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Parkinson DiseaseNCT07434089

Impact of C-Mill Rehabilitation on the Gut-Brain Axis in Parkinson's Disease

A study testing C-Mill technology treadmill equipped with semi-immersive VR, C-Mill treatment without semi-immersive virtual reality (VR) and Conventional physiotherapy training in people with Parkinson Disease, run by IRCCS Centro Neurolesi Bonino Pulejo at 1 site in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The GM-REHAB-2025 study aims to evaluate the impact of physiotherapy interventions using the C-Mill treadmill, with and without semi-immersive virtual reality, on gut microbiota and metabolic parameters in patients with Parkinson's disease. Read more about this study

Who is it for?
Ages 40 to 70 years
Conditions the study is for
Parkinson Disease
What is being tested?
C-Mill technology treadmill equipped with semi-immersive VR, C-Mill treatment without semi-immersive virtual reality (VR) and Conventional physiotherapy training
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteItaly
Study dates
20 Oct 2025to 20 Oct 2028
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 40 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosis of PD according to the Movement Disorder Society Clinical
  • Diagnostic Criteria for Parkinson's Disease
  • Age comprised between 40 to 70 years
  • Patients with moderate to advanced disease (2 ≤ Hoehn and Yahr classification grade ≤ 4)
  • Individuals able to walk independently (FAC > 2)

Who cannot join

  • PD patients with (1) weight > 135 kg and Height > 200 cm
  • Open lesions or bandages whether in contact with the harness of C-Mill strumentation
  • chronic gastro-intestinal (GI) disease including malabsorption;
  • clinical history of gastric lesions, gastro-resection or major intestinal surgery;
  • systemic and/or neurologic infectious, inflammatory, or autoimmune diseases of gastro-intestinal (GI) eg. Chron disease;
  • Acute GI phlogosis or GI disease in the last 4 weeks before recruitment;
Show all 9Show fewer
  • Use of domperidone, or any drug potentially affecting gastrointestinal motility and integrity;
  • Use, in the last 4 weeks preceding the recruitment and until t2, of pre-probiotics or therapy based upon steroids, nonsteroidal anti-inflammatory drugs, antibiotics or antifungals;
  • anamnesis suggestive of GI cancer pathology.

Trial locations and contacts

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

Italy1 site, 1 recruiting
  • Irccs Centro Neurolesi Bonino Pulejo

    Messina, Messina, 98123

    Maria Lui, (+39) 09060128163, maria.lui@irccsme.it

    Recruiting

Other trials in Italy

About this study

Official title: Gut-Brain Axis and Rehabilitation: Study on the Effects of C-Mill Technology on the Intestinal Microbiota of Parkinson's Disease Patients

The GM-REHAB-2025 study aims to evaluate the impact of physiotherapy interventions using the C-Mill treadmill, with and without semi-immersive virtual reality, on gut microbiota and metabolic parameters in patients with Parkinson's disease. Three groups will be involved: one undergoing conventional physiotherapy, one treated with the C-Mill without virtual reality (VR), and one treated with C-Mill technology combined with VR. Clinical assessments and the collection of biological samples (stool, serum, and plasma) will be carried out at three time points: at baseline, at the end of treatment (21 days), and after 3 months.

Being tested
C-Mill technology treadmill equipped with semi-immersive VR, C-Mill treatment without semi-immersive virtual reality (VR), Conventional physiotherapy training
Medical subject headings
Parkinson Disease

What participants receive

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

  • C-Mill technology treadmill equipped with semi-immersive VRDevice

    C-Mill treatment combined with semi-immersive virtual reality (VR). The VR component will feature visual obstacles, such as virtual traffic cones or country paths, in conjunction with audio-visual stimuli to promote engagement and guide movement.

  • C-Mill treatment without semi-immersive virtual reality (VR)Device

    C-Mill treatment will be administrated as a standalone therapy, without the integration of virtual reality (VR).

  • Conventional physiotherapy trainingOther

    Will be carried under the manual guidance and supervision of a physiotherapist. The rehabilitation program will include weight-shifting exercises, as well as monopodal and bipodal balance exercises.

Study groups in NCT07434089
Study groupRoleWhat they receive
C-mill + VR treatedExperimentalincludes 20 patients with PD undergoing C-Mill treatment combined with semi-immersive virtual reality (VR). This group will participate in 12 training sessions, each lasting 45 minutes, four times a week for three weeks. Gait training in each session will include exercises such as path with obstacles, tandem walking, slalom, and walking at varying speeds, all enhanced with semi-immersive VR scenarios projected on the treadmill's floor. The VR component will feature visual obstacles, such as virtual traffic cones or country paths, in conjunction with audio-visual stimuli to promote engagement and guide movement.
Receives: Device: C-Mill technology treadmill equipped with semi-immersive VR
C-Mill treatedExperimentalConsists of 20 patients with Parkinson's Disease (PD) undergoing C-Mill treatment as a standalone therapy, without the integration of virtual reality (VR). Participants will complete 12 training sessions, each lasting 45 minutes, four times a week for three weeks. The training sessions will include exercises such as tandem walking, slalom walking, obstacle courses, and walking at varying speeds, all designed to enhance gait and balance.
Receives: Device: C-Mill treatment without semi-immersive virtual reality (VR)
Conventional physiotherapy treatedExperimentalConsists of 20 patients with PD, who will undergo conventional physiotherapy training under the manual guidance and supervision of a physiotherapist. The rehabilitation program will include weight-shifting exercises, as well as monopodal and bipodal balance exercises. Gait training will incorporate obstacle courses (e.g., bricks, boxes) of varying shapes and colors, or paths created by the physiotherapist using furniture and equipment (e.g., chairs, traffic cones, sandbags). Patients will also perform slalom walking exercises, with auditory stimuli (e.g., music, therapist's voice) and visual cues (e.g., colored tape on the floor) to guide the exercises, adjusting their walking speed based on the auditory cues provided by the therapist.
Receives: Other: Conventional physiotherapy training

