Effects of Virtual Reality Based Games in Rehabilitation of Parkinson's Disease

Study Overview
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Brief Summary
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The purpose of this study is to investigate the effects of virtual reality based games on upper extremities, trunk and cognitive functions in patients with Parkinson's Disease.

Official Title
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Effects of Virtual Reality Based Games on Upper Extremities, Trunk and Cognitive Functions in Parkinson's Disease

Conditions
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Parkinson Disease

Intervention / Treatment
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* Other: Virtual reality based games
* Other: Conventional exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosed with Parkinson's disease 50 years old and over Stage 1.5-3 according to the modified Hoehn-Yahr Staging Scale Mini mental test score of 24 and above Exclusion Criteria: Additional neurological disease or symptom other than Parkinson's disease Orthopedic disorder that will prevent them from doing exercises Severe mental disorders

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: study group<br>1 hour physiotherapy session for 3 times a week and 8 weeks in total. | Other: Virtual reality based games<br>* In an hour physiotherapy session first 40 minutes of session includes conventional physiotherapy program tailored to patient's needs. Last 20 minutes of session includes virtual reality based games aiming improvement on upper extremities, trunk and cognitive functions.<br>|
| Active Comparator: control group<br>1 hour physiotherapy session for 3 times a week and 8 weeks in total. | Other: Conventional exercises<br>* In an hour physiotherapy session first 40 minutes of session includes conventional physiotherapy program tailored to patient's needs. Last 20 minutes of session includes conventional physiotherapy approaches aiming improvement on upper extremities, trunk and cognitive functions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Upper extremities performance with 9 hole peg test | The patient sits with a table in front of him/her and places 9 small wooden sticks on the surface with nine holes on them, takes them out again and lays them on his/her side. He/she is asked to do it as quickly as possible and his/her time is saved | Change from Baseline at 8 weeks | 
| Upper extremities performance with Minnesota Manual Dexterity Test | It involves taking small disc-shaped objects, each of standard size, to different distances on the table in the shortest possible time and placing them in sequence, while the patient is in a sitting position with a table in front of him/her. | Change from Baseline at 8 weeks | 
| Cognitive Status with Montreal Cognitive Assessment | its validity and reliability in Turkish have been established. The total score ranges from 0-30, and a higher score indicates a better cognitive status. Below 21 points indicates cognitive impairment. | Change from Baseline at 8 weeks | 
| Trunk Functions with Trunk Impairment Scale | It is a valid and reliable scale for evaluating the motor disorders and balance of the trunk in Parkinson's patients. The total score in the scale, which consists of 17 items in 3 sections, ranges from 0 to 23. A higher score indicates better trunk function and balance. | Change from Baseline at 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dynamic balance with functional reach test | Functional reach test is frequently used to assess dynamic balance and fall risk. While the patient is standing by the wall, he/she raises his/her arm to 90 degrees and tries to reach as far as he/she can without taking his/her feet off the ground. Extending a longer distance indicates better balance and less risk of falling | Change from Baseline at 8 weeks | 
| Balance and mobility with Timed Up and Go Test | While the patient is in a sitting position, he/she is asked to stand up from the chair, walk 3 meters, turn around, come back and sit down, and the time is recorded. Doing it in less time demonstrates better balance and mobility | Change from Baseline at 8 weeks | 
| Quality of life with Parkinson's Disease Questionnaire | The 39-item Parkinson's Disease Questionnaire was developed to evaluate the quality of life of Parkinson's patients and has Turkish validity and reliability. Higher scores mean worse outcome. | Change from Baseline at 8 weeks | 
| Disease severity and symptoms with Unified Parkinson Disease Rating Scale Part 2 and 3 | It is one of the most frequently used scales to evaluate the severity of the disease in Parkinson's patients. It evaluates many problems such as motor and non-motor problems, treatment complications, problems in daily living activities and consists of 4 sections. However, in our study, the 2nd and 3rd sections which evaluate motor problems and activities of daily living will be used. Higher scores mean worse outcome. | Change from Baseline at 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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parkinson disease, physiotherapy, exergames