The Effect of the Reaction Training in Parkinson's Disease

NCT ID: NCT06807385

Last Updated: 2026-01-08

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 26 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-02-17
• Study Completion Date: 2025-11-06

Brief Summary

Parkinson's disease (PD) is one of the most common neurodegenerative diseases. Patients frequently experience decreased amplitude and speed of movements, balance, and gait problems. Although the basal ganglia have been the target neuroanatomical region for movement disorders in Parkinson's disease for many years, recent neuroscience studies have shown that the cerebellum also plays an important role in the disease and is an important alternative target for treatment applications. While medical applications are becoming current for this purpose, there is a significant deficiency in the literature in terms of physiotherapy applications. Reaction and dual task are activities that have been shown to naturally stimulate the cerebellum. The aim of this study is to examine the effects of combined exercise training, which includes dual skills and reaction activities that have been shown to stimulate the cerebellum in PD, on the reaction time, intuitive postural adjustments, and balance of PD. Our study is an original study that targets the cerebellum in PD with reaction training according to current neuroscience results, aims to contribute to the field of neuroscience and translational medicine, and has no previous example in the literature. This study will include patients diagnosed with idiopathic Parkinson's disease by a specialist physician. The PD patients included in the study will be randomly divided into two groups. The reaction group will be applied a combined reaction training program consisting of 15 exercises, including a light reaction measurement and an exercise system. The conventional group will be applied an exercise program consisting of only 15 exercises without reaction training. The patients included in the study will be subjected to reaction time, amplitude of intuitive postural adjustments, balance, and functional mobility assessments before and after the training. The light reaction measurement and exercise system will be applied for the measurement of reaction time of the volunteers, the static-dynamic balance assessment device for the assessment of intuitive postural adjustments and the static-dynamic balance assessment device for balance assessments, and the Timed Up and Go Test will be applied to assess functional mobility. At the end of the study, we aim to demonstrate the effect of combined exercise training targeting the cerebellum compared to conventional exercise training in Parkinson's patients, to create clinical outcomes for the inclusion of the cerebellum in more physiotherapy programs in Parkinson's disease, and to provide clinical outcomes for physiotherapists for a new exercise protocol, as well as making scientific contributions to the fields of translational medicine and neuroscience.

Conditions

Parkinson' Disease

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Reaction Training Group

In this group, we will use a reaction training and measurement system (Blazepod) for visual stimuli reaction training. Each exercise duration will be three minutes. The experimental group will apply reaction training two times a week for eight weeks. Each session will complet in 60 minutes.

Group Type: EXPERIMENTAL

Reaction Training

Intervention Type: OTHER

• The exercise list consists of 15 different exercises that aim to both shorten reaction time and improve stability with upper and lower extremity movements in different positions. In addition, the program includes both dual motor tasks and difficulties that require the physiotherapist to give the patient constantly changing motor tasks (tasks related to the color of the light to be touched, giving the command to read lights that are lit in different directions) and a second cognitive task.
• Each station will be worked for 3 minutes, with at least 1 minute of rest between stations. Sessions will be planned by selecting the exercises in the exercise list for 60 minutes.

• Appropriate modifications will be made to the station so that the difficulty of the exercise in the relevant station will be moderate (12-15 points) according to the Borg scale.

Control Group

The exercises used in reaction training will be applied as in conventional training without visual aids. The difficulty of the exercise will be increased by changing the support surface and ground properties, taking the difficulty perceived by the individual as the criterion, as in reaction training.

Group Type: ACTIVE_COMPARATOR

Conventional Exercises

Intervention Type: OTHER

The exercises used in reaction training will be applied as in conventional training without reaction training system. The difficulty of the exercise will be increased by changing the support surface and ground properties, taking the difficulty perceived by the individual as the criterion, as in reaction training.

The exercise list consists of 15 different exercises that aim to improve stability with upper and lower extremity movements in different positions. In addition, the program includes both dual motor tasks and difficulties that require the physiotherapist to give the patient constantly changing motor tasks and a second cognitive task. Each station will be worked for 3 minutes, with at least 1 minute of rest between stations. Sessions will be planned by selecting the exercises in the exercise list for 60 minutes. Appropriate modifications will be made to the station so that the difficulty of the exercise in the relevant station will be moderate (12-15 points for Borg Scale).

