The Effects of Tele-Rehabilitation-Based Dual-Task Upper Extremity Training in Patients With Parkinson's Disease

Investigating the Effects of Tele-Rehabilitation-Based Dual-Task Upper Extremity Training in Patients With Parkinson's Disease

The aim of this study is to compare the effects of tele-rehabilitation-based synchronous and asynchronous dual-task upper extremity training with clinical based dual-task upper extremity training and conventional single-task upper extremity training in patients with Parkinson's disease. The main questions it aims to answer are:

• Whether there are differences in motor symptoms, hand dexterity, upper extremity functions, grip strength, executive functions, daily living activities, and treatment satisfaction between tele-rehabilitation-based synchronous and asynchronous dual-task upper extremity training, clinical-based dual-task upper extremity training, and conventional single-task upper extremity training in patients with Parkinson's disease.
• Whether there is a difference in telemedicine satisfaction between tele-rehabilitation-based synchronous and asynchronous dual-task upper extremity training in patients with Parkinson's disease.

Researchers will compare conventional single-task upper extremity training, clinical-based dual-task upper extremity training, tele-rehabilitation-based synchronous upper extremity training and tele-rehabilitation-based asynchronous upper extremity training.

Participants will:

• Receive upper extremity exercise training at the study clinic or home, twice a week for approximately 60 minutes each time, for 6 weeks.
• Participate in assessments at the study clinic before and after exercise training.

Study Overview

• Status: Not yet recruiting
• Conditions: Parkinson's Disease (PD)
• Intervention / Treatment: Other: Conventional Single Task Upper Extremity Exercise Training; Other: Clinic-Based Dual Task Upper Extremity Exercise Training; Other: Tele-Rehabilitation Based Synchronous Dual Task Upper Extremity Exercise Training; Other: Tele-Rehabilitation Based Asynchronous Dual Task Upper Extremity Exercise Training

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Having been diagnosed with Parkinson's disease by a neurologist according to the UK Brain Bank criteria
• Being in stage 3 or higher according to the Hoehn-Yahr Scale
• Having a caregiver capable of providing the necessary assistance during tele-rehabilitation sessions and using the required equipment and programs.
• Having the device and software to conduct remote video calls for tele-rehabilitation

Exclusion Criteria:

• Presence of a neurological disease other than Parkinson's disease
• Cognitive impairment (Standardized Mini Mental Test score less than 24)
• Having undergone deep brain stimulation surgery
• Having a visual, auditory, or perceptual problem
• Having any orthopedic, rheumatological, or other condition that may affect hand functions

