Effects of Exercise With Visual Feedback in Parkinson's Disease

Condition(s) studied

Investigational drug(s) / intervention(s)

Control Group: The exercises will start with 6-8 repetitions and will increase by 2 repetitions each week. Cervical Region: Cervical rotation, lateral flexion, chin-tuck exercises Upper Extremity: Shoulder joint range of motion exercises with a wand, scapular adduction, shoulder retraction Lower Extremity: Bridge exercise, hip flexion, extension, abduction exercises, knee extension exercises, ankle dorsiflexion - plantar flexion exercises Balance Exercises: Perturbation exercises with eyes open and eyes closed on a hard surface, perturbation exercises with eyes open and eyes closed on a soft surface, maintaining a tandem stance Ambulation: Walking training on a treadmill with a Modified Borg Scale of level 3-4. Walking training will begin with 6 minutes in the first week and will increase by 1 minute each week.

Visual Feedback Exercise Group: The visual feedback exercise will be performed using a wearable laser pointer attached to the trunk and lower extremities, along with a visual tracking screen. The exercise duration is 20 minutes. The laser placed on the trunk will be used in various exercises, including maintaining stability in a seated position, on a Swiss ball, while standing, during different movements, and on various surfaces. Additionally, trunk control exercises will involve rotational, vertical-horizontal, and circular movements. Exercises targeting trunk control in a crawling position will also be included. For the lower extremities, the program will focus on ankle dorsiflexion, hip abduction and extension, and knee extension. All exercises will be progressively individualized on a weekly basis.

Study summary

Patients with Parkinson's disease who apply to the Hasan Kalyoncu University Application and Research Center and meet the inclusion criteria will be included in the study. The included participants will be randomly assigned into either the intervention group or the control group using a sealed-envelope method. Both groups will undergo a standard exercise program, consisting of posture, strengthening, and balance training, under the supervision of a physiotherapist for 8 weeks, 3 days per week. In addition to this, the intervention group will receive an additional exercise program incorporating visual feedback using a laser pointer, targeting the trunk and lower extremities, also under the supervision of a physiotherapist for 8 weeks, 3 days per week.

Eligibility

Primary outcome measure(s)

• Center of Pressure Elliptical Area — up to 8 weeks
  Postural control will be assessed using the Gyko wearable device. After the wearable vest is properly fitted, the participant will be asked to maintain balance for 30 seconds under four conditions: firm surface with eyes open, firm surface with eyes closed, soft surface with eyes open, and soft surface with eyes closed. The elliptical area of center of pressure displacement (mm²) obtained from the Gyko system will be recorded for each condition and used as the primary outcome measure.
• Berg Balance Scale — up to 8 weeks
  The Berg Balance Scale is used to assess functional balance. It evaluates both dynamic and static balance through 14 tasks related to different positions, postural changes, and mobility. Each task is scored between 0 and 4 based on the individual's ability to perform the task independently, for a certain period, or over a specific distance (0: unable to perform, 4: normal performance). The highest possible score on the scale is 56, and a higher score indicates greater independence.

Trial sites (1)

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