A treadmill training program in a gamified virtual reality environment combined with transcranial direct current stimulation in Parkinson's Disease: Study protocol for a randomized controlled trial

• Published in: PloS one 2024-07, Vol.19 (7), p.e0307304
• Main Authors: Bosch-Barceló, Pere, Climent-Sanz, Carolina, Martínez-Navarro, Oriol, Masbernat-Almenara, Maria, Pakarinen, Anni, Ghosh, Pradip K, Fernández-Lago, Helena
• Format: Article
• Language: English
• Subjects: Aged; Biology and Life Sciences; Biomedical research; Clinical trials; Cognition; Cognitive ability; Cognitive learning; Cognitive tasks; Cognitive therapy; Computer and Information Sciences; Computer applications; Direct current; Disease control; Diseases; Dopamine; Earth Sciences; Electrical stimulation of the brain; Engineering and Technology; ESB; Exercise Therapy - methods; Female; Fitness equipment; Gait; Gait - physiology; Gait recognition; Gamification; Humans; Intervention; Learning; Male; Medical research; Medicine and Health Sciences; Medicine, Experimental; Middle Aged; Motor ability; Motor skill; Motor skill learning; Movement disorders; Neurodegenerative diseases; Neurology; Parkinson Disease - physiopathology; Parkinson Disease - rehabilitation; Parkinson Disease - therapy; Parkinson's disease; Physical therapy; Randomized Controlled Trials as Topic; Rehabilitation; Research and Analysis Methods; Skills; Social Sciences; Spain; Study Protocol; Therapeutics, Physiological; Training; Transcranial Direct Current Stimulation - methods; Treadmills; Virtual Reality; Walking
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0307304

Parkinson's Disease (PD) affects movement and cognition, and physiotherapy, particularly treadmill gait training, has potential in addressing movement dysfunctions in PD. However, treadmill training falls short in addressing cognitive aspects and adherence. Virtual reality (VR) and gamification can enhance motor and cognitive retraining and improve adherence. People with Parkinson's Disease (PWPD) have decreased motor skill learning efficiency, but tDCS can improve motor and cognitive learning. 78 participants with PD will be randomly allocated in a 1:1:1 ratio to one of three groups: (1) treadmill + Gamified Virtual Reality Environment (GVRE) + tDCS training group; (2) treadmill + GVRE training group or (3) treadmill training group. Participants will follow a 6-week, 12-session treadmill gait training plan, gradually increasing session duration from 20 to 45 minutes. Participants in (1) and (2) will undergo a GVRE training protocol, with (1) also receiving tDCS for the first 20 minutes of each session. Assessments will occur at baseline, post-intervention, and at a 6-week follow-up. The primary outcome measure will be gait speed during single and dual-task performance. Secondary measures will include additional gait parameters, executive tests for cognitive performance, and clinical outcomes for disease stage, cognitive status, and physical condition. This randomized clinical trial presents an innovative neurorehabilitation protocol that aims to improve gait and cognition in PWPD. The study also examines how tDCS can enhance motor and cognitive training. Results could contribute to enhancing the motor and cognitive state of PWPD through a GVRE and tDCS-based neurorehabilitation protocol. NCT05243394. 28/02/2024 -v3.2.