Effects of Whole Body Vibration Versus Proprioceptive Neuromuscular Facilitation Pattern With Rhythmic Based Training on Clinical Outcomes in Patients With Parkinson's Disease.

July 20, 2026 updated by: Lahore University of Biological and Applied Sciences
This study has important clinical, academic, and practical relevance in neuromuscular rehabilitation. Clinically, it aims to identify effective and tolerable rehabilitation strategies for individuals with Parkinson's disease by comparing whole-body vibration therapy with proprioceptive neuromuscular facilitation (PNF) patterns combined with rhythmic-based training, thereby supporting evidence-based physiotherapy practice and improving patient adherence. Academically, it contributes to the limited literature on comparative effectiveness of these interventions and incorporates patient-centered outcomes such as exercise perception, which are often underreported. From a practical and societal perspective, identifying a more acceptable and effective approach may enhance long-term participation in rehabilitation, potentially slow disease progression, improve quality of life, and reduce the overall healthcare burden associated with Parkinson's disease.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Parkinson's disease is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra, leading to motor symptoms such as tremor, rigidity, bradykinesia, and postural instability. It also presents with non-motor symptoms including cognitive decline, autonomic dysfunction, and reduced quality of life. The title of the present study focuses on evaluating the effectiveness of a combined rehabilitation approach integrating rhythmic-based training, whole-body vibration, and proprioceptive neuromuscular facilitation to improve gait, balance, and functional mobility in individuals with Parkinson's disease. The proposed protocols involve structured rhythmic auditory cueing exercises to enhance movement coordination and timing, whole-body vibration sessions aimed at improving neuromuscular activation and muscle strength, and proprioceptive neuromuscular facilitation techniques to facilitate motor control, flexibility, and functional movement patterns; these interventions are delivered in a progressive manner, tailored to patient tolerance and disease severity, with close monitoring to ensure safety and adherence. The study design is a randomized clinical trial with two experimental groups. The study duration is expected to span 8 to 12 weeks, allowing sufficient time for neuromuscular adaptations and observable functional improvements while maintaining feasibility and participant compliance. Outcome measures include standardized and validated tools such as the Unified Parkinson's Disease Rating Scale for assessing disease severity, the Timed Up and Go test for functional mobility, the 10-Meter Walk Test for gait speed, the Mini-BESTest for dynamic balance, and quality of life scales to evaluate overall patient well-being; these measures are recorded at baseline and post-intervention to determine the effectiveness of the combined rehabilitation protocol, providing comprehensive insight into motor performance, balance control, and functional independence in individuals with Parkinson's disease.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
42

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Shakargarh, Punjab Province, Pakistan, 51580
        • THQ Shakargarh

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age between 40 and 60 years.
  • Patients of both genders (male and female).
  • Parkinson's disease severity at Hoehn and Yahr (H&Y) stage 2 and 3.
  • Ability to walk independently for 6 minutes without an assistive device.
  • Score greater than 40 on the Berg Balance Scale.

Exclusion Criteria:

  • Presence of impaired Cognition.
  • Significant Orthopedic and Musculoskeletal conditions that limit the adherence to exercise and WBV requirements.
  • Other medical conditions like thrombosis, cardiovascular conditions and medical implants that are contradicted for WBV.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Whole Body Vibration with Rhythmic Based Training
Whole Body Vibration (WBV) and Rhythm-Based Training (RBT) are adjunct therapeutic interventions used to enhance functional mobility, balance, and motor coordination. WBV provides mechanical oscillatory stimuli to the body through a vibration platform, aiming to improve neuromuscular activation and postural control. RBT utilizes external auditory cues to guide movement timing, promoting auditory-motor entrainment and improving movement coordination and gait performance.
Other: Whole Body Vibration with Rhythmic Based Training
WBV will be applied during standing exercises using a vibration platform set at a frequency of 11 Hz and an amplitude of 3-6 mm (vertical oscillation). The intervention will be administered in intermittent cycles of 1 minute of vibration followed by 1 minute of rest, with a total cumulative exposure of 10-14 minutes per session (5-7 bouts). Concurrently, RBT will be delivered using an auditory metronome providing rhythmic cues synchronized with the exercise movements, with the tempo maintained between 110-130 beats per minute (BPM) to facilitate timing, coordination, and motor performance.
Experimental: Proprioceptive Neuromuscular Facilitation Pattern with Rhythmic Based Training
Proprioceptive Neuromuscular Facilitation (PNF) Rhythmic Initiation (RI) D1 patterns combined with Rhythm-Based Training (RBT) are used to facilitate motor learning, improve movement initiation, and enhance neuromuscular coordination. The D1 flexion and extension patterns of PNF target coordinated multi-planar upper and lower limb movements, progressing through passive, active-assisted, and active-resistive phases to improve motor control, normalize muscle tone, and increase movement efficiency. RBT provides external auditory cueing to enhance timing and rhythmic synchronization of voluntary movement.
Other: Proprioceptive Neuromuscular Facilitation Pattern with Rhythm-Based Training
The patient will perform PNF Rhythmic Initiation (RI) D1 flexion and extension patterns for both upper and lower extremities in standing. The D1 flexion pattern involves shoulder extension, abduction, and external rotation progressing to flexion, adduction, and internal rotation, while the D1 extension pattern represents the reverse movement. The exercise will be progressed from passive to active-assisted and then to active-resistive movements to facilitate motor control and movement initiation. In addition, Rhythm-Based Training (RBT) will be applied using an auditory metronome to provide rhythmic cues synchronized with the active phase of the PNF movements, particularly during transitions between flexion and extension, with a consistent tempo of 110-130 beats per minute (BPM).

