Upper Extremity Rehabilitation With Virtual Reality in Parkinson's Disease Patients

March 26, 2026 updated by: Ramazan KURUL

Effectiveness of Virtual Reality Supported Upper Extremity Position Matching Exercises in Parkinson's Disease Patients

Upper extremities are the first part of the body to be affected by Parkinson's disease. Although studies have shown that virtual reality-assisted rehabilitation methods are effective on gait and balance, studies on their use for upper extremity rehabilitation are limited. For this reason, the aim of the project is to examine whether virtual reality supported upper extremity position matching exercises, which will be specially prepared according to joint ranges of motion, will provide functional improvement in the upper extremities of individuals with Parkinson's disease.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor disorders. Difficulties in using the upper limbs caused by these motor impairments are common with the disease. Upper limb motor impairments in PD include slowness of movement, difficulties in performing sequential tasks and limitations in upper limb function. Studies show that the upper extremities are usually the most affected body region in the early stages of PD. Despite this, the number of rehabilitation methods that can be used for upper extremity rehabilitation is limited. Impairments in upper extremity motor function constitute a leading problem in the lives of individuals with PD by affecting their ability to perform activities of daily living. Virtual reality applications stand out as an innovative approach in neurorehabilitation. Previous studies have reported positive effects of virtual reality on gait function and balance in PD. However, the number of studies designed with virtual reality for the upper limb is limited. Therefore, this project aims to fill the gap in the literature by examining the effectiveness of virtual reality-based rehabilitation in PD with a particular focus on upper extremity motor function and proprioception.

Study Type

Interventional

Enrollment (Actual)

44

Phase

  • 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

  • Turkey (Türkiye)
    • Merkez
      • Bolu, Merkez, Turkey (Türkiye), 14100
        • Faculty of Health Sciences Bolu Abant Izzet Baysal University

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

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Accepting to participate in the research
  • Being diagnosed with Parkinson's Disease by a neurologist
  • Continuing anti-parkinsonian medication
  • Hoehn-Yahr (H-Y) stage 3 and below
  • Ability to walk independently
  • To have full range of motion in shoulder abduction and elbow extension movements

Exclusion Criteria:

  • Presence of additional neurological diseases other than Parkinson's Disease
  • Scores below 21 on the Montreal Cognitive Assessment Scale
  • Change in medication dosage in the last 1 month
  • Severe visual impairment or complete hearing impairment in both ears
  • Having a rheumatologic, musculoskeletal, etc. disease that may affect upper extremity functions
  • The occurrence of severe tremors or dyskinesias due to the end of the drug dose
  • Failing the Titmus butterfly test

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: VR group
group to receive virtual reality supported upper extremity rehabilitation in addition to conventional physiotherapy
Other: Upper extremity position matching exercises in virtual reality
In addition to conventional treatment approaches for 20 minutes 2 days a week for 8 weeks, joint positioning exercises (4 different game sequences of 4 minutes, 1 minute rest between each sequence, total 20 minutes) designed specifically for the individual's existing range of motion will be applied to the VR group.
Other: Conventional physiotherapy
proprioceptive neuromuscular facilitation techniques, parkinson-specific upper extremity and balance and gait exercises
Active Comparator: Control group
The group that will receive conventional physiotherapy for the total treatment time of the VR group
Other: Conventional physiotherapy
proprioceptive neuromuscular facilitation techniques, parkinson-specific upper extremity and balance and gait exercises

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proprioception Assessment
Time Frame: through study completion, an average of 1 year
Position, i.e. proprioceptive sensation, will be evaluated with the "angle repetition test", one of the methods commonly used in the clinic. The person will be positioned in a sitting position with his/her back unsupported and feet touching the floor. The angle repetition test will be performed with a mobile device fixed above the elbow and between the shoulder. The person's eyes will be closed during the assessment to prevent the learning effect and the use of visual reference. After the shoulder is brought to the reference angle, the person is allowed to perceive the angle by waiting 10 seconds. The person will then be asked to bring his/her shoulder to the side of his/her body and then repeat the taught reference angle as he/she perceived it. The absolute value of the angle deviated from the target will be recorded. Measurements in the shoulder joint will be made at 40° and 100° angles.
through study completion, an average of 1 year
Box and Block Test (BBT)
Time Frame: through study completion, an average of 1 year

