An interventional study of Control Group and Visual Feedback Exercise Group in Parkinson Disease, Balance Impairment and Exercise Training, sponsored by Hasan Kalyoncu University. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2026-01-27.
Sponsored by Hasan Kalyoncu University · Not applicable, Interventional, and Treatment
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.
This study aims to investigate the effects of visual feedback exercise training focused on balance, postural control, and lower extremity mobility using a laser pointer, in addition to standard rehabilitation, on activity and participation in individuals with Parkinson's disease.
Hypotheses:
H1: Incorporating visual feedback-based trunk and lower extremity exercises using a laser pointer into standard rehabilitation improves body structure and function in individuals with Parkinson's disease.
H2: Incorporating visual feedback-based trunk and lower extremity exercises using a laser pointer into standard rehabilitation enhances activity and participation in individuals with Parkinson's disease.
Exclusion Critera
Participants in the standard exercise group will receive a physiotherapist-supervised exercise program, performed three times per week for a total duration of eight weeks.
Other: Control Group
Participants in the standard exercise program and visual feedback-based exercise program group will receive a physiotherapist-supervised exercise program, performed three times per week for eight weeks.
Other: Control Group · Other: Visual Feedback Exercise 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.
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.
Center of Pressure Elliptical Area
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.
Time frame: up to 8 weeks
Berg Balance Scale
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.
Time frame: up to 8 weeks
L Test
The L Test is a functional mobility assessment. The participant starts from a seated position in a chair without armrests and, upon command, walks at a comfortable speed to a marked 3-meter point, turns right, continues walking for 7 meters, turns around, and returns to sit in the chair. The total time to complete the test (seconds) will be recorded.
Time frame: up to 8 weeks
Unified Parkinson's Disease Rating Scale
The first section evaluates non-motor features, the second section assesses activities of daily living, the third section involves motor examination, and the fourth section evaluates treatment complications. The four sections total 42 items. Each item is scored from 0 (no symptoms or signs) to 4 (the most severe symptoms or signs).
Time frame: up to 8 weeks
New York Postural Assessment Test
For each of the 13 body segments, three diagrams are provided. The posterior view includes the head, shoulders, spine, hips, and feet, while the lateral view includes the neck, chest, shoulders, upper back, trunk, abdomen, and lumbar region. Each body segment is scored as follows: 5 points (correct posture), 3 points (moderate deviation), and 1 point (severe deviation). The total score ranges from 13 to 65. A higher score indicates better posture.
Time frame: up to 8 weeks
Visual Analog Scale
Pain intensity was assessed using the Visual Analog Scale (VAS), which consists of a 100-mm horizontal line with scores ranging from 0 to 100 mm. Participants were instructed to mark the point on the line that best represented their current pain intensity, where 0 indicated "no pain" and 100 indicated "worst imaginable pain." The distance in millimeters from the left end of the line to the marked point was measured using a ruler. Higher VAS scores indicate greater pain intensity.
Time frame: up to 8 weeks
Parkinson Fatigue Scale
Consists of a total of 16 questions related to fatigue. Participants are asked to rate their agreement with the statements on a scale from 1 to 5 (1: strongly disagree, 5: strongly agree). The test result is determined by calculating the average of the responses to all questions.
Time frame: up to 8 weeks
10-Meter Walk Test
Gait speed will be assessed using the 10-Meter Walk Test. Participants will be instructed to walk a marked 10-meter distance at their usual walking speed. The time taken to complete the distance will be recorded, and walking speed (m/s) will be calculated.
Time frame: up to 8 weeks
Activities-specific Balance Confidence Scale
It consists of 16 tasks related to daily living activities performed both indoors and outdoors. Each item is rated on a scale from 0% (no confidence) to 100% (full confidence). Scores below 67% indicate a risk of falling, while higher scores reflect greater balance confidence.
Time frame: up to 8 weeks
Functional Reach Test
Postural stability will be assessed using the Functional Reach Test. The participant stands next to a wall with the arm closest to the wall elevated to 90° of shoulder flexion. The initial and final positions of the third finger are marked, and the reach distance (cm) is calculated.
Time frame: up to 8 weeks
Five Times Sit-to-Stand Test
Lower extremity strength and functional mobility will be evaluated using the Five Times Sit-to-Stand Test. Participants are instructed to stand up and sit down five times as quickly as possible from an armless chair with arms crossed. The total completion time (seconds) is recorded.
Time frame: up to 8 weeks
Freezing of Gait Questionnaire
Used to assess freezing episodes in patients with Parkinson's disease. It consists of six questions, each scored on a 0 to 4 scale (0: no symptoms, 4: severe). The total score ranges from 0 to 24, with higher scores indicating more severe freezing-related impairment.
Time frame: up to 8 weeks
Parkinson's Disease Quality of Life Questionnaire (PDQ-39)
İt consists of 39 items divided into eight domains. Participants respond based on their experiences over the past month. Each question is scored on a 0 to 4 scale (0: never, 1: rarely, 2: sometimes, 3: often, 4: always). To calculate the domain score, the total score of the questions within that domain is summed, divided by the maximum possible score for that domain, and multiplied by 100. The total PDQ-39 score is obtained by summing the eight domain scores and dividing by 8, providing an overall quality of life measure.
Time frame: up to 8 weeks
Plan to share: No
Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.
Contact study teamGet an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Hasan Kalyoncu University