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Single Task Training; Conventional, clinic-based, single task upper extremity training	Other: Conventional Single Task Upper Extremity Exercise Training; Conventional single task upper extremity exercise training at clinical setting. The first 5 minutes of the training session will consist of a warm-up period of stretching and breathing exercises, followed by a cool-down period of the same exercises.Nine different upper extremity activities (using a fork and spoon, tying shoelaces, reaching, throwing a ball, filling water, folding a sheet, drawing shapes, buttoning, and fastening nuts) will be performed for 3 minutes each, in a random order. A 2-minute rest period will be given between each activity.
Experimental: Clinic-Based Dual Task Training; Clinic-based, dual task upper extremity training	Other: Clinic-Based Dual Task Upper Extremity Exercise Training; Dual task upper extremity exercise training at clinical setting. The first 5 minutes of the training session will consist of a warm-up period of stretching and breathing exercises, followed by a cool-down period of the same exercises.Nine different upper extremity activities (using a fork and spoon, tying shoelaces, reaching, throwing a ball, filling water, folding a sheet, drawing shapes, buttoning, and fastening nuts) will be performed simultaneously with three randomly selected cognitive tasks (arithmetic task, verbal fluency, digit span) for 3 minutes each, in a random order. A 2-minute rest period will be given between each activity.
Experimental: Tele-Rehabilitation Based Synchronous Dual Task Training; Tele-rehabilitation based synchronous dual task upper extremity training	Other: Tele-Rehabilitation Based Synchronous Dual Task Upper Extremity Exercise Training; Dual task upper extremity exercise training at patient's home, synchronous with a researcher via tele-rehabilitation method. The first 5 minutes of the training session will consist of a warm-up period of stretching and breathing exercises, followed by a cool-down period of the same exercises.Nine different upper extremity activities (using a fork and spoon, tying shoelaces, reaching, throwing a ball, filling water, folding a sheet, drawing shapes, buttoning, and fastening nuts) will be performed simultaneously with three randomly selected cognitive tasks (arithmetic task, verbal fluency, digit span) for 3 minutes each, in a random order. A 2-minute rest period will be given between each activity.
Experimental: Tele-Rehabilitation Based Asynchronous Dual Task Training; Tele-rehabilitation based asynchronous dual task upper extremity training	Other: Tele-Rehabilitation Based Asynchronous Dual Task Upper Extremity Exercise Training; Dual task upper extremity exercise training at patient's home, asynchronous under a researcher supervision. It will be carried out according to the pre-determined schedule and will be video recorded. The first 5 minutes of the training session will consist of a warm-up period of stretching and breathing exercises, followed by a cool-down period of the same exercises.Nine different upper extremity activities (using a fork and spoon, tying shoelaces, reaching, throwing a ball, filling water, folding a sheet, drawing shapes, buttoning, and fastening nuts) will be performed simultaneously with three randomly selected cognitive tasks (arithmetic task, verbal fluency, digit span) for 3 minutes each, in a random order. A 2-minute rest period will be given between each activity.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Unified Parkinson's Disease Rating Scale (UPDRS) - PART 3	UPDRS is a reliable and valid scale that assesses cognitive skills, mood, daily living activities, motor skills, motor fluctuations, dyskinesias and autonomic dysfunction and is widely used in clinical studies and research in Parkinson's disease. The motor symptoms section, which is the third section of this scale, will be used.	From enrollment to the end of training at 6 weeks
Hoehn & Yahr Scale	It is a staging system that provides information quickly in determining the severity and symptoms of Parkinson's disease.	From enrollment to the end of treatment at 6 weeks
Unified Parkinson's Disease Rating Scale (UPDRS) - PART 2	It consists of thirteen items. The assessment is based on anamnesis information regarding how the patient functions in various activities. The presence of sensory complaints that may be related to tremor and parkinsonism is also included in this section as they can affect daily living activities. Each item is evaluated using a scoring system between '0' and '4'.	From enrollment to the end of treatment at 6 weeks
Trail Making Test	It is used to assess executive functions and attention. The test consists of two parts, A and B. In part A, the individual is asked to combine numbers from 1 to 25, and the completion time is recorded. In part B, the individual completes a sequence where each number corresponds to a letter, and the completion time is recorded.	From enrollment to the end of treatment at 6 weeks
Nine-Hole Peg Test	During the test, individuals use only one hand to pick up nine wooden pegs one by one and insert them into the holes as quickly as possible. After inserting all the pegs, they quickly place them back into the container one by one. The timer starts when the individual touches the first peg and ends when the last peg is placed back into the container.	From enrollment to the end of treatment at 6 weeks
Coin Rotation Test	This test assesses the coordination of independent finger movements. In this test, the person is asked to rotate a coin 180 degrees as many times as possible between their thumb, index finger, and middle finger within 10 seconds without dropping it. The person's performance is video recorded and later analyzed. An increase in the number of times the patient rotates the coin within 10 seconds indicates better fine motor skills.	From enrollment to the end of treatment at 6 weeks
Manual Ability Measure-36	This is a 36-question survey that assesses fine motor skills based on individual self-reports. The survey includes questions related to daily life, such as drinking water, tying shoelaces, brushing teeth, and turning book pages. Each question is scored from 0 (almost impossible) to 4 (easy). The resulting score is converted to a 100-point system. Higher scores indicate good fine motor skills.	From enrollment to the end of treatment at 6 weeks
Grip Strength	Grip strength will be assessed using a Jamar hand dynamometer (JAMAR®, Performance Health Holdings, Inc., USA). During the tests, the individual will be positioned in a chair with the arm at the side of the body, the elbow flexed at 90°, and the wrist in a neutral position. Individuals will be asked to make a fist to assess their grip strength.	From enrollment to the end of treatment at 6 weeks
Dual-Task Impact on Daily-Living Activities Questionnaire	This test is used to assess the difficulties experienced in daily tasks involving dual task execution. It consists of 19 questions, with a scale of 0 (not difficult at all) to 4 (extremely difficult). A higher overall score indicates a higher perceived level of difficulty when performing dual tasks during daily life activities.	From enrollment to the end of treatment at 6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment Satisfaction	Patient satisfaction with treatment will be assessed post-treatment using a 100 mm long visual-analog scale.	At end of treatment at 6 weeks
Telemedicine Satisfaction Questionnaire	This survey consists of 14 items. It assesses patients' satisfaction levels with the software or system they use for treatment or other remote rehabilitation services. The total score ranges from 14 to 70, with a maximum of 5 points per question. A higher score indicates higher satisfaction.	At end of treatment at 6 weeks

Collaborators and Investigators

• Sponsor: Saglik Bilimleri Universitesi
• Collaborators: Eskisehir Osmangazi University; Anadolu University

Study record dates

Study Major Dates

• Study Start (Estimated): June 15, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 15, 2026

Study Registration Dates

• First Submitted: June 6, 2026
• First Submitted That Met QC Criteria: June 6, 2026
• First Posted (Actual): June 11, 2026

Study Record Updates

• Last Update Posted (Actual): June 11, 2026
• Last Update Submitted That Met QC Criteria: June 6, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Parkinson's Disease; Upper Extremity; Tele-Rehabilitation; Dual Task Training
• 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: 2026-151

Drug and device information, study documents

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