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ParkinsonNCT05931692

Virtual Reality and Fear of Falling in Parkinson's Disease

An observational study of Parkinson and Parkinson Disease, run by Ahram Canadian University at 1 site in Egypt.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Background: Falls are common in elderly individuals and those with neurological conditions like Parkinson's disease. Parkinson's disease causes postural instability and mobility issues that lead to falls and reduced quality of life. Read more about this study

Who is it for?
Ages 40 years and olderHealthy volunteers can take part
What is being tested?
Virtual reality, Electroencephalogram and Electromyography
How many people
15 participants
Where
1 siteEgypt
Study dates
17 Jul 2023to 31 Jan 2026
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Two groups of participants, who age 40 or older, will be involved in this study. Each group will have from 10 to 30 participants. The first group will include a group of individuals without Parkinson's disease and the second group will include people with Parkinson's disease, both will be screened for eligibility. Participants who meet the inclusion criteria will go through the planned assessment procedure.

Who may be able to join

  • People ≥ 40 years old.
  • Participants diagnosed with Parkinson's disease by a neurologist, regardless the type.
  • Modified Hoehn and Yahr stages I to III.
  • Able to follow instructions and understand questions.
  • Able to walk independently and without walking aids.
  • People who experience excessive fear of falling and fear of movement.
  • Able to communicate verbally.
  • Stable use of Parkinson's Disease or other comorbidities medications.

Who cannot join

  • Impaired vision and hearing.
  • Unstable medical condition.
  • Co-existing neurological or orthopedic conditions that may limit mobility and affect participation.
  • Dizziness, vertigo, headache, and motion-sickness.
  • Cognition impairments.
  • Pregnancy.

Trial locations and contacts

1 site in 1 country.

Yasmine S Gomaa, Ph.d contact

+201001590520

yasmeen_gomaa@pt.kfs.edu.eg

Mohamed I Awad, Ph.d contact

+201123222146

Mohammed.awad@eng.asu.edu.eg

Egypt1 site, 1 recruiting
  • Human Mechatronics Lab, Ain Shams Virtual Hospital, Ain Shams University

    Cairo, 11535

    Mohamed I Awad, Ph.d, +201123222146, Mohammed.awad@eng.asu.edu.eg

    Recruiting

Other trials in Egypt

About this study

Official title: The Role of Virtual Reality in Examining the Effect of Fear of Falling (FOF) on Postural Stability in Individuals Without and With Parkinson's Disease in Egypt: A Mixed Methods Feasibility Study

Background: Falls are common in elderly individuals and those with neurological conditions like Parkinson's disease. Parkinson's disease causes postural instability and mobility issues that lead to falls and reduced quality of life. The fear of falling (FoF), a natural response to unstable balance, can exacerbate postural control problems. However, evaluating FoF relies primarily on subjective self-reports due to a lack of objective assessment methods.

Objectives: This mixed-methods feasibility study aims to develop an objective method for assessing fear of falling during motion and walking using virtual reality. This protocol examines a range of FoF-related responses, including cognitive, neuromuscular, and postural stability factors.

Read more

Methods: Individuals without and with Parkinson's disease will complete questionnaires, movement tasks, and walking assessments in real and virtual environments where FoF can be elicited using virtual reality (VR) technology. Data from center-of-pressure measurements, electromyography, heart rate monitoring, motion capture, and usability metrics will evaluate the method's acceptability and safety. Semi-structured interviews will gather participants' and researchers' experiences of the protocol.

Discussion: This method may allow accurate assessment of how FoF impacts movement by measuring cognitive, neuromuscular, and postural responses during gait and motion. Virtual environments reproduce real-life scenarios that trigger FoF. Rigorously assessing FoF with this approach could demonstrate its ability to quantify the effects of FoF on movement.

Conclusions: This protocol aims to improve FoF assessment by evaluating multiple responses during movement in virtual environments. It addresses current measures' limitations. A feasibility study will identify areas for improvement specific to Parkinson's disease. Successful validation could transform how FoF is evaluated and managed.

Being tested
Virtual reality, Electroencephalogram, Electromyography, Motion Capture system, Polar H10 Heart Sensor
Medical subject headings
Parkinson Disease, Parkinsonian Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Virtual realityDiagnostic test

    Virtual environment that triggers fear of falling

  • ElectroencephalogramDiagnostic test

    Detect brain waves in response to fear of falling

  • ElectromyographyDiagnostic test

    Measures muscle activity and response to fear of falling

  • Motion Capture systemDiagnostic test

    Measures postural and gait responses to fear of falling

  • Polar H10 Heart SensorDiagnostic test

    Heart rate monitor

  • Inertial measurement UniteDiagnostic test

    Measure Postural sway

Study groups in NCT05931692
Study groupRoleWhat they receive
Individuals without Parkinson's diseasePeople over 40 years old
Receives: Diagnostic Test: Virtual reality; Diagnostic Test: Electroencephalogram; Diagnostic Test: Electromyography; Diagnostic Test: Motion Capture system; Diagnostic Test: Polar H10 Heart Sensor; Diagnostic Test: Inertial measurement Unite
Parkinson DiseasePeople over 40 years old who have Parkinson's Disease at stage I to III Hoehn and Yahr scale
Receives: Diagnostic Test: Virtual reality; Diagnostic Test: Electroencephalogram; Diagnostic Test: Electromyography; Diagnostic Test: Motion Capture system; Diagnostic Test: Polar H10 Heart Sensor; Diagnostic Test: Inertial measurement Unite

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Movement Control

    Movement control throughout the movement scenario will be assessed using a Qualisys motion capture system (MCS).

    Measured: 5 minutes

  2. Balance Assessment

    Force platforms will measure the center of pressure (COP) displacement during the movement scenario.

    Measured: 5 minutes

  3. Postural Sway

    A postural Inertial Measurement Unit (IMU) will be placed over the projected center of mass located at the 4th lumbar vertebra to evaluate postural sway.

    Measured: 5 minutes

  4. EEG Monitoring

    The electroencephalogram (EEG) will be used to monitor the neuromuscular system's reaction to fear throughout the movement scenario. power in alpha and beta frequency bands will be recorded.

    Measured: 5 minutes

  5. EMG Monitoring

    The electromyography (EMG) will be employed to monitor the neuromuscular system's reaction to fear throughout the movement scenario. Muscle activation of lower limb muscles such as tibialis anterior and quadriceps will be recorded by surface EMG.

    Measured: 5 minutes

  6. Heart Rate Monitoring

    The unit of measurement for heart rate monitoring is typically beats per minute (BPM). The Polar H10 heart rate sensor will be used in to measure the electrical signals produced by the heart and provides continuous and accurate heart rate readings in BPM.

    Measured: 5 minutes

  7. Suitability Evaluation

    the Suitability Evaluation Questionnaire (SEQ) is the SEQ Suitability Evaluation Questionnaire for Virtual Rehabilitation Systems. The range of scores is 0 to 100, with higher scores indicating a better outcome. The SEQ is scored by summing the responses to the 14 items. The items are scored on a 7-point Likert scale, with 1 = strongly disagree and 7 = strongly agree. The total score can range from 0 to 98. A higher score on the SEQ indicates that the VR system is perceived as being more user-friendly, enjoyable, and safe. This suggests that the patient is more likely to use the VR system and to benefit from it.

    Measured: 30 minutes

  8. Sense of Presence

    The iGroup Presence Questionnaire (IPQ) has a range of scores is 0 to 6, with higher scores indicating a better outcome. The IPQ is scored by summing the responses to the 14 items. The items are scored on a 7-point Likert scale, with 1 = disagree strongly and 7 = agree strongly. The total score can range from 0 to 98. A higher score on the IPQ indicates that the user feels more present in the Virtual environment (VE). This suggests that the VE is more immersive and engaging, and that the user is more likely to be absorbed in the experience.

    Measured: 30 minutes

  9. Effort

    The Borg Rated Perceived Exertion (RPE) scale will record effort during the session. The Borg Rated Perceived Exertion (RPE) Scale: Range 0-10, higher scores indicate greater perceived exertion.

    Measured: 30 minutes

  10. Adverse events

    any adverse events during the procedure and after effects will be documented. Number of participants reporting adverse events as per study protocol

    Measured: 30 minutes

Secondary outcomes (8)
  1. Fear of Falling Assessment

    Fear of falling will be assessed using the Falls Efficacy Scale International (FES-I).

    Measured: 45 minutes

  2. Cognition Assessment

    Montreal Cognitive Assessment (MoCA) is a brief, 30-item cognitive screening test that is used to assess a person's cognitive abilities. Montreal Cognitive Assessment has a minimum value of 0 and maximum value of 3 with Higher score indicates better outcome. A score of 26 or higher is considered normal, while a score of 25 or lower may indicate cognitive impairment.

    Measured: 45 minutes

  3. Depression Assessment

    Hamilton Depression Rating Scale (HAM-D) will be used to assess depression level. Minimum value is 0 and the maximum value is 52. Lower scores indicate better outcome. The HAM-D is a 17-item clinician-rated scale that is used to assess the severity of depression. The scale was developed by Max Hamilton in 1960 and has been used in a wide range of studies to assess depression. The HAM-D covers a range of symptoms of depression, including depressed mood, feelings of guilt, suicidal ideation, insomnia, agitation or retardation, anxiety, weight loss, and somatic symptoms. Each item is scored on a 5-point scale, with 0 = absent and 4 = severe. The total score can range from 0 to 52, with a higher score indicating more severe depression.

    Measured: 45 minutes

  4. Anxiety Assessment

    Hamilton Anxiety Rating Scale will be used to assess level of anxiety. the Minimum value is 0 and Maximum value is 56. Lower score indicates better outcome. It is a 14-item clinician-rated scale that is used to assess the severity of anxiety. The scale was developed by Max Hamilton in 1959 and has been used in a wide range of studies to assess anxiety. It covers a range of symptoms of anxiety, including anxious mood, tension, fears, insomnia, intellectual, somatic (muscular), somatic (sensory), cardiovascular, respiratory, gastrointestinal, genitourinary, autonomic symptoms, and behavior at interview. Each item is scored on a 4-point scale, with 0 = absent and 4 = severe. The total score can range from 0 to 56, with a higher score indicating more severe anxiety.

    Measured: 45 minutes

  5. Participation Assessment

    Participation levels will be assessed using the World Health Organization Disability Assessment Schedule 2.0. the Minimum value is 0 and Maximum value is 100. Lower score indicates better outcome. The WHODAS 2.0 is a 12-item self-report questionnaire that is used to assess the impact of a health condition on an individual's functioning. The items are scored on a 5-point scale, with 0 = no difficulty and 4 = extreme difficulty. The total score can range from 0 to 100, with a lower score indicating less disability. The WHODAS 2.0 covers six domains of functioning: cognition, mobility, self-care, getting along, life activities, and participation. The scale was developed by the World Health Organization (WHO) and is based on the International Classification of Functioning, Disability and Health (ICF).

    Measured: 45 minutes

  6. Health-related Quality of Life Assessment

    Health-related quality of life will be evaluated using the Parkinson's Disease Questionnaire 39 (PDQ-39). Parkinson's Disease Questionnaire 39 has a Minimum value of 0 and Maximum value of 100. Lower score indicates better outcome. The PDQ-39 is a 39-item self-report questionnaire that is used to assess the impact of Parkinson's disease (PD) on an individual's quality of life. The items are scored on a 5-point scale, with 0 = no problem and 4 = severe problem. The total score can range from 0 to 100, with a lower score indicating better quality of life.

    Measured: 45 minutes

  7. Balance confidence

    Balance confidence will be evaluated using Activity-specific Balance Confidence scale (ABC scale). Which is a self-administered scale to indicate the level of confidence the person has in doing the activity without losing his/her balance. The ABC is an 16 point scale and ratings should consist of whole numbers (0 to 100) for each item. Total the ratings and divide by 16 to get each subject's ABC score.

    Measured: 10 minutes

  8. Combined Balance assessment

    Mini Balance Evaluation System Test (mini-BESTest) will be used and it assesses 4 domains: Anticipatory postural adjustments, Reactive postural control, Sensory orientation, and Dynamic gait. The test has a maximum score of 28 points from 14 items that are each scored from 0-2. "0" indicates the lowest level of function and "2" the highest level of function.

    Measured: 15 minutes

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Jul 2023
  2. Study start17 Jul 2023
  3. Primary completion30 Sep 2025 (estimated)
  4. Study completion31 Jan 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Cross-sectional
Enrolment
15 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05931692
Sponsor's protocol ID
P.T/ NEUR /3/2023/46
Status last verified
Apr 2024
First submitted
15 Jun 2023
Last updated
26 Apr 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Gomaa YS, Awad MI, Emara T, Elbokl A, Al-Yahya E, ElMeligie MM. Role of virtual reality in examining the effect of fear of falling (FOF) on postural stability in individuals without and with Parkinson's disease in Egypt: a mixed-methods feasibility study protocol. BMJ Open. 2024 May 1;14(5):e080592. doi: 10.1136/bmjopen-2023-080592.

    PubMed 38692713

Questions about this trial

What is this clinical trial studying?

An observational study of Parkinson and Parkinson Disease, run by Ahram Canadian University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 26 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Yasmine S Gomaa, Ph.d (+201001590520, yasmeen_gomaa@pt.kfs.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Movement Control (time frame: 5 minutes). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05931692, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Apr 2024.

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