective, and capable of providing symptomatic relief.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recent developments in the pharmacological treatment of Parkinson's disease. Tuite, P., Riss, J.[2019]

In a study of 154 participants, those with Parkinson's disease who received treatment guided by objective measurements showed significant improvements in their overall disability scores compared to those who were treated based on conventional assessments.

The use of objective measurements led to better management of both motor and non-motor symptoms of Parkinson's disease, highlighting the importance of incorporating technology into treatment strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A blinded, controlled trial of objective measurement in Parkinson's disease. Woodrow, H., Horne, MK., Fernando, CV., et al.[2020]

This study successfully identified objective methods to assess motor symptoms in Parkinson's disease (PD) patients, distinguishing between those treated with deep brain stimulation (DBS) and those treated with levodopa, using advanced sensor technology.

The classification accuracy of the methods was high, with 81% for training and 71% for test groups, indicating that these objective measures can effectively differentiate between healthy individuals and those with PD, enhancing the evaluation of treatment efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feature visualization and classification for the discrimination between individuals with Parkinson's disease under levodopa and DBS treatments. Machado, AR., Zaidan, HC., Paixão, AP., et al.[2018]

The Unified Parkinson's Disease Rating Scale is the most commonly used outcome measure in clinical trials for Parkinson's disease, but it has limitations such as poor inter-rater reliability and a lack of focus on nonmotor symptoms, prompting a revision to improve its effectiveness.

There is a significant need for better-defined measures of motor complications and quality of life in Parkinson's disease trials, as current methods lack consensus and validation, which could impact the assessment of neuroprotective therapies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcome measures for clinical trials in Parkinson's disease: achievements and shortcomings. Marras, C., Lang, AE.[2019]

In a study of 450 Parkinson's disease patients, switching from standard levodopa to Sinemet CR led to significant improvements in motor function and daily living activities, especially in those with motor complications.

The treatment was generally well-tolerated, with only 10% of patients discontinuing due to side effects, and a majority of patients preferred Sinemet CR over their previous treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Quality of life in patients with Parkinson's disease who transfer from standard levodopa to Sinemet CR: the STAR Study. The STAR Multicenter Study Group. Grandas, F., Martínez-Martín, P., Linazasoro, G.[2019]

The quantitative movement analysis (QMA) technique is a reliable and valid measure for assessing MS tremor and is sensitive to improvements following thalamic surgery, making it suitable for clinical trials.

Standard disability scales were found to be insensitive to functional improvements after surgery, while the box and blocks test effectively distinguished between patients with varying degrees of surgical success.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Surgical therapy for tremor in multiple sclerosis: an evaluation of outcome measures. Matsumoto, J., Morrow, D., Kaufman, K., et al.[2022]

Quantitative measures of motor performance, such as movement time and reaction time, can detect early signs of Parkinson's disease in patients with symptoms lasting less than 2 years, indicating their potential for early diagnosis.

Tests focusing on bradykinesia were found to be the most sensitive for detecting early Parkinson's disease, while rest tremor detection was the most specific, suggesting these tests could be useful for screening at-risk individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Electrophysiologic analysis of early Parkinson's disease. Watts, RL., Mandir, AS., Ahn, KJ., et al.[2006]

The ASAP protocol, which uses sensors to measure grip force under varying cognitive loads, provides a quantitative and reliable way to assess motor impairment in individuals with early to moderate Parkinson's disease, based on a study of 30 participants.

The protocol demonstrated a mean prediction error of about 3.5 points on the Unified Parkinson Disease Rating Scale (UPDRS), accounting for 76% of the variability in scores, suggesting it can effectively track changes in motor symptoms over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Application of Modified Regression Techniques to a Quantitative Assessment for the Motor Signs of Parkinson's Disease. Brewer, ., Pradhan, S., Carvell, G., et al.[2021]

Citations

1. nature.com nature.com/articles/s41598-025-96594-3

Parkinson's disease functional movement battery a ... The PD-FUNC could provide a comprehensive assessment within 30–40 min and could be used to evaluate disease progression and medication ...

2. frontiersin.org frontiersin.org/journals/computer-science/articles/10.3389/fcomp.2020.00020/full

Innovative Parkinson's Disease Patients' Motor Skills ... The Assessment Tests of the iPrognosis Games can be used as an important component of self-management, by bringing PD symptoms handling to patients at their own ...

3. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/n/ukhta2830/s3/

Results of the review of clinical effectiveness - - NCBI - NIH This suggests that PKG is able to measure key PD motor outcomes. The one study of sleep disturbance showed slightly poorer diagnostic accuracy (80% sensitivity, ...

4. neurology.org neurology.org/doi/10.1212/WNL.0000000000200236

Outcome Assessment in Parkinson Disease Prevention Trials In this review, we will cover the current state of the field for measuring motor performance in the prodromal phase of PD and approaches to assessment.

5. jmir.org jmir.org/2025/1/e71169

Effectiveness of Telemedicine Interventions on Motor and ... Outcomes assessed included total motor symptoms, quality of life, cognitive function, depressive and anxiety symptoms, fear of falling, 6-minute ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9723979/

Digital Devices for Assessing Motor Functions in Mobility ... With the advent of smart sensing technology, mobile and wearable devices can provide continuous and objective monitoring and assessment of motor function ...

7. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/36602886/

Physical exercise for people with Parkinson's disease Eighty-five studies (5192 participants) provided safety data. Here, we present the main results. We observed evidence of beneficial effects for ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S1360859225004231

A proposal for adaptation to Parkinson's disease (AFAS-PD) To describe the adaptation process of the assessment of aquatic motor skills using the Aquatic Functional Assessment Scale (AFAS) for people ...