Concurrent exergaming and transcranial direct current stimulation to improve balance in people with Parkinson's disease: study protocol for a randomised controlled trial

Journal article

Dale M. Harris, Timo Rantalainen, Makii Muthalib, Liam Johnson, Rachel L. Duckham and Stuart T. Smith. (2018). Concurrent exergaming and transcranial direct current stimulation to improve balance in people with Parkinson's disease: study protocol for a randomised controlled trial. Trials. 19(387), pp. 1-13. https://doi.org/10.1186/s13063-018-2773-6
AuthorsDale M. Harris, Timo Rantalainen, Makii Muthalib, Liam Johnson, Rachel L. Duckham and Stuart T. Smith
Abstract

Background
People with Parkinson’s disease (PD) commonly experience postural instability, resulting in poor balance and an increased risk of falls. Exercise-based video gaming (exergaming) is a form of physical training that is delivered through virtual reality technology to facilitate motor learning and is efficacious in improving balance in aged populations. In addition, studies have shown that anodal transcranial direct current stimulation (a-tDCS), when applied to the primary motor cortex, can augment motor learning when combined with physical training. However, no studies have investigated the combined effects of exergaming and tDCS on balance in people with PD.

Methods/design
Twenty-four people with mild to moderate PD (Hoehn and Yahr scale score 2–4) will be randomly allocated to receive one of three interventions: (1) exergaming + a-tDCS, (2) exergaming + sham a-tDCS or (3) usual care. Participants in each exergaming group will perform two training sessions per week for 12 weeks. Each exergaming session will consist of a series of static and dynamic balance exercises using a rehabilitation-specific software programme (Jintronix) and 20 minutes of either sham or real a-tDCS (2 mA) delivered concurrently. Participants allocated to usual care will be asked to maintain their normal daily physical activities. All outcome measures will be assessed at baseline and at 6 weeks (mid-intervention), 12 weeks (post-intervention) and 24 weeks (3-month follow-up) after baseline. The primary outcome measure will be the Limits of Stability Test. Secondary outcomes will include measures of static balance, leg strength, functional capacity, cognitive task-related cortical activation, corticospinal excitability and inhibition, and cognitive inhibition.

Discussion
This will be the first trial to target balance in people with PD with combined exergaming and a-tDCS. We hypothesise that improvements in balance, functional and neurophysiological outcome measures, and neurocognitive outcome measures will be greater and longer-lasting following concurrent exergaming and a-tDCS than in those receiving sham tDCS or usual care.

Keywordsbalance; exergaming; cognition; TMS; fNIRS
Year2018
JournalTrials
Journal citation19 (387), pp. 1-13
PublisherBioMed Central
ISSN1745-6215
Digital Object Identifier (DOI)https://doi.org/10.1186/s13063-018-2773-6
Scopus EID2-s2.0-85050074366
Open accessPublished as ‘gold’ (paid) open access
Publisher's version
License
File Access Level
Open
Publication process dates
Deposited10 May 2021
Permalink -

https://acuresearchbank.acu.edu.au/item/8w009/concurrent-exergaming-and-transcranial-direct-current-stimulation-to-improve-balance-in-people-with-parkinson-s-disease-study-protocol-for-a-randomised-controlled-trial

Log in to edit

Download files

Publisher's version
OA_Harris_2018_Concurrent_exergaming_and_transcranial_direct_current.pdf
License: CC BY 4.0
File access level: Open

  • 118
    total views
  • 34
    total downloads
  • 2
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

