Parkinson Disease
Conditions
Keywords
Parkinson disease, Eye exercises, Balance, Fall risk, Physical function, Functional mobility, Gait, Postural stability
Brief summary
Parkinson's disease is commonly associated with impaired gait, postural instability, reduced physical function, and increased concern about falling, all of which contribute substantially to disability and reduced quality of life. Exercise-based rehabilitation is increasingly recommended as a core non-pharmacological strategy for improving mobility and balance in people with Parkinson's disease. In parallel, recent clinical and neurorehabilitation research suggests that eye-movement and gaze-stabilization training may influence postural control, visuomotor integration, and movement performance in neurological disorders, including Parkinson's disease. This randomized controlled trial will evaluate whether a supervised in-center eye-exercise program can improve dynamic balance, functional mobility, gait performance, and fall-related concern in patients with Parkinson's disease.
Detailed description
Parkinson's disease is a progressive neurodegenerative disorder characterized not only by tremor and bradykinesia, but also by impaired gait, postural instability, reduced turning ability, slowed mobility, and increased fear of falling. These impairments are major contributors to functional limitation, reduced independence, and decreased quality of life in people with Parkinson's disease. Recent systematic reviews and network meta-analyses have demonstrated that exercise interventions can improve physical function, balance, gait performance, and mobility-related outcomes in this population. However, balance impairment and falls remain highly prevalent despite conventional rehabilitation approaches, highlighting the need for additional targeted non-pharmacological interventions. Visual and oculomotor dysfunction are increasingly recognized as clinically relevant features of Parkinson's disease. Abnormalities in saccadic eye movements, smooth pursuit, gaze stabilization, and visuomotor control have been reported in patients with Parkinson's disease and may contribute to impaired postural control, gait dysfunction, and difficulties with movement coordination. Recent studies in neurorehabilitation and eye-movement research suggest that eye exercises and visually guided training may positively influence balance control, mobility, and motor-related performance by enhancing sensory integration and visuomotor coordination. Emerging rehabilitation studies have reported promising effects of structured eye-movement interventions on dynamic balance, walking performance, and functional mobility in individuals with Parkinson's disease. In addition, recent advances in eye-tracking and oculomotor assessment research further support the potential therapeutic relevance of visually guided interventions in Parkinson's disease rehabilitation. Nevertheless, high-quality randomized controlled trials investigating supervised eye-exercise programs in clinical settings remain limited. Therefore, the present study will investigate the effects of a structured supervised in-center eye-exercise program on physical function, dynamic balance, and fall-related concern in patients with Parkinson's disease. The intervention will be delivered under direct supervision in a controlled rehabilitation/clinic setting. By focusing on clinically meaningful functional outcomes, this trial aims to determine whether supervised eye exercises may represent a practical and effective adjunct rehabilitation strategy for improving mobility- and balance-related outcomes in people with Parkinson's disease. All functional assessments will be performed at approximately the same time of day and in the participant's usual "ON" medication state, preferably 1-2 hours after antiparkinsonian medication intake, where feasible. Medication timing will be recorded at each assessment.
Interventions
BEHAVIORALSupervised In-Center Eye Exercises
The participants in the study group will perform the eye-exercise program in a standardized seated position under supervision by trained study personnel in a rehabilitation/clinic setting. The exercises will be administered face-to-face and will include progressive visual fixation, smooth pursuit, saccadic eye movements, convergence/divergence, gaze stabilization, and combined eye-head coordination tasks. Progression will be based on increases in movement speed, number of repetitions, task complexity, and participant tolerance, while maintaining the standardized seated position and ensuring safety throughout the intervention.
Sponsors
Pardis Specialized Wellness Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
A research project collaborator who is not informed about grouping of participants will obtain outcome measurements of the functional tests. Outcome adjudicators and data analysts will be kept blinded to the allocation. Due to the nature of the behavioral intervention, participants and intervention personnel cannot be blinded to group allocation. Outcome assessors and data analysts will remain blinded to group allocation. Participants will be instructed not to disclose their group assignment to the outcome assessor.
Intervention model description
Participants will be randomly allocated to intervention group or control group and will be examined in the same way.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18-80 years with clinically diagnosed idiopathic Parkinson's disease; * Hoehn and Yahr stage 1-3; * Stable antiparkinsonian medication regimen for at least 4 weeks before enrollment; * Able to stand unaided and walk independently with or without an assistive device; * Adequate corrected vision to perform eye-exercise tasks; * Able to understand and follow simple exercise instructions; * Able to attend supervised in-center sessions three times per week for 8 weeks; * Able to provide written informed consent.
Exclusion criteria
* Unstable cardiovascular, orthopedic, vestibular, or neurological condition interfering with safe participation; * Active infection or acute medical illness; * Severe uncorrected visual impairment preventing participation in eye-exercise tasks; * Recent myocardial infarction or stroke within the past 3 months; * Change in antiparkinsonian medication during the 4 weeks before enrollment or planned medication change during the intervention period; * Severe dizziness, uncontrolled vertigo, or other condition that may be worsened by eye-head coordination exercises; * Any other condition judged by the study physician to make participation unsafe.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in dynamic balance | Baseline and 8 weeks | Dynamic balance will be assessed using the Mini-BESTest total score. The Mini-BESTest evaluates anticipatory postural adjustments, reactive postural control, sensory orientation, and dynamic gait. Higher scores indicate better dynamic balance and postural control. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in functional mobility | Baseline and 8 weeks | Assessed with the Timed Up and Go test. Shorter completion times indicate better functional mobility. |
| Change in gait speed | Baseline and 8 weeks | Assessed with the 10-Meter Walk Test. Faster walking speed indicates better gait performance. |
| Change in fall-related concern | Baseline and 8 weeks | Assessed with the Falls Efficacy Scale-International (FES-I). Higher scores indicate greater concern about falling. |
| Change in walking endurance | Baseline and 8 weeks | Assessed with the 6-Minute Walk Test. Greater distance indicates better walking endurance and physical function. |
| Number of participants with adverse events during the intervention period | Baseline and 8 weeks | Adverse events will include dizziness, nausea, headache, eye strain, worsening balance, near-falls, falls, musculoskeletal discomfort, or any event requiring session termination or medical evaluation. |
Countries
Iran
Contacts
STUDY_DIRECTORMohammad Ali Tabibi, Dr
Pardis Specialized Wellness Institute
Outcome results
None listed