What is being measured

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

  1. Relative abundance of bacterial and fungal taxa in fecal samples

    Relative abundance of bacterial and fungal taxa determined by sequencing the V3-V4 regions of the 16S rRNA and ITS1-IT2 regions from fecal samples.

    Unit of measurement: percentage of total sequencing reads(%).

    Measured: From enrollment to the 3 months follow-up

  2. Alpha Diversity of the Gut Microbiota

    Within-sample microbial diversity derived from sequencing of the V3-V4 regions of the 16S rRNA gene and ITS1-ITS2 regions from fecal samples, expressed as an alpha diversity index. Unit of Measure: alpha diversity index value. Higher values indicate greater microbial diversity.

    Measured: From enrollment to the 3 months follow-up

  3. Beta Diversity of the Gut Microbiota

    Between-sample microbial community derived from the sequencing of V3-V4 regions of the 16S rRNA and ITS1-ITS2 and expressed as a beta diversity distance. Unit of Measure: beta diversity distance. Higher values indicate greater dissimilarity between samples.

    Measured: From enrollment to the 3 months follow-up

  4. Distance Covered During the 6-Minute Walk Test

    Functional walking capacity measured as the total distance walked during the 6-Minute Walk Test. Unit of Measure: meters. Higher values indicate better walking capacity.

    Measured: From enrollment to the 3 months follow-up

  5. Time Required to Complete the 10-Meter Walk Test

    Walking ability assessed by measuring the time required to walk 10 meters at usual pace. Unit of Measure: seconds. Lower values indicate better walking performance.

    Measured: From enrollment to the 3 months follow-up

  6. Time Required to Complete the Timed Up and Go Test

    Mobility and fall risk assessed by the time needed to stand up, walk 3 meters, turn, return, and sit down. Unit of Measure: seconds. Lower values indicate better functional mobility.

    Measured: From enrollment to the 3 months follow-up

  7. Balance Performance Assessed by the Berg Balance Scale

    Balance measured using the Berg Balance Scale (range: 0-56). Higher scores indicate better balance and lower fall risk. Unit of Measure: total score.

    Measured: From enrollment to the 3 months follow-up

  8. Balance and Gait Performance Assessed by the Tinetti Scale

    Balance and gait evaluated using the Tinetti Scale (range: 0-29). Higher scores indicate better mobility and lower fall risk. Unit of Measure: total score.

    Measured: From enrollment to the 3 months follow-up

  9. Fear of Falling Assessed by the Short Falls Efficacy Scale-International

    Concern about falling measured using the Short Falls Efficacy Scale-International (range: 7-28). Higher scores indicate greater fear of falling. Unit of Measure: total score.

    Measured: From enrollment to the 3 months follow-up

  10. Motor Symptom Severity Assessed by the MDS-UPDRS Part III (Motor Examination)

    Motor impairment evaluated using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III, the Motor Examination section. Total score range from 0 to 132. Unit of Measure: total score. Higher scores indicate worse motor impairment.

    Measured: From enrollment to the 3 months follow-up

  11. Functional Independence Assessed by the Functional Independence Measure

    Global functional status assessed using the Functional Independence Measure (range: 18-126). Higher scores indicate greater independence in daily activities.

    Unit of Measure: total score.

    Measured: From enrollment to the 3 months follow-up

  12. Severity of Constipation Assessed by the Constipation Scoring System

    Constipation severity measured using the Constipation Scoring System questionnaire (range: 0-30). Higher scores indicate more severe constipation.

    Unit of Measure: total score.