ZOom Delivered Intervention Against Cognitive decline (ZODIAC) COVID-19 pandemic adaptations to the Post-Ischaemic Stroke Cardiovascular Exercise Study (PISCES) : protocol for a randomised controlled trial of remotely delivered fitness training for brain health
Brodtmann, Amy, Billett, Alex, Telfer, Rachael, Adkins, Kim, White, Laura, McCambridge, Laura J. E., Burrell, Louise, Thijs, Vincent, Kramer, Sharon, Werden, Emilio, Cardoso, Barbara R., Case, Matthew, Hung, Stanley Hughwa, Churilov, Leonid, Bernhardt, Julie, Hayward, Kathryn and Johnson, Liam Gerard. (2024). ZOom Delivered Intervention Against Cognitive decline (ZODIAC) COVID-19 pandemic adaptations to the Post-Ischaemic Stroke Cardiovascular Exercise Study (PISCES) : protocol for a randomised controlled trial of remotely delivered fitness training for brain health. Trials. 25(1), pp. 1-12. https://doi.org/10.1186/s13063-024-08154-1
Is early initiated cardiorespiratory fitness training within a model of stroke-integrated cardiac rehabilitation safe and feasible?
Machado, Natasha, Williams, Gavin, Olver, John and Johnson, Liam Gerard. (2024). Is early initiated cardiorespiratory fitness training within a model of stroke-integrated cardiac rehabilitation safe and feasible? Journal of Stroke & Cerebrovascular Diseases. 33(2), pp. 1-10. https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107493
The safety and feasibility of early cardiorespiratory fitness testing after stroke
Machado, Natasha, Williams, Gavin, Olver, John and Johnson, Liam. (2023). The safety and feasibility of early cardiorespiratory fitness testing after stroke. PM&R. 15(3), pp. 291-301. https://doi.org/10.1002/pmrj.12787
Physical activity preferences of people living with brain injury : Formative qualitative research to develop a discrete choice experiment
Haynes, Abby, Howard, Kirsten, Johnson, Liam, Williams, Gavin, Clanchy, Kelly, Tweedy, Sean, Scheinberg, Adam, Chagpar, Sakina, Wang, Belinda, Vassallo, Gabrielle, Ashpole, Rhys, Sherrington, Catherine and Hassett, Leanne. (2023). Physical activity preferences of people living with brain injury : Formative qualitative research to develop a discrete choice experiment. Patient. 16(4), pp. 385-398. https://doi.org/10.1007/s40271-023-00628-9
Effect of exercise on brain-derived neurotrophic factor in stroke survivors : A systematic review and meta-analysis
Ashcroft, Sarah K., Ironside, Daniel D., Johnson, Liam, Kuys, Suzanne S. and Thompson-Butel, Angelica G.. (2022). Effect of exercise on brain-derived neurotrophic factor in stroke survivors : A systematic review and meta-analysis. Stroke. 53(12), pp. 3706-3716. https://doi.org/10.1161/STROKEAHA.122.039919
Maintenance of cardiorespiratory fitness in people with stroke : A systematic review and meta-analysis
Machado, Natasha, Wingfield, Matthew, Kramer, Sharon, Olver, John, Williams, Gavin and Johnson, Liam. (2022). Maintenance of cardiorespiratory fitness in people with stroke : A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation. 103(7), pp. 1410-1421. https://doi.org/10.1016/j.apmr.2022.01.151
Revisiting poststroke upper limb stratification : Resilience in a larger cohort
Varley, Benjamin J., Shiner, Christine T., Johnson, Liam, McNulty, Penelope A. and Thompson Butel, A.. (2021). Revisiting poststroke upper limb stratification : Resilience in a larger cohort. Neurorehabilitation and Neural Repair. 35(3), pp. 280-289. https://doi.org/10.1177/1545968321992048
Determining maximal tolerable aerobic training intensity in the acute phase after stroke : A novel dose ranging trial protocol
