Home Exercise for Neurodegenerative Disease

Recruiting in Palo Alto (17 mi)

Overseen by Jennifer Keller, PT

Age: Any Age

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Disqualifiers: Uncontrolled hypertension, diabetes, dementia, others

No Placebo Group

Trial Summary

What is the purpose of this trial?

The primary goal of this study is to address the need for targeted therapeutic interventions for impairments that impact walking in related neurodegenerative diseases.

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's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Home exercise, Resistance training, Exercise therapy, Physical therapy for neurodegenerative diseases?

Research shows that home exercise and resistance training can improve muscle strength and flexibility in people with Parkinson's disease, and help make exercise a regular habit. Additionally, a home-based exercise program has been found feasible and potentially beneficial for improving functional performance in patients with Alzheimer's disease. ^{1 2 3 4 5}

Is home exercise safe for people with neurodegenerative diseases?

Research on home exercise programs for conditions like Parkinson's and Alzheimer's disease suggests they are generally safe and can be beneficial, especially since they are designed to be done at home, making them more convenient and easier to stick with. ^{2 3 4 6 7}

How is home exercise unique as a treatment for neurodegenerative diseases?

Home exercise is unique because it can be done at home, making it more convenient and potentially increasing adherence. It focuses on improving physical function, like flexibility and muscle strength, and can help reduce the time spent lying down, which is beneficial for people with neurodegenerative diseases. ^{1 3 5 6 8}

Research Team

Jennifer Keller, PT

Principal Investigator

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Eligibility Criteria

This trial is for individuals with specific neurodegenerative diseases like ataxia, leukodystrophy, or those with cerebellar damage due to stroke or tumor. Participants must have a confirmed genetic mutation related to their condition, be able to stand and walk with or without support, and not have other health issues that could interfere with the exercise program.

Inclusion Criteria

I am a female diagnosed with X-linked adrenoleukodystrophy.

Patients with other neurodegenerative diseases similar to these disorders as determined by chart review and clinical exam

I can stand and walk without much help.

Exclusion Criteria

Other medical or psychological conditions which in the clinical judgement of the investigator would interfere with acquiring the study information or performing the exercises safely including but not limited to uncontrolled hypertension, orthopedic conditions, diabetes, seizure disorder, peripheral vestibular loss, severe aphasia, dementia, pregnancy

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in an individually designed home exercise program to improve motor function and sleep quality

12 weeks

Remote supervision

Follow-up

Participants are monitored for changes in balance and walking post intervention

4 weeks

Treatment Details

Interventions

• Home exercise (Behavioral Intervention)

Trial Overview The study tests a home exercise regimen designed to improve walking abilities in people suffering from neurodegenerative diseases. It aims to create targeted therapeutic interventions tailored for these conditions.

Participant Groups

Group I: Home exercise Experimental Treatment 1 Intervention

Individually designed home exercise program

Who Is Running the Clinical Trial?

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Lead Sponsor

Trials

93

Recruited

25,200+

Dr. Bradley L. Schlaggar

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Chief Executive Officer since 2018

MD/PhD from Washington University in St. Louis

Dr. Ali Fatemi

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Chief Medical Officer since 2019

MD from Medical University of Vienna, MBA from Johns Hopkins Carey Business School

Findings from Research

A home-based exercise program for patients with Alzheimer's Disease (AD) showed good adherence and a trend towards improved functional performance, particularly in hand function and lower extremity strength, after 6 and 12 weeks.

Despite the positive trends in functional performance, there were also indications of worse depression and lower quality of life ratings among participants, suggesting the need for further research to optimize the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a home-based exercise program in the treatment of Alzheimer's disease: the Maximizing Independence in Dementia (MIND) study. Steinberg, M., Leoutsakos, JM., Podewils, LJ., et al.[2022]

Resistance training (RT) significantly improves knee extension, knee flexion, and leg press strength in people with Parkinson's disease compared to control groups, based on a systematic review of nine studies.

Combining RT with other forms of exercise, such as aerobic or balance training, leads to even greater improvements in strength, although RT alone may not always outperform other exercise types for certain muscle groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Resistance Training on Measures of Muscular Strength in People with Parkinson's Disease: A Systematic Review and Meta-Analysis. Roeder, L., Costello, JT., Smith, SS., et al.[2018]

A study involving 10 clients with Parkinson's disease and Huntington's disease, along with 8 physiotherapists, revealed that both groups identified significant barriers to participating in home exercise programs, including disease-specific impairments and safety concerns.

To improve participation, it is essential for therapists to collaborate with clients to tailor exercise programs that address individual barriers and preferences, ensuring the programs are both acceptable and feasible.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Client and therapist views on exercise programmes for early-mid stage Parkinson's disease and Huntington's disease. Quinn, L., Busse, M., Khalil, H., et al.[2022]

Resistance exercise programs can positively impact muscle strength and functional mobility in individuals with Parkinson's disease, as shown in a systematic review of five studies, including three randomized controlled trials.

The studies indicated that resistance training leads to increases in fat-free mass, muscle strength, and endurance, suggesting it may be an effective strategy to delay or reverse functional decline in Parkinson's disease patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of resistance training for people with Parkinson's disease: a systematic review. Brienesse, LA., Emerson, MN.[2019]

A 2-month home exercise program for 10 patients with Parkinson's disease led to significant improvements in flexibility and muscle strength, indicating that guided exercise can enhance physical function.

The intervention also resulted in a reduction in the time spent lying down and an increase in sitting time, suggesting that it may help patients become more active in their daily lives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of home exercise on physical function and activity in home care patients with Parkinson's disease. Nakae, H., Tsushima, H.[2020]

A home-based multimodal exercise program for 40 older adults with mild to moderate Alzheimer's disease is expected to improve muscle strength, balance, cognition, and overall functioning after 16 weeks of training.

The study aims to provide a foundation for future clinical interventions and health promotion strategies tailored for older individuals with Alzheimer's, highlighting the potential benefits of at-home exercise for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home-based multimodal exercise program in older people with Alzheimer disease: Randomized controlled trial protocol. Cezar, NOC., Ansai, JH., de Andrade, LP.[2021]

Treadmill training is feasible and safe for individuals with Lewy body dementia (LBD) and Huntington's disease (HD), as no adverse events were reported during the sessions.

However, the study found that participants with LBD and HD did not show significant improvements in gait measures or motor function after treadmill training, suggesting that longer and more frequent sessions may be necessary to achieve beneficial effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Immediate effects of treadmill walking in individuals with Lewy body dementia and Huntington's disease. Kegelmeyer, DA., Kostyk, SK., Fritz, NE., et al.[2021]

References

1. England pubmed.ncbi.nlm.nih.gov

Evaluation of a home-based exercise program in the treatment of Alzheimer's disease: the Maximizing Independence in Dementia (MIND) study. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Effects of Resistance Training on Measures of Muscular Strength in People with Parkinson's Disease: A Systematic Review and Meta-Analysis. [2018]

3. England pubmed.ncbi.nlm.nih.gov

Client and therapist views on exercise programmes for early-mid stage Parkinson's disease and Huntington's disease. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Effects of resistance training for people with Parkinson's disease: a systematic review. [2019]

5. Japan pubmed.ncbi.nlm.nih.gov

Effects of home exercise on physical function and activity in home care patients with Parkinson's disease. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Home-based multimodal exercise program in older people with Alzheimer disease: Randomized controlled trial protocol. [2021]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Effects of Resistance Training on Motor- and Non-Motor Symptoms in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Immediate effects of treadmill walking in individuals with Lewy body dementia and Huntington's disease. [2021]