Cognitive Cueing + Video Intervention for Parkinson's Disease

(CogCueVidPD Trial)

Overseen By Sarah V Park

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Western University, Canada

Disqualifiers: Deep brain stimulation, SMMSE < 24, others

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

Compensation: Varies

Number of Visits: 4

Duration: 17 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if mental prompts (Cognitive Cue) while walking can help people with Parkinson's Disease improve their gait and confidence in their balance. It also examines whether adding a personalized video (Gait Training Video) to these mental prompts can lead to further improvements. Participants will practice walking with these cues and videos and share their experiences. This trial suits those diagnosed with Parkinson's Disease who can walk independently for at least 10 minutes and are fluent in English. As an unphased trial, this study offers participants a unique opportunity to contribute to innovative research that could enhance walking and balance confidence for those with Parkinson's Disease.

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 seems focused on walking and cognitive cues, so you may not need to change your medication routine.

What prior data suggests that this cognitive cueing and video intervention is safe for individuals with Parkinson's Disease?

Research shows that thinking about taking big steps while walking is generally safe for people with Parkinson's disease. Studies have found that these mental reminders can improve walking and reduce the risk of falls. People with Parkinson's report handling these cues well, and no major safety issues have emerged.

Similarly, using personalized videos for walking exercises at home is safe for people with Parkinson's. Reviews of video-based training for balance and walking suggest it is safe and can enhance movement. Most people manage this type of training well, without significant side effects.

Overall, existing research considers both methods—mental reminders and training videos—safe and well-tolerated. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Cognitive Cueing + Video Intervention for Parkinson's Disease because it explores a novel approach to managing symptoms. Unlike standard treatments such as medications like Levodopa, which primarily aim to replenish dopamine levels, this intervention focuses on cognitive cueing combined with video prompts to enhance motor function and daily activity engagement. The use of video technology as a therapeutic tool is particularly promising, as it offers patients a more interactive and engaging way to manage their condition, potentially improving adherence and quality of life. This approach also opens up possibilities for remote therapy, making it more accessible for patients who may have difficulty with regular in-person visits.

What evidence suggests that cognitive cueing and gait training video could be effective for Parkinson's Disease?

This trial will compare the effects of cognitive cueing and gait training videos on movement and balance in people with Parkinson's Disease. Research has shown that mental reminders, such as thinking about taking bigger steps, can help individuals with Parkinson's Disease walk more effectively, resulting in faster and steadier walking. One study found that these reminders also improve balance and overall quality of life. Additionally, personalized walking training videos have increased walking speed and step length, improved balance, and boosted confidence in avoiding falls. Participants in this trial will receive either cognitive cueing or gait training videos to assess their impact on movement and balance. ^{2 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for individuals with Parkinson's Disease who are interested in improving their walking, mobility, and balance confidence. Participants will be asked to complete walking trials, use a personalized gait training video at home, fill out online surveys about their condition and experiences, and visit the research facility several times.

Inclusion Criteria

Fluent in English

I have been diagnosed with Parkinson's Disease.

I don't have brain-related health issues like tumors or recent injuries.

Exclusion Criteria

Presence of Deep Brain Stimulation (DBS) implant

Standardized Mini Mental State Examination (SMMSE) score less than 24

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants complete initial walking trials and online surveys to assess gait, mobility, balance confidence, and quality of life

1 week

1 visit (in-person)

Treatment

Participants practice cognitive cueing and personalized gait training video at home, with periodic assessments at the research facility

17 weeks

3-4 visits (in-person)

Follow-up

Participants are monitored for changes in gait, mobility, balance confidence, and quality of life after the treatment phase

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Cognitive Cue
• Gait Training Video

Trial Overview The study tests if cognitive cueing (thinking about specific walking techniques) alone or combined with a personalized gait training video can enhance gait and mobility in Parkinson's patients. It compares changes over time in participants' walking ability when using these methods separately or together.

How Is the Trial Designed?

Group I: Video Start Experimental Treatment 2 Interventions

Group II: Video Delay Experimental Treatment 2 Interventions

Who Is Running the Clinical Trial?

Western University, Canada

Lead Sponsor

Trials

270

Recruited

62,500+

Published Research Related to This Trial

A novel client-centered cognitive strategy training intervention for people with Parkinson's disease (PD) was found to be feasible and well-accepted, with high participant satisfaction and engagement scores.

The intervention showed promising effects on self-identified cognitive problems, with significant improvements in functional ratings measured by the Canadian Occupational Performance Measure (COPM) after treatment sessions lasting an average of 9.2 weeks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of a cognitive strategy training intervention for people with Parkinson's disease. Foster, ER., Spence, D., Toglia, J.[2019]

Computerized cognitive training (CCT) has been shown to provide small but statistically significant improvements in overall cognitive function for people with Parkinson's disease, particularly benefiting those with mild cognitive impairment (PD-MCI).

The study analyzed 17 trials with 679 participants and found that greater doses of CCT were linked to larger cognitive benefits, indicating that CCT can be effective even when delivered remotely, but more extensive trials are needed to determine the best training regimens.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Computerized cognitive training in Parkinson's disease: A systematic review and meta-analysis. Gavelin, HM., Domellöf, ME., Leung, I., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9671304/

Brain activity response to cues during gait in Parkinson's ... Our recent fNIRS study showed no change in PFC activity in PD with tactile cues compared to usual walking, which was despite gait improvements ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S2590112524000550

The effect of tactile cueing on dual task performance in ... The meta-analysis provides weak evidence that tactile cueing may enhance walking speed and step length in DT conditions in PD.

3. mdpi.com mdpi.com/2076-3417/14/24/11781

Cueing Interventions for Gait and Balance in Parkinson's ... This review explores the effectiveness of cueing on gait, balance, and quality of life outcomes in PD. Methods: A scoping review of six studies was conducted, ...

4. clinicaltrials.gov clinicaltrials.gov/study/NCT06941779

CuePD: Investigating the Effect of Personalised Auditory ... This research project aims to examine personalised auditory cueing to improve gait in PwPD. Inertial sensors will capture and analyze validated gait-related ...

5. nature.com nature.com/articles/s41598-018-33942-6

Internal cueing improves gait more than external cueing in ... Results indicate that internal cueing was associated with improvements in gait velocity, cadence, and stride length in the backward direction.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8593320/

Brain Activity Response to Visual Cues for Gait Impairment in ... Gait impairments are common in Parkinson's disease (PD) and increase falls risk. Visual cues can improve gait in PD, particularly freezing of gait (FOG), but ...

7. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0306452222005401

Does Cueing Need Attention? A Pilot Study in People with ... Poor sleep quality is associated with cognitive, mobility, and anxiety disability that underlie freezing of gait in Parkinson's disease. Gait ...

8. movementdisorders.onlinelibrary.wiley.com movementdisorders.onlinelibrary.wiley.com/doi/10.1002/mds.29889

Investigating the Brain Mechanisms of Externally Cued Sit‐to ... These findings provide the first neural evidence for why and how cueing improves motor function in sit-to-stand movement in Parkinson's disease.

9. mdpi.com mdpi.com/1424-8220/22/18/6746

Visual Cues for Turning in Parkinson's Disease Findings suggest that visual cueing can modify turning during walking in PD, with response influenced by FoG status and turn amplitude.