Interventions

Reaction Training

• The exercise list consists of 15 different exercises that aim to both shorten reaction time and improve stability with upper and lower extremity movements in different positions. In addition, the program includes both dual motor tasks and difficulties that require the physiotherapist to give the patient constantly changing motor tasks (tasks related to the color of the light to be touched, giving the command to read lights that are lit in different directions) and a second cognitive task.
• Each station will be worked for 3 minutes, with at least 1 minute of rest between stations. Sessions will be planned by selecting the exercises in the exercise list for 60 minutes.

• Appropriate modifications will be made to the station so that the difficulty of the exercise in the relevant station will be moderate (12-15 points) according to the Borg scale.

Intervention Type: OTHER

Conventional Exercises

The exercises used in reaction training will be applied as in conventional training without reaction training system. The difficulty of the exercise will be increased by changing the support surface and ground properties, taking the difficulty perceived by the individual as the criterion, as in reaction training.

The exercise list consists of 15 different exercises that aim to improve stability with upper and lower extremity movements in different positions. In addition, the program includes both dual motor tasks and difficulties that require the physiotherapist to give the patient constantly changing motor tasks and a second cognitive task. Each station will be worked for 3 minutes, with at least 1 minute of rest between stations. Sessions will be planned by selecting the exercises in the exercise list for 60 minutes. Appropriate modifications will be made to the station so that the difficulty of the exercise in the relevant station will be moderate (12-15 points for Borg Scale).

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Being diagnosed with "Parkinson's Disease" by a specialist neurologist according to the diagnostic criteria of the Movement Disorders Association
• Being between stages 1-3 according to the Hoehn and Yahr Staging
• Having additional neurological (migraine etc.), orthopedic (osteoarthritis etc.), cardiovascular (hypertension, benign arrhythmias etc.) diseases

Exclusion Criteria

• Having a Standardized Mini-Mental Test score of >25
• Having a visual or hearing impairment that cannot be corrected with a device
• Having additional neurological (migraine etc.), orthopedic (osteoarthritis etc.), cardiovascular (hypertension, benign arrhythmias etc.) diseases

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Gazi University

OTHER

Sponsor Role: lead

Responsible Party

Mustafa Can Salamci

MSc

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Gazi University

Ankara, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

References

Lewis MM, Galley S, Johnson S, Stevenson J, Huang X, McKeown MJ. The role of the cerebellum in the pathophysiology of Parkinson's disease. Can J Neurol Sci. 2013 May;40(3):299-306. doi: 10.1017/s0317167100014232.

Reference Type: RESULT

PMID: 23603164 (View on PubMed)

Gündüz, A. G., Otman, A. S., Köse, N., Bilgin, S., & Elibol, B. (2009). Parkinson hastalığında farklı denge ölçeklerinin karşılaştırılması. Fizyoterapi Rehabilitasyon, 20(1), 17-24.

Reference Type: RESULT

Gao L, Zhang J, Hou Y, Hallett M, Chan P, Wu T. The cerebellum in dual-task performance in Parkinson's disease. Sci Rep. 2017 Mar 30;7:45662. doi: 10.1038/srep45662.

Reference Type: RESULT

PMID: 28358358 (View on PubMed)

Lupinacci NS, Rikli RE, Jones CJ, Ross D. Age and physical activity effects on reaction time and digit symbol substitution performance in cognitively active adults. Res Q Exerc Sport. 1993 Jun;64(2):144-50. doi: 10.1080/02701367.1993.10608791.

Reference Type: RESULT

PMID: 8341837 (View on PubMed)

Akbostanci MC, Bayram E, Yilmaz V, Rzayev S, Ozkan S, Tokcaer AB, Saka E, Durmaz Celik FN, Barut BO, Tufekcioglu Z, Acarer A, Balaban H, Erer S, Dogu O, Kibaroglu S, Aydin N, Hanagasi H, Elibol B, Emre M, Stebbins GT, Goetz CG. Turkish Standardization of Movement Disorders Society Unified Parkinson's Disease Rating Scale and Unified Dyskinesia Rating Scale. Mov Disord Clin Pract. 2017 Nov 16;5(1):54-59. doi: 10.1002/mdc3.12556. eCollection 2018 Jan-Feb.

Reference Type: RESULT

PMID: 30363359 (View on PubMed)

Other Identifiers

2023-925

Identifier Type: -

Identifier Source: org_study_id