Functional Magnetic Resonance Imaging, Parkinson Disease, Virtual Reality Therapy
Conditions
Keywords
fMRI, Virtual Reality Therapy, Exercise Therapy
Brief summary
Parkinson's Disease (PD) is one of the most common neurodegenerative disease. Bradykinesia, tremor, resting tremor and postural instability are the main motor characteristics of this disease. As the disease progresses, mobility, walking, balance are reducing, the risk of falls is increasing and patients become functionally dependent. Along with these symptoms, cognitive functions are also disturbed. The most commonly distorted cognitive functions are executive functions such as planning and reasoning, working memory, episodic memory, attention and visual-spatial skills. Pharmacological and surgical treatments are used in Parkinson's disease. Pharmacologic treatment has a proven effect on motor symptoms, but since there is no approved pharmacologic treatment which has a direct effect on cognitive functions, recent studies suggest non-pharmacological treatments to improve cognitive function. Physiotherapy is also accepted among non-pharmacological treatments. Conventional physiotherapy focuses on optimizing patient independence and safety, focusing on hinting strategies, cognitive movement strategies and exercises utilizing transfers, posture, upper extremity function, balance (and falls), gait, physical capacity and (in)activity. Virtual Reality (VR) technology, a promising commonly used new rehabilitation tool, is a treatment method that can be used as one of the non-pharmacological treatment methods in Parkinson's Disease. In order to understand how neuronal network dysfunction in the Parkinson's Disease leads to clinical symptoms, both the component elements and the interconnections within these networks need to be examined in greater detail. Studies of resting state-fMRI (rs-fMRI) use correlation of activation of brain regions and time series fluctuations between brain regions to give information about connectivity in brain. The purpose of this study is to investigate the therapeutic effects of virtual reality on motor and cognitive symptoms of PD. Furthermore, the investigation of possible effects of this effect on neuroplasticity through functional brain networks is our other objective. This study will be the first study to evaluate the plasticity effect of virtual reality application with rs-fMRI in Parkinson's disease.
Interventions
BEHAVIORALVirtual Reality
Virtual Reality Based Rehabilitation including static balance, dynamic balance and walking
BEHAVIORALExercise Therapy
The conventional physical Therapy program includes parameters for improving strength, flexibility, transfers, posture, balance and coordination, and sensory stimulation. These activities consist of various types of exercises that focus on lower extremity movements.
Sponsors
Farzin Hajebrahimi, PT, MSc
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
50 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* To be 50 years old and older * Clinical diagnosis of PD within the -framework of Brain Bank criteria * Getting a stable antiparkinsonian medication at least for the last 1 month (or the treatment has not changed)
Exclusion criteria
* Having a story of unstable medical condition * History of head trauma, stroke, or exposure to toxic substances * Implying Parkinson plus syndromes in neurological examinations; pyramidal, cerebellar examination findings, gaze paresis, autonomic dysfunction * Being diagnosed with Dementia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Motor Level | Change from Baseline at 4 weeks. | Unified Parkinson's Disease Rating Scale-Motor (UPDRS-III) |
| Cognitive Level | Change from Baseline at 4 weeks. | Montreal Cognitive Asssessment (MoCA) |
| Neuroplasticity | Change from Baseline at 4 weeks. | Resting State Networks functional connectivity |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional Capacity | Change from Baseline at 4 weeks. | Six Minute Walk Test (6MWT) |
| Depression | Change from Baseline at 4 weeks. | The Geriatric Depression Scale (GDS) |
| Balance | Change from Baseline at 4 weeks. | Berg Balance Scale (BBS) |
| Cognitive Assessment | Change from Baseline at 4 weeks. | Neuropsychological assessment test (NPT) battery |
| Balance Confidence | Change from Baseline at 4 weeks. | The Activities-specific Balance Confidence (ABC) Scale |
| Quality of Life in patients with Parkinson's Disease | Change from Baseline at 4 weeks. | The Parkinson's Disease Questionnaire (PDQ-39) |
| Mobility | Change from Baseline at 4 weeks. | Timed Up and Go Test (TUG), |
Countries
Turkey (Türkiye)
Outcome results
None listed