# Partnered Rhythmic Rehabilitation for Enhanced Motor-Cognition in Prodromal Alzheimer's Disease

> **NIH NIH R01** · EMORY UNIVERSITY · 2020 · $696,962

## Abstract

Project Abstract
Interventions that affect multiple factors rather than a single factor are more likely to be
successful in preventing and treating Alzheimer’s disease (AD). Functional decline in AD is
severely impacted by impaired ability to integrate and modulate complex cognitive and motor
abilities, i.e., motor-cognitive integration. Many interventions have ignored this area, although
impaired motor-cognitive integration occurs in the early stages of AD (i.e., prodromal AD, pAD)
and may precede other symptoms. Combined motor and cognitive training has been
recommended for pAD, thus we propose to use partnered, rhythmic rehabilitation (PRR), an
ideal intervention to simultaneously target cardiovascular, social and motor-cognitive domains
important to AD. PRR is moderate intensity, cognitively-engaging social dance that targets
postural control systems, involves learning multiple, varied stepping and rhythmic patterns, and
fosters tactile communication of motor goals between partners, enhancing social interaction’s
effect on cognition. Previous research by the PI demonstrates that PRR classes are safe and
result in no injurious falls. Recently, we discovered PRR improves motor–cognitive integration in
older adults with cognitive impairment. As such, we propose to conduct a 1-year Phase II single-
blind randomized clinical trial using PRR in 60 patients with pAD. Our overarching hypothesis is
that PRR is safe, tolerable and associated with improved motor-cognitive function, and
neuronal, vascular and inflammatory intermediaries. Our rationale: PRR includes a physical-
activity component which impacts CV fitness and systemic inflammation. Our prior work has
also shown that PRR impacts cognitive domains needed for motor-cognitive integration
(visuospatial, executive and attention/working memory (WM)), and social domains via one-on-
one tactile and rhythmic interactions. We discovered PRR training increases activity in the
inferior frontal and inferior temporal gyri. Both regions are implicated in motor-cognition and are
possible targets for AD-related pathologies. Participants with pAD will be assigned to three
months of biweekly sessions, followed by nine months of weekly sessions of PRR or control
(group walking (WALK)) with 1:1 allocation. Group walking in the control group will isolate our
ability to detect the effect of the cognitively-engaging elements of PRR. Using an intent-to-treat
approach, this innovative pilot study will 1) Determine acceptability, safety, tolerability and
satisfaction with PRR in pAD; 2) Compare efficacy of PRR vs. WALK for improving motor-
cognitive integration in pAD; 3) Identify the most sensitive endpoint for a Phase III trial from a
set of motor-cognitive, volumetric MRI (hippocampal volume) and cognitive measures; and 4)
Explore potential neural, vascular and inflammatory mechanisms by which PRR affects pAD to
derive effect size of these intermediary measures and hence aid us in estimating sample size
for a futu...

## Key facts

- **NIH application ID:** 9952292
- **Project number:** 5R01AG062691-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Madeleine Eve Hackney
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $696,962
- **Award type:** 5
- **Project period:** 2019-06-15 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9952292

## Citation

> US National Institutes of Health, RePORTER application 9952292, Partnered Rhythmic Rehabilitation for Enhanced Motor-Cognition in Prodromal Alzheimer's Disease (5R01AG062691-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9952292. Licensed CC0.

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