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Timed Up and Go (TUG) Test
Time Frame: [Time Frame: baseline, 8 weeks (post intervention), 12 weeks (follow up)]
The Timed Up and Go (TUG) test is a simple functional mobility assessment that measures the time taken (in seconds) to stand from a chair, walk 3 meters, turn, walk back, and sit down. It evaluates balance, gait, and functional mobility in a single task. Lower scores indicate better performance, with <10 seconds considered normal, 10-20 seconds indicating mostly independent mobility, and >20 seconds suggesting functional limitation. It is also commonly used as an indicator of fall risk, especially in neurological populations such as Parkinson's disease.
[Time Frame: baseline, 8 weeks (post intervention), 12 weeks (follow up)]
Unified Parkinson's Disease Rating Scale - Part III (UPDRS-III)
Time Frame: [Time Frame: baseline, 8 weeks (post intervention), 12 weeks (follow up)]
The Unified Parkinson's Disease Rating Scale (UPDRS-III) is a clinician-administered tool used to evaluate motor impairment in Parkinson's disease. It assesses key motor domains including tremor, rigidity, bradykinesia, posture, gait, and postural stability through direct observation. Each item is scored on a 0-4 scale, where 0 represents normal function and 4 indicates severe impairment, with a maximum total score of 132. Higher scores reflect greater motor dysfunction. The scale is widely used for monitoring disease severity and progression in both clinical and research settings.
[Time Frame: baseline, 8 weeks (post intervention), 12 weeks (follow up)]
Mini-Balance Evaluation Systems Test (Mini-BESTest)
Time Frame: [Time Frame: baseline, 8 weeks (post intervention), 12 weeks (follow up)]
The Mini-BESTest is a clinical balance assessment designed to evaluate dynamic balance and postural control across multiple systems, including anticipatory postural adjustments, reactive postural control, sensory orientation, and gait stability. It consists of 14 items scored from 0 to 2, with a total score ranging from 0 to 28, where higher scores indicate better balance performance. It is particularly sensitive in detecting balance impairments and fall risk in individuals with neurological conditions such as Parkinson's disease.
[Time Frame: baseline, 8 weeks (post intervention), 12 weeks (follow up)]
10-Meter Walk Test (10MWT)
Time Frame: [Time Frame: baseline, 8 weeks (post intervention), 12 weeks (follow up)]
The 10-Meter Walk Test (10MWT) is a standardized measure of gait speed, where the time taken to walk a central 10-meter distance is recorded and converted into meters per second (m/s). It assesses functional walking ability and mobility performance. The test can be performed at a comfortable or fast pace to evaluate functional capacity. It is widely used in Parkinson's disease to monitor gait impairments and response to rehabilitation, as gait speed is a strong indicator of overall functional status.
[Time Frame: baseline, 8 weeks (post intervention), 12 weeks (follow up)]

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Lahore University of Biological and Applied Sciences

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
May 1, 2026

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 9, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
July 9, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 20, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 20, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 23, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 23, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 20, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • UBAS/ERB/26/04/038

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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