Kramer, Sharon F., Cumming, Toby, Johnson, Liam, Churilov, Leonid and Bernhardt, Julie. (2020). Determining maximal tolerable aerobic training intensity in the acute phase after stroke : A novel dose ranging trial protocol. Journal of Stroke and Cerebrovascular Diseases. 29(12), p. Article 105359. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105359
Emerging stroke clinicians and scientists : An Australian experience
Hayward, Kathryn S., Johnson, Liam and Yassi, Nawaf. (2020). Emerging stroke clinicians and scientists : An Australian experience. Stroke. 51(2), pp. e21-e23. https://doi.org/10.1161/STROKEAHA.119.028210
Physical fitness training for stroke patients
Saunders, D. H., Sanderson, M., Hayes, S., Johnson, L., Kramer, S., Carter, D. D., Jarvis, H., Brazzelli, M. and Mead, G. E.. (2020). Physical fitness training for stroke patients. Cochrane Database of Systematic Reviews. (3). https://doi.org/10.1002/14651858.CD003316.pub7
Safety of performing a graded exercise test early after stroke and transient ischemic attack
Johnson, Liam, Kramer, Sharon F., Catanzariti, Gabriella, Kaffenberger, Tina, Cumming, Toby and Bernhardt, Julie. (2020). Safety of performing a graded exercise test early after stroke and transient ischemic attack. Physical Medicine and Rehabilitation. 12(5), pp. 445-453. https://doi.org/10.1002/pmrj.12259
An Innovative STRoke Interactive Virtual thErapy (STRIVE) online platform for community-dwelling stroke survivors : A randomized controlled trial
Johnson, Liam, Bird, Marie-Louise, Muthalib, Makii and Teo, Wei-Peng. (2020). An Innovative STRoke Interactive Virtual thErapy (STRIVE) online platform for community-dwelling stroke survivors : A randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 101, pp. 1131-1137. https://doi.org/10.1016/j.apmr.2020.03.011
Acute hospital admission for stroke is characterised by inactivity
Sheedy, R., Kramer, S. F., Johnson, L., Shields, N., Churilov, L., Cadilhac, D. A. and Bernhardt, J.. (2020). Acute hospital admission for stroke is characterised by inactivity. Stroke Research and Treatment. 2020, p. 5879295. https://doi.org/10.1155/2020/5879295
Telehealth intervention programs for seniors: An observational study of a community-embedded health monitoring initiative
Hamilton, Taya, Johnson, Liam, Quinn, Brian T., Coppola, Jean, Sachs, David, Migliaccio, John, Phipps, Colette, Schwartz, Jennifer, Capasso, Marikay, Carpenter, Mae and Putrino, David. (2020). Telehealth intervention programs for seniors: An observational study of a community-embedded health monitoring initiative. Telemedicine and e-health. 26(4), pp. 438-445. https://doi.org/10.1089/tmj.2018.0248
An automated, electronic assessment tool can accurately classify older adult postural stability
Johnson, Liam, Fry, Adam, Dehbandi, Behdad, Rubin, Lawrence, Halem, Michael, Barachant, Alexandre, Smeragliuolo, Anna H. and Putrino, David. (2019). An automated, electronic assessment tool can accurately classify older adult postural stability. Journal of Biomechanics. 93, pp. 6-10. https://doi.org/10.1016/j.jbiomech.2019.06.001
Possible hormone predictors of physical performance in adolescent team sport athletes
Martin, Alanna C., Heazlewood, Ian, Kitic, Cecilia M., Lys, Isabelle and Johnson, Liam. (2019). Possible hormone predictors of physical performance in adolescent team sport athletes. Journal of Strength and Conditioning Research. 33(2), pp. 417 - 425. https://doi.org/10.1519/JSC.0000000000002014
The post ischaemic stroke cardiovascular exercise study : Protocol for a randomised controlled trial of fitness training for brain health
Johnson, Liam, Werden, Emilio, Shirbin, Chris, Bird, Laura, Landau, Elizabeth, Cumming, Toby, Churilov, Leonid, Bernhardt, Julie A., Thijs, Vincent and Brodtmann, Amy. (2018). The post ischaemic stroke cardiovascular exercise study : Protocol for a randomised controlled trial of fitness training for brain health. European Stroke Journal. 3(4), pp. 379-386. https://doi.org/10.1177/2396987318785845