The Box and Block Test (BBT) is widely used in neurological rehabilitation to assess upper extremity motor function, gross manual dexterity, and coordination. The test apparatus consists of a partitioned box measuring 53.7 × 25.4 × 8.5 cm and 150 wooden cubes.

During administration, the box is placed in front of the participant with the partition aligned to the midline. The participant is instructed to transfer the cubes from one compartment to the other using the test hand as quickly as possible. At the end of the trial, the therapist records the score by counting the number of cubes successfully transferred.
through study completion, an average of 1 year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Unified Parkinson's Disease Rating Scale
Time Frame: through study completion, an average of 1 year
It is the most frequently used, valid and reliable scale for the assessment of impairments and disabilities in PD. It contains 42 items, consists of 4 sections and assesses patients' mental status, behavior and mental state (4 items), activities of daily living (13 items), motor functions (14 items) and treatment complications (11 items), respectively. Mental status; 16 points, activities of daily living; 52 points, motor functions; 108 points and treatment complications; 23 points, totaling 199 points. Higher scores indicate worsening of the patient's condition. An 8-point change in the total score was found to determine minimal clinically significant change.
through study completion, an average of 1 year
Disabilities of the Arm, Shoulder, and Hand Questionnaire
Time Frame: through study completion, an average of 1 year
It is a questionnaire consisting of a total of 30 questions used to evaluate the ability of the patient with upper extremity problems in activities of daily living and upper extremity functions. The first 21 questions ask about the degree of difficulty in performing various activities of daily living with the dominant limb in the last week, the next 5 questions ask about the degree of pain, numbness, weakness during activities and the last 4 questions ask about the effect of pathologies on sleep, work, social life and psychological status. For each question, the patient marked the appropriate response on a 5-point Likert-type scale. 1 indicates no difficulty, 2 indicates mild difficulty, 3 indicates moderate difficulty, 4 indicates extreme difficulty, and 5 indicates no difficulty at all. The questionnaire is evaluated between 30 and 150 points.
through study completion, an average of 1 year
Parkinson's Disease Questionnaire (PDQ-8)
Time Frame: through study completion, an average of 1 year
The questions in the PDQ-8 assess the condition of the individual in the last 1 month and are scored between 0 (never) and 4 (always). The total score is converted to a 100-point system and a high score indicates a decrease in quality of life.
through study completion, an average of 1 year
Intrinsic Motivation Inventory (IMI)
Time Frame: average 1 year after the completion of the study
The Intrinsic Motivation Inventory (IMI) is used to assess motivation and satisfaction during task performance. It is a multidimensional questionnaire that evaluates interest/enjoyment, perceived competence, pressure/tension, perceived choice, and value/usefulness. Responses are rated on a Likert scale ranging from "not at all true" to "very true." The total motivation score is calculated by summing the item scores.
average 1 year after the completion of the study

Collaborators and Investigators

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

Sponsor

Ramazan KURUL

Collaborators

Abant Izzet Baysal University

Investigators

  • Principal Investigator: Ramazan Kurul, Ph.D, Abant Izzet Baysal University

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)

November 1, 2023

Primary Completion (Actual)

October 1, 2024

Study Completion (Actual)

October 15, 2024

Study Registration Dates

First Submitted

September 27, 2023

First Submitted That Met QC Criteria

November 22, 2023

First Posted (Actual)

November 28, 2023

Study Record Updates

Last Update Posted (Actual)

March 31, 2026

Last Update Submitted That Met QC Criteria

March 26, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • AIBU-FTR-BENLI-005

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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