Steps against the burden of Parkinson's disease (StepuP): Protocol of a randomized controlled trial elucidating the biomechanical and neurophysiological mechanisms of a speed dependent treadmill training intervention
Abstract
Objective: Parkinson's disease can impair gait and stability, leading to reduced independence and increased fall risk. While speed dependent treadmill training (SDTT) is clinically effective, the specific biomechanical and neurophysiological mechanisms driving these improvements remain unclear. The "StepuP" multicenter randomized controlled trial aims to elucidate these mechanisms and determine whether training enriched with virtual reality or mechanical perturbations (SDTT+) enhances gait efficacy and transfer to daily life.
Methods: We will recruit 126 individuals with Parkinson's disease across four clinical sites and 21 healthy older adults as a reference group. Participants will be randomized to receive either standard SDTT or SDTT+ for 12 sessions. To capture the trajectory of recovery and retention, assessments will occur at three distinct timepoints: baseline, post-intervention, and a 12-week follow-up, each assessment including synchronized 64-channel electroencephalography (EEG), electromyography (EMG), and 3D kinematics. This multimodal setup allows for the quantification of cortical beta-band activity, corticomuscular coherence, and stability-related foot placement control. Furthermore, we will assess participant's satisfaction, usability, and engagement through questionnaires and interviews to understand individual adherence and barriers to training.
Significance: The primary clinical endpoint is comfortable overground walking speed. We hypothesize that gait…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 126 participants or records.
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