Activity monitors for increasing physical activity in adult stroke survivor
Elizabeth A. Lynch, Karen Borschmann, Michele Callisaya, N. Fini, Heidi Janssen, Liam Johnson, Taryn M. Jones, Sharon Kramer, Suzanne Kuys, Niruthikha Mahendran, Dawn B. Simpson and Carolie English. (2018). Activity monitors for increasing physical activity in adult stroke survivor. Cochrane Database of Systematic Reviews. (7). https://doi.org/10.1002/14651858.CD012543.pub2
Innovative STRoke Interactive Virtual thErapy (STRIVE) online platform for community-dwelling stroke survivors: A randomised controlled trial protocol
Johnson, Liam, Bird, Marie-Louise, Muthalib, Makii and Teo, Wei-Peng. (2018). Innovative STRoke Interactive Virtual thErapy (STRIVE) online platform for community-dwelling stroke survivors: A randomised controlled trial protocol. BMJ Open. 8(1), pp. 1 - 8. https://doi.org/10.1136/bmjopen-2017-018388
Activity monitors for increasing physical activity in adult stroke survivors
Lynch, Elizabeth A., Jones, Taryn M., Simpson, Dawn B., Fini, Natalie A., Kuys, Suzanne S., Borschmann, Karen, Kramer, Sharon, Johnson, Liam, Callisaya, Michele L., Mahendran, Niruthikha, Janssen, Heidi and English, Carolie. (2018). Activity monitors for increasing physical activity in adult stroke survivors. Cochrane Database of Systematic Reviews. 2018(7), pp. 1 - 63. https://doi.org/10.1002/14651858.CD012543.pub2
Validity of multi-sensory array to measure energy expenditure of an activity bout in early stroke survivors
Kramer, Sharon Flora, Johnson, Liam, Bernhardt, Julie and Cumming, Toby. (2018). Validity of multi-sensory array to measure energy expenditure of an activity bout in early stroke survivors. Stroke Research and Treatment. 2018, pp. 1 - 8. https://doi.org/10.1155/2018/9134547
The energy cost of steady-state physical activity in acute stroke
Kramer, Sharon, Cumming, Toby, Bernhardt, Julie and Johnson, Liam. (2018). The energy cost of steady-state physical activity in acute stroke. Journal of Stroke and Cerebrovascular Diseases. 27(4), pp. 1047 - 1054. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.11.010
Using non-invasive transcranial stimulation to improve motor and cognitive function in parkinson’s disease: a systematic review and meta-analysis scientific reports
Goodwill, Alicia, Lum, Jarrad, Hendy, Ashlee, Muthalib, Makii, Johnson, Liam, Albein-Urios, Natalia and Teo, Wei-Peng. (2017). Using non-invasive transcranial stimulation to improve motor and cognitive function in parkinson’s disease: a systematic review and meta-analysis scientific reports. Scientific Reports. 7, pp. 1 - 11. https://doi.org/10.1038/s41598-017-13260-z
Early rehabilitation after stroke
Bernhardt, Julie, Godecke, Erin, Johnson, Liam and Langhorne, Peter. (2017). Early rehabilitation after stroke. Current Opinion in Neurology. 30(1), pp. 48 - 54. https://doi.org/10.1097/WCO.0000000000000404
Overexpression and knock-down studies highlight that a disintegrin and metalloproteinase 28 controls proliferation and migration in human prostate cancer
Caroline Rudnicka, Satsuki Mochizuki, Yasunori Okada, Claire McLaughlin, Peter J. Leedman, Lisa Stuart, Michael Epis, Gerard Hoyne, Sherif Boulos, Liam Johnson, Markus Schlaich and Vance Matthews. (2016). Overexpression and knock-down studies highlight that a disintegrin and metalloproteinase 28 controls proliferation and migration in human prostate cancer. Medicine. 95(40), pp. 1-8. https://doi.org/10.1097/MD.0000000000005085
