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Concurrent transcranial direct current stimulation and progressive resistance training in Parkinson's disease: study protocol for a randomised controlled trial

Hendy, Ashlee M., Tillman, Alex, Rantalainen, Timo, Muthalib, Makii, Johnson, Liam, Kidgell, Dawson J., Wundersitz, Daniel, Enticott, Peter G. and Teo, Wei-Peng 2016, Concurrent transcranial direct current stimulation and progressive resistance training in Parkinson's disease: study protocol for a randomised controlled trial, Trials, vol. 17, Article number: 326, pp. 1-13, doi: 10.1186/s13063-016-1461-7.

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Title Concurrent transcranial direct current stimulation and progressive resistance training in Parkinson's disease: study protocol for a randomised controlled trial
Author(s) Hendy, Ashlee M.
Tillman, Alex
Rantalainen, TimoORCID iD for Rantalainen, Timo orcid.org/0000-0001-6977-4782
Muthalib, Makii
Johnson, Liam
Kidgell, Dawson J.
Wundersitz, Daniel
Enticott, Peter G.ORCID iD for Enticott, Peter G. orcid.org/0000-0002-6638-951X
Teo, Wei-PengORCID iD for Teo, Wei-Peng orcid.org/0000-0003-3929-9778
Journal name Trials
Volume number 17
Season Article number: 326
Start page 1
End page 13
Total pages 13
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2016
ISSN 1745-6215
Keyword(s) Parkinson's disease
balance
gait
neuroplasticity
non-invasive brain stimulation
fNIRS
Summary BACKGROUND: Parkinson's disease (PD) results from a loss of dopamine in the brain, leading to movement dysfunctions such as bradykinesia, postural instability, resting tremor and muscle rigidity. Furthermore, dopamine deficiency in PD has been shown to result in maladaptive plasticity of the primary motor cortex (M1). Progressive resistance training (PRT) is a popular intervention in PD that improves muscular strength and results in clinically significant improvements on the Unified Parkinson's Disease Rating Scale (UPDRS). In separate studies, the application of anodal transcranial direct current stimulation (a-tDCS) to the M1 has been shown to improve motor function in PD; however, the combined use of tDCS and PRT has not been investigated.

METHODS/DESIGN: We propose a 6-week, double-blind randomised controlled trial combining M1 tDCS and PRT of the lower body in participants (n = 42) with moderate PD (Hoehn and Yahr scale score 2-4). Supervised lower body PRT combined with functional balance tasks will be performed three times per week with concurrent a-tDCS delivered at 2 mA for 20 minutes (a-tDCS group) or with sham tDCS (sham group). Control participants will receive standard care (control group). Outcome measures will include functional strength, gait speed and variability, balance, neurophysiological function at rest and during movement execution, and the UPDRS motor subscale, measured at baseline, 3 weeks (during), 6 weeks (post), and 9 weeks (retention). Ethical approval has been granted by the Deakin University Human Research Ethics Committee (project number 2015-014), and the trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615001241527).

DISCUSSION: This will be the first randomised controlled trial to combine PRT and a-tDCS targeting balance and gait in people with PD. The study will elucidate the functional, clinical and neurophysiological outcomes of combined PRT and a-tDCS. It is hypothesised that combined PRT and a-tDCS will significantly improve lower limb strength, postural sway, gait speed and stride variability compared with PRT with sham tDCS. Further, we hypothesise that pre-frontal cortex activation during dual-task cognitive and gait/balance activities will be reduced, and that M1 excitability and inhibition will be augmented, following the combined PRT and a-tDCS intervention.
Language eng
DOI 10.1186/s13063-016-1461-7
Field of Research 110999 Neurosciences not elsewhere classified
1102 Cardiovascular Medicine And Haematology
1103 Clinical Sciences
Socio Economic Objective 920111 Nervous System and Disorders
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30085432

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.