Comparison of Strength-Balance Exercises, Virtual Reality-Based Exercises, and Combined Exercises on Neuroplasticity, Quality of Life, Balance, and Fall Risk in Patients with Parkinson's Disease

The aim of this study is to evaluate the impact of strength-balance exercises, virtual reality-based exercises, and combined exercises on neuroplasticity, quality of life, balance, and fall risk in patients with Parkinson's disease.

This study is a randomized controlled trial with three intervention groups and one control group. Randomization is computer-generated, and outcomes are assessed before and after 8 weeks of intervention using a double-blind design.

En The study will take place at the Biomechanics Laboratory, Faculty of Physical Education and Sport Sciences, Kharazmi University.

The inclusion criteria consist of patients diagnosed with Parkinson's disease confirmed by a specialist; aged between 50 and 70 years; moderate to severe symptoms based on the UPDRS-III scale; and the ability to engage in physical exercises.The exclusion criteria include individuals with other neurological disorders, severe cardiac, pulmonary, or renal diseases, or musculoskeletal conditions that prevent participation in the exercise regimen.

Control Group: Receives no intervention and undergoes standard treatment. Intervention Group 1 (Strength-Balance Exercises): Receives strength and balance exercises for 8 weeks, three times a week, including resistance training and balance exercises such as standing on balance boards. Intervention Group 2 (Virtual Reality-Based Exercises): Uses virtual reality systems for balance and movement exercises, three times a week for 8 weeks, with each session lasting 30 minutes. Intervention Group 3 (Combined Exercises): Receives a combination of strength-balance exercises and virtual reality-based exercises, each for 30 minutes, three times a week for 8 weeks.

The primary outcome variables are: neuroplasticity quality of life, balance , and fall risk

After the initial assessment of the participants, randomization was carried out based on four-block randomization. Participants are randomly assigned to one of two groups using four-block randomization. One of the research team members, who is not involved in the sample selection process, determines the random allocation sequence using the online tool (randomizer.org). Sealed opaque envelopes containing the randomization sequence will be used for allocation concealment.

In this study, the outcome assessor is blind to the groups’ randomization and interventions receiving by participants. in this way, during the evaluation before and after the intervention protocol, they do not make mistakes in their judgments in favor of a specific therapeutic intervention.