Progesterone and estradiol levels are predictors of performance in a test of anaerobic capacity in young female netball athletes
Heazlewood, Ian, Martin, Alanna, Johnson, Liam, Lys, Isabelle and Kitic, Cecilia M.. (2016). Progesterone and estradiol levels are predictors of performance in a test of anaerobic capacity in young female netball athletes. Australia: Exercise & Sports Science Australia. pp. 167 - 167
Accelerometer use in young people with Down syndrome: A preliminary cross-validation and reliability study
Peiris, Casey L., Cumming, Toby B., Kramer, Sharon, Johnson, Liam, Taylor, Nicholas and Shields, Nora. (2016). Accelerometer use in young people with Down syndrome: A preliminary cross-validation and reliability study. Journal of Intellectual and Developmental Disability. 42(4), pp. 339-350. https://doi.org/10.3109/13668250.2016.1260100
Testosterone levels are predictors of multistage fitness test performance in young male and female hockey athletes
Heazlewood, Ian, Martin, Alanna, Johnson, Liam, Lys, Isabelle Yoke Yien and Kitic, Cecilia M.. (2016). Testosterone levels are predictors of multistage fitness test performance in young male and female hockey athletes. 7th Exercise and Sports Science Australia (ESSA) Research to Practice Conference, Melbourne, Australia, 14th - 16th April, 2016. Australia: Exercise & Sports Science Australia.
An acute bout of exercise improves the cognitive performance of older adults
Johnson, Liam, Addamo, Patricia K., Raj, Isaac Selva, Borkoles, Erika, Wyckelsma, Victoria, Cyarto, Elizabeth V. and Polman, Remco C.. (2016). An acute bout of exercise improves the cognitive performance of older adults. Journal of Aging and Physical Activity. 24(4), pp. 591-598. https://doi.org/10.1123/japa.2015-0097
Proposal for a candidate core set of fitness and strength tests for patients with childhood or adult idiopathic inflammatory myopathies
Van Der Stap, Djamilla K. D., Rider, Lisa G., Alexanderson, Helene, Huber, Adam M., Gualano, Bruno, Gordon, Patrick, Van Der Net, Janjaap, Mathiesen, Pernille, Johnson, Liam G., Ernste, Floranne C., Feldman, Brian M., Houghton, Kristin M., Singh-Grewal, Davinder, Kutzbach, Abraham Garcia, Munters, Li Alemo and Takken, Tim. (2016). Proposal for a candidate core set of fitness and strength tests for patients with childhood or adult idiopathic inflammatory myopathies. Journal of Rheumatology. 43(1), pp. 169 - 176. https://doi.org/10.3899/jrheum.150270
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. 17(1), pp. 1 - 13. https://doi.org/10.1186/s13063-016-1461-7
Energy Expenditure and Cost during Walking after Stroke: A Systematic Review
Kramer, Sharon, Johnson, Liam, Bernhardt, Julie and Cumming, Toby. (2016). Energy Expenditure and Cost during Walking after Stroke: A Systematic Review. Archives of Physical Medicine and Rehabilitation. 97(4), pp. 619-632. https://doi.org/10.1016/j.apmr.2015.11.007
An exploratory analysis of possible hormone predictors of physical performance in male and female adolescent basketball athletes
Martin, Alanna, Heazlewood, Ian, Kitic, Cecilia M., Lys, Isabelle Yoke Yien and Johnson, Liam. (2016). An exploratory analysis of possible hormone predictors of physical performance in male and female adolescent basketball athletes. Australia: Australian Strength and Conditioning Association. pp. 1 - 1
Light physical activity is positively associated with cognitive performance in older community dwelling adults
Johnson, Liam G., Butson, Michael L., Polman, Remco C., Raj, Isaac S., Borkoles, Erika, Scott, David, Aitken, Dawn and Jones, Graeme. (2016). Light physical activity is positively associated with cognitive performance in older community dwelling adults. Journal of Science and Medicine in Sport. 19(11), pp. 877-882. https://doi.org/10.1016/j.jsams.2016.02.002
