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

NCT07641556 | Not Yet Recruiting

• 1 other identifier: 2026-151
• Study Type: interventional
• Target: 40
• Locations: 0 countries
• Sites: N/A

Brief Summary

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.

Conditions

Parkinson's Disease (PD)

Keywords

Parkinson's Disease; Dual Task Training; Upper Extremity; Tele-Rehabilitation

Outcome Measures

Primary Outcomes (9)

• 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

• 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

• 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

• 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

• 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 Outcomes (2)

• Treatment Satisfaction

  At end of treatment at 6 weeks

• Telemedicine Satisfaction Questionnaire

  At end of treatment at 6 weeks

Study Arms (4)

Single Task Training

ACTIVE COMPARATOR

Conventional, clinic-based, single task upper extremity training

Other: Conventional Single Task Upper Extremity Exercise Training

Clinic-Based Dual Task Training

EXPERIMENTAL

Clinic-based, dual task upper extremity training

Other: Clinic-Based Dual Task Upper Extremity Exercise Training

Tele-Rehabilitation Based Synchronous Dual Task Training

EXPERIMENTAL

Tele-rehabilitation based synchronous dual task upper extremity training

Other: Tele-Rehabilitation Based Synchronous Dual Task Upper Extremity Exercise Training

Tele-Rehabilitation Based Asynchronous Dual Task Training

EXPERIMENTAL

Tele-rehabilitation based asynchronous dual task upper extremity training

Other: Tele-Rehabilitation Based Asynchronous Dual Task Upper Extremity Exercise Training

Interventions

Clinic-Based Dual Task Upper Extremity Exercise Training OTHER

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.

Clinic-Based Dual Task Training

Conventional Single Task Upper Extremity Exercise Training OTHER

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.

Single Task Training

Tele-Rehabilitation Based Synchronous Dual Task Upper Extremity Exercise Training OTHER

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.

Tele-Rehabilitation Based Synchronous Dual Task Training

Tele-Rehabilitation Based Asynchronous Dual Task Upper Extremity Exercise Training OTHER

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.

Tele-Rehabilitation Based Asynchronous Dual Task Training

Eligibility Criteria

• Age: 40 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Saglik Bilimleri Universitesi: lead
• Anadolu University: collaborator
• Eskisehir Osmangazi University: collaborator

MeSH Terms

Conditions

Parkinson Disease

Condition Hierarchy (Ancestors)

Parkinsonian Disorders; Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: June 6, 2026
• First Posted: June 11, 2026
• Study Start: June 15, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 15, 2026
• Last Updated: June 11, 2026

Record last verified: 2026-06