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Parkinson DiseaseVR PNF RPT PDNCT07308093

Comparative Effects of Virtual Reality and Proprioceptive Neuromuscular Facilitation in Patients With Parkinson's Disease

A study testing Intervention 1 and artificial intelligence in people with Parkinson Disease, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Parkinson's Disease is a chronic neurodegenerative disorder marked by the progressive loss of dopaminergic neurons in the substantia nigra and accumulation of α-synuclein (Lewy bodies).It impacts both motor and non-motor systems, with growing global prevalence-affecting 7-10 million people, mostly men over 60… Read more about this study

Who is it for?
Ages 50 to 80 years
Conditions the study is for
Parkinson Disease
What is being tested?
Intervention 1 and artificial intelligence
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
28 participants
Where
1 sitePakistan
Study dates
15 Nov 2026to 31 Dec 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 50 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Idiopathic Parkinson's Disease according to Gelb's criteria
  • Stage II-IV Hoehn \&Yahr scale
  • Intact cognition status (MMSE > 24)
  • 50-80 years of age

Who cannot join

  • History of PD surgery
  • Phobia of virtual gaming systems
  • Visual anomalies
  • Cardiovascular problems
  • Severe dyskinesia or "on-off" fluctuations

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Shoaib Waqas, PhD contact

03024552109

shoaib.waqas@ubas.edu.pk

Pakistan1 site
  • Lahore University of Biological and Applied Sciences

    Lahore, Punjab Province, 54000

    Shoaib Waqas, PhD, shoaib.waqas@ubas.edu.pk

Other trials in Pakistan

About this study

Official title: Effects of Virtual Reality and Proprioceptive Neuromuscular Facilitation on Upper Limb Sensorimotor Control Among Patients With Parkinson's Disease.

Parkinson's Disease is a chronic neurodegenerative disorder marked by the progressive loss of dopaminergic neurons in the substantia nigra and accumulation of α-synuclein (Lewy bodies).It impacts both motor and non-motor systems, with growing global prevalence-affecting 7-10 million people, mostly men over 60 years-due to increasing life expectancy and demographic shifts.

PD shows motor symptoms like tremors and bradykinesia, along with non-motor issues like depression, REM sleep disorder, and cognitive decline. Diagnosis is often delayed due to subtle early signs like constipation or shoulder pain and atypical cases lacking classical tremors.

Read more

VR offers immersive, task-specific therapy that enhances motor learning and neuroplasticity in a safe, engaging environment. By integrating sensory feedback and real-time motion tracking, VR reduces tremors, promotes cortical reorganization (notably in the sensorimotor cortex and cerebellum), and increases rehabilitation motivation through gamified experiences.

PNF is a hands-on therapy using tactile, auditory, and proprioceptive cues to improve coordination, strength, and movement patterns. Especially useful in Parkinson's rehabilitation, PNF targets rigidity, bradykinesia, tremors, and postural instability by reinforcing neuromuscular coordination and improving movement execution in functional, diagonal planes.

Sensorimotor control is the dynamic integration of sensory input, motor planning, and execution, which becomes disrupted in PD due to impaired proprioception and feedback loops. Patients rely excessively on visual feedback, making movement effortful, highlighting the need for focused upper limb rehabilitation strategies.

Read the detailed description
  • Experimental: (VR+ RPT) Participants in this group received Virtual Reality (VR)-based training in addition to Routine Physical Therapy (RPT). The VR intervention was delivered using the Oculus Meta Quest 3 headset and consisted of immersive, goal-directed tasks performed three times per week for six weeks, each session lasting 30 minutes at a moderate intensity (RPE 11-13). VR tasks were designed to target specific motor impairments, including pick-and-place tasks for kinetic tremor reduction, tracing tasks to address bradykinesia, and reaching and grasping tasks to improve proprioception. Participants interacted with five virtual balls in a simulated environment, transferring them from one basket to another under therapist supervision. Alongside VR, participants also underwent Routine Physical Therapy (RPT) three times per week for six weeks, each 40-minute session consisting of a warm-up with diaphragmatic breathing, 30 minutes of stretching and strengthening for the core, hip, knee, back, and elbow extensors, and a cool-down with static stretches for major muscle groups.
  • Control: (PNF+RPT) Participants in this group received Proprioceptive Neuromuscular Facilitation (PNF) therapy in addition to Routine Physical Therapy (RPT). PNF was administered three times per week for six weeks, with each session lasting 30 minutes at a moderate intensity (RPE 11-13). Specific PNF techniques were selected for symptom management: slow reversal for kinetic tremor to improve coordinated agonist-antagonist contractions, rhythmic initiation for bradykinesia to facilitate movement initiation, and tactile input to enhance proprioception and body awareness. PNF was administered under the direct guidance of a physical therapist, with manual contact and graded resistance tailored to individual capacity. Participants also received RPT on the same schedule and with the same structure as described for the experimental group, including warm-up breathing, targeted stretching and strengthening, and cool-down static stretches.
Being tested
Intervention 1, artificial intelligence
Keywords
Parkinson Disease, Sensorimotor Control, Virtual Reality Therapy, Proprioceptive Neuromuscular Facilitation, Upper Limb Rehabilitation, Neuroplasticity
Medical subject headings
Parkinson Disease

What participants receive

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

  • Intervention 1Other

    Also called Proprioceptive Neuromuscular Facilitation

    Participants in the control group received Proprioceptive Neuromuscular Facilitation (PNF) therapy three times per week for a total duration of six weeks. Each session lasted approximately 30 minutes and was conducted at a moderate intensity, corresponding to an RPE of 11-13 on the Borg scale. For kinetic tremors, the slow reversal technique was applied. For bradykinesia, the rhythmic initiation technique was used. And to enhance proprioception, tactile input was provided through manual contact, resistance, and stretch applied by the therapist at key points of the movement pattern.