    Measured: From enrollment to the 3 months follow-up

Secondary outcomes (10)
  1. Serum Concentration of TNF-α

    Serum TNF-α, a key pro-inflammatory cytokine, measured by ELISA to assess systemic inflammatory activation. Unit of Measure: pg/mL

    Measured: From enrollment to the 3 months follow-up

  2. Serum Concentration of IL-1β

    Serum IL-1β, a pro-inflammatory cytokine involved in immune response, measured by ELISA. Unit of Measure: pg/mL

    Measured: From enrollment to the 3 months follow-up

  3. Serum Concentration of IL-6

    Serum IL-6, a pro-inflammatory cytokine that mediates systemic inflammation, measured by ELISA. Unit of Measure: pg/mL

    Measured: From enrollment to the 3 months follow-up

  4. Serum Concentration of IL-10

    Serum IL-10, an anti-inflammatory cytokine that regulates immune responses, measured by ELISA. Unit of Measure: pg/mL

    Measured: From enrollment to the 3 months follow-up

  5. Serum Concentration of IL-4

    Serum IL-4, an anti-inflammatory cytokine involved in immune modulation, measured by ELISA. Unit of Measure: pg/mL

    Measured: From enrollment to the 3 months follow-up

  6. Serum Concentration of FNDC5

    Serum FNDC5, a metabolic peptide measured by ELISA. Unit of Measure: ng/mL

    Measured: From enrollment to the 3 months follow-up

  7. Serum Concentration of Adiponectin

    Serum Adiponectin, a metabolic peptide measured by ELISA. Unit of Measure: ng/mL

    Measured: From enrollment to the 3 months follow-up

  8. Serum Concentration of Reduced Glutathione

    Serum Reduced Glutathione (GSH), a key antioxidant reflecting oxidative stress status, measured by ELISA. Unit of Measure: µmol/L

    Measured: From enrollment to the 3 months follow-up

  9. Serum Concentration of Oxidized Glutathione

    Serum Oxidized Glutathione (GSSG), the oxidized form of glutathione indicating oxidative stress, measured by ELISA. Unit of Measure: µmol/L

    Measured: From enrollment to the 3 months follow-up

  10. Serum Concentration of High-Sensitivity C-Reactive Protein

    Serum High-Sensitivity C-Reactive Protein (hs-CRP), an acute-phase protein reflecting systemic inflammation, measured by ELISA. Unit of Measure: mg/L

    Measured: From enrollment to the 3 months follow-up

Timeline

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

  1. First posted25 Feb 2026
  2. Study start20 Oct 2025
  3. Primary completion20 Oct 2027 (estimated)
  4. Study completion20 Oct 2028 (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
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07434089
Sponsor's protocol ID
GM-REHAB-2025
Status last verified
Feb 2026
First submitted
13 Feb 2026
Last updated
25 Feb 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Pullia M, Ciatto L, Andronaco G, Donato C, Aliotta RE, Quartarone A, De Cola MC, Bonanno M, Calabro RS, Cellini R. Treadmill Training Plus Semi-Immersive Virtual Reality in Parkinson's Disease: Results from a Pilot Study. Brain Sci. 2023 Sep 12;13(9):1312. doi: 10.3390/brainsci13091312.

    PubMed 37759913
  • Malik AN, Tariq H, Afridi A, Rathore FA. Technological advancements in stroke rehabilitation. J Pak Med Assoc. 2022 Aug;72(8):1672-1674. doi: 10.47391/JPMA.22-90.

    PubMed 36280946
  • Dockx K, Bekkers EM, Van den Bergh V, Ginis P, Rochester L, Hausdorff JM, Mirelman A, Nieuwboer A. Virtual reality for rehabilitation in Parkinson's disease. Cochrane Database Syst Rev. 2016 Dec 21;12(12):CD010760. doi: 10.1002/14651858.CD010760.pub2.

    PubMed 28000926
  • Mayer EA, Tillisch K. The brain-gut axis in abdominal pain syndromes. Annu Rev Med. 2011;62:381-96. doi: 10.1146/annurev-med-012309-103958.

    PubMed 21090962
  • Drossman DA, Tack J, Ford AC, Szigethy E, Tornblom H, Van Oudenhove L. Neuromodulators for Functional Gastrointestinal Disorders (Disorders of Gut-Brain Interaction): A Rome Foundation Working Team Report. Gastroenterology. 2018 Mar;154(4):1140-1171.e1. doi: 10.1053/j.gastro.2017.11.279. Epub 2017 Dec 22.

    PubMed 29274869
  • Trindade MFD, Viana RA. Effects of auditory or visual stimuli on gait in Parkinsonic patients: a systematic review. Porto Biomed J. 2021 Aug 4;6(4):e140. doi: 10.1097/j.pbj.0000000000000140. eCollection 2021 Jul-Aug.

    PubMed 34368491
  • Mak MKY, Wong-Yu ISK. Exercise for Parkinson's disease. Int Rev Neurobiol. 2019;147:1-44. doi: 10.1016/bs.irn.2019.06.001. Epub 2019 Jun 27.

    PubMed 31607351
  • Tang X, Huang Z, Zhu G, Liang H, Sun H, Zhang Y, Tan Y, Cui M, Gong H, Wang X, Chen YH. Matching supplementary motor area-primary motor cortex paired transcranial magnetic stimulation improves motor dysfunction in Parkinson's disease: a single-center, double-blind randomized controlled clinical trial protocol. Front Aging Neurosci. 2024 Aug 1;16:1422535. doi: 10.3389/fnagi.2024.1422535. eCollection 2024.

    PubMed 39149144
  • Frazzitta G, Ferrazzoli D, Folini A, Palamