Conventional Physical Therapy Action Observation Therapy on Freezing of Gait and Functional Mobility in Parkinson's Disease

Effects Of Conventional Physical Therapy With And Without Action Observation Therapy On Freezing Of Gait And Functional Mobility In Participants With Parkinson's Disease: A Randomised Clinical Trial

The goal of this study is to determine the effects of action observation therapy with conventional physical therapy on freezing gait and functional limitation in participants with Parkinson's disease.

Study Overview

• Status: Completed
• Conditions: Parkinson Disease; Neuro-Degenerative Disease
• Intervention / Treatment: Other: Conventional Physical Therapy; Other: Action Observation plus conventional Physical Therapy

Detailed Description

Parkinson's disease is a neurodegenerative disorder that is characterized by rigidity, tremors, and bradykinesia, along with non-motor dysfunction. The exercise rehabilitation has a positive impact on motor and non-motor functions in individuals with Parkinson's disease. Conventional physical therapy (CPT) that involves isometric exercises, stretching techniques, and strength and balance training is useful to improve the severity of functional mobility and freezing of gait. In action observation therapy (AOT), small video clips of different goal-directed tasks were added to rehabilitation to determine the combined effects on outcome.

• Study Type: Interventional
• Enrollment (Actual): 42
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • The University of Lahore

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria: The participants were included based on the UK Parkinson's Disease Society Brain Bank diagnostic criteria, with clinical findings supporting the diagnosis. The eligible participants were aged between 50 and 80 years, of both genders, labelled as stage ≤ 3, with a minimum of 2 years since being diagnosed with PD and a freezing of gait score of 9 or higher on FOG-Q, and able to understand and follow commands.

Exclusion Criteria:

The exclusion criteria were systemic disease and neurological issues that could affect the assessment and outcomes of treatment, implantation for deep brain stimulation, and visual or acoustic limitations.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Conventional Physiotherapy Group; This group included conventional physical therapy that contains isometric exercise, stretching techniques, and strength and balance training.	Other: Conventional Physical Therapy; Group A received conventional physical therapy treatment. The CPT program consists of isometric exercises, stretching, and strength training based on the patient's physical condition and the severity of functional mobility and freezing of Gait.
Experimental: Experimental Group; This group included action observation therapy in addition to conventional physical therapy, in which small videos containing specific task will be made available to follow to the participants.	Other: Action Observation plus conventional Physical Therapy; Group B was given action observation therapy with conventional physical therapy treatment. In AOT, the therapist showed small video clips of different goal-directed tasks to participants, and they were asked to follow every step and movement. The therapist maintained the patient's attention with verbal feedback

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in functional mobility	The TUG is an efficient test that measures mobility and balance, requiring participants to rise from a chair, walk 3 meters, turn, walk back, and sit down. The time taken to complete this sequence is recorded, with longer times indicating potential mobility issues. A score of more than or equal to fourteen seconds indicates a high risk of falls.	The assessment was made at baseline before the treatment session, and any change in mobility status was observed at the end of 6th week and 12th week after the intervention.
Change in Freezing of gait	The FOG-Q is a reliable tool for evaluating the effectiveness of treatment intervention on FOG for Parkinson's disease. The questionnaire consists of 6 items designed to assess the severity of freezing of gait. Each item is rated on a five-point Likert scale, with '0' indicating no symptoms and '4' indicating the most severe symptoms. The total score can range from 0 to 24, with higher scores indicating greater severity of freezing of gait.	The freezing of gait was assessed at baseline, and any change in it was measured at the end of 6th week and 12th week after the intervention.

Collaborators and Investigators

• Sponsor: University of Lahore
• Investigators: Study Director: Ishfaq Ahmed, PhD Physiotherapy, University of Lahore

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2023
• Primary Completion (Actual): June 1, 2024
• Study Completion (Actual): July 1, 2024

Study Registration Dates

• First Submitted: November 17, 2025
• First Submitted That Met QC Criteria: November 17, 2025
• First Posted (Actual): November 24, 2025

Study Record Updates

• Last Update Posted (Actual): November 24, 2025
• Last Update Submitted That Met QC Criteria: November 17, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Balance; Parkinson's Disease; Function; Mobility; Freezing of Gait
• Additional Relevant MeSH Terms: Synucleinopathies; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurodegenerative Diseases; Movement Disorders; Parkinsonian Disorders; Basal Ganglia Diseases; Parkinson Disease
• Other Study ID Numbers: Kiran Maqsood

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data (IPD) that underlie the results reported in the study will be shared.
• IPD Sharing Time Frame: Three years after the publication of result findings

IPD Sharing Access Criteria

Access to the de-identified individual participant data (IPD) and supporting documents will be available to qualified researchers affiliated with recognized academic or research institutions. Interested researchers may request access by submitting a written proposal outlining the study objectives and analysis plan to the principal investigator or corresponding author.

Upon approval, the data (including de-identified participant-level datasets, study protocol, and statistical analysis plan) will be shared via a secure institutional data repository or encrypted email. Data will be provided solely for non-commercial, academic research purposes and must comply with applicable ethical and data protection standards.

• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No