  • artificial intelligenceDevice

    Participants in the experimental group underwent Virtual Reality (VR) training three times per week for a total of six weeks. Each session lasted approximately 30 minutes and was conducted at a moderate intensity, defined by the repetition of VR tasks five times per session. The intervention was delivered using the Oculus Meta Quest 2 head-mounted display, providing an immersive and interactive environment under the close supervision of a licensed physical therapist. The central activity involved 2 modules. Ball Shifting Module picking and placing five virtual balls within the simulated environment and transferring them from one basket to another. Cube Navigation Module, in this task, users guide a virtual cube through highlighted cells or routes using deliberate movements, requiring precise hand positioning and controlled movement paths.

Study groups in NCT07308093
Study groupRoleWhat they receive
Virtual RealityExperimentalParticipants in this group received Virtual Reality (VR)-based training in addition to Routine Physical Therapy (RPT). The VR intervention was delivered using the Oculus Meta Quest 3 headset and consisted of immersive, goal-directed tasks performed three times per week for six weeks, each session lasting 30 minutes at a moderate intensity (RPE 11-13). VR tasks were designed to target specific motor impairments, including pick-and-place tasks for kinetic tremor reduction, tracing tasks to address bradykinesia, and reaching and grasping tasks to improve proprioception. Participants interacted with five virtual balls in a simulated environment, transferring them from one basket to another under therapist supervision. Alongside VR, participants also underwent Routine Physical Therapy (RPT) three times per week for six weeks, each 40-minute session consisting of a warm-up with diaphragmatic breathing, stretching, strengthening and cool-down.
Receives: Device: artificial intelligence
Proprioceptive Neuromuscular FacilitationActive comparatorParticipants in this group received Proprioceptive Neuromuscular Facilitation (PNF) therapy in addition to Routine Physical Therapy (RPT). PNF was administered three times per week for six weeks, with each session lasting 30 minutes at a moderate intensity (RPE 11-13). Specific PNF techniques were selected for symptom management: slow reversal for kinetic tremor to improve coordinated agonist-antagonist contractions, rhythmic initiation for bradykinesia to facilitate movement initiation, and tactile input to enhance proprioception and body awareness. PNF was administered under the direct guidance of a physical therapist, with manual contact and graded resistance tailored to individual capacity. Participants also received RPT on the same schedule and with the same structure as described for the experimental group, including warm-up breathing, targeted stretching and strengthening, and cool-down static stretches.
Receives: Other: Intervention 1

What is being measured

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

  1. Kinetic Tremors

    Kinetic Tremors It is going to be measured by: Fahn-Tolosa-Marin tremor rating scale with internal consistency of Cronbach's α = 0.90.

    FTMTRS - Kinetic Tremor Section

    Rate the severity of tremor during each task using the following scale:

    1. Writing: _______
    2. Drawing (Archimedes spiral): _______
    3. Pouring water: _______
    4. Drinking from a cup: _______ • Total Kinetic Tremor Score: _______/16 (0 = No tremor, 1 = Mild, intermittent, 2 = Moderate, intermittent or mild, continuous, 3 = Marked, intermittent or moderate, continuous, 4 = Severe, continuous)

    Measured: 6 weeks

  2. Bradykinesia

    It is going to be measured by: MDS-UPDRS Part III with internal consistency of Cronbach's α: 0.90-0.93.

    MDS-UPDRS Part III - Bradykinesia Items (3.4-3.6)

    Rate each movement on a scale from 0 (normal) to 4 (severe):

    1. 3.4 L\&R Finger Tapping: _______
    2. 3.5 L\&R Hand Movements (open/close hands): _______
    3. 3.6 L\&R Pronation-Supination of Hands: _______ • Total Bradykinesia Score (3.4-3.6): _______/24

    Measured: 6 weeks

  3. Proprioception

    •It is going to be measured by: Fugl Meyer UE Proprioception subscale with internal consistency of Cronbach's α: at 0.94-0.98.

    Scoring:

    0 = Only a few degrees (less than 10° in shoulder)

    1. = Decreased
    2. = Normal

    Shoulder Movement 0 1 2 Flexion (0°-180°) ☐ ☐ ☐ Abduction (0°-90°) ☐ ☐ ☐ External Rotation ☐ ☐ ☐ Internal Rotation ☐ ☐ ☐ Elbow Movement 0 1 2 Flexion ☐ ☐ ☐ Extension ☐ ☐ ☐ Forearm Movement 0 1 2 Pronation ☐ ☐ ☐ Supination ☐ ☐ ☐ Wrist Movement 0 1 2 Flexion ☐ ☐ ☐ Extension ☐ ☐ ☐ Fingers Movement 0 1 2 Flexion ☐ ☐ ☐ Extension ☐ ☐ ☐

    Measured: 6 weeks

Timeline

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

  1. First posted29 Dec 2025
  2. Study start15 Nov 2026 (estimated)
  3. Primary completionDec 2027 (estimated)
  4. Study completion31 Dec 2027 (estimated)

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Not Needed
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
28 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07308093
Sponsor's protocol ID
DPT/ERB/33
Other IDs
U1111-1332-3369
Acronym
VR PNF RPT PD
Status last verified
Nov 2026
First submitted
15 Dec 2025
Last updated
5 Nov 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: After the publication

Questions about this trial

What is this clinical trial studying?

A study testing Intervention 1 and artificial intelligence in people with Parkinson Disease, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.

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 4 inclusion and 5 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: opening soon, as of the sponsor's last update on 5 Nov 2026. 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 Pakistan. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Shoaib Waqas, PhD (03024552109, shoaib.waqas@ubas.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Kinetic Tremors (time frame: 6 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 5 Nov 2026.

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