Early mobilization after stroke: Early adoption but limited evidence
Bernhardt, Julie, English, Carolie, Johnson, Liam and Cumming, Toby B.. (2015). Early mobilization after stroke: Early adoption but limited evidence. Stroke. 46(4), pp. 1141 - 1146. https://doi.org/10.1161/STROKEAHA.114.007434
Lower limb progressive resistance training improves leg strength but not gait speed or balance in Parkinson's disease: A systematic review and meta-analysis
Tillman, Alex Tillman, Muthalib, Makii, Hendy, Ashlee M., Johnson, Liam G., Rantalainen, Timo, Kidgell, Dawson J., Enticott, Peter G. and Teo, Wei-Peng. (2015). Lower limb progressive resistance training improves leg strength but not gait speed or balance in Parkinson's disease: A systematic review and meta-analysis. Frontiers in Aging Neuroscience. 7, pp. 1 - 10. https://doi.org/10.3389/fnagi.2015.00040
Interactive effects of GPI stimulation and levodopa on postural control in Parkinson's disease
Johnson, Liam, Rodrigues, Julian, Teo, Wei-Peng, Walters, Susan, Stell, Rick, Thickbroom, Gary and Mastaglia, Frank. (2015). Interactive effects of GPI stimulation and levodopa on postural control in Parkinson's disease. Gait & Posture. 41(4), pp. 929 - 934. https://doi.org/10.1016/j.gaitpost.2015.03.346
Progesterone and estradiol levels predict planned agility, 10M and 20M sprint performance in young male Australian football athletes
Martin, Alanna C., Heazlewood, Ian T., Lys, Isabelle, Kitic, Cecilia M. and Johnson, Liam. (2015). Progesterone and estradiol levels predict planned agility, 10M and 20M sprint performance in young male Australian football athletes. Journal of Australian Strength and Conditioning. 23(6), pp. 43 - 46.
Exergaming as a viable therapeutic tool to improve static and dynamic balance among older adults and people with idiopathic Parkinson's disease: A systematic review and meta-analysis
Harris, Dale M., Rantalainen, Timo, Muthalib, Makii, Johnson, Liam G. and Teo, Wei-Peng. (2015). Exergaming as a viable therapeutic tool to improve static and dynamic balance among older adults and people with idiopathic Parkinson's disease: A systematic review and meta-analysis. Frontiers in Aging Neuroscience. 7, pp. 1 - 12. https://doi.org/10.3389/fnagi.2015.00167
The effects of a supervised Pilates training program on balance in Parkinson's disease
Johnson, Liam, Putrino, David, James, Ian, Rodrigues, Julian, Stell, Rick, Thickbroom, Gary and Mastaglia, Frank. (2013). The effects of a supervised Pilates training program on balance in Parkinson's disease. Advances in Parkinson's Disease. 2(2), pp. 58 - 61. https://doi.org/10.4236/apd.2013.22011
Clinical and posturographic correlates of falling in Parkinson's disease
Johnson, Liam, James, Ian, Rodrigues, Julian, Stell, Rick, Thickbroom, Gary and Mastaglia, Frank. (2013). Clinical and posturographic correlates of falling in Parkinson's disease. Movement Disorders. 28(9), pp. 1250 - 1256. https://doi.org/10.1002/mds.25449
Allied health professionals and cardiometabolic disease risk screening in the workplace: a study of two companies in Darwin, Australia
Semple, Stuart J. and Johnson, Liam. (2012). Allied health professionals and cardiometabolic disease risk screening in the workplace: a study of two companies in Darwin, Australia. 18(1), pp. 65 - 74.
A controlled trial of mindfulness training in schools : The importance of practice for an impact on well-being
Huppert, Felicia and Johnson, D. (2010). A controlled trial of mindfulness training in schools : The importance of practice for an impact on well-being. The Journal of Positive Psychology. 5(4), pp. 264 - 274. https://doi.org/10.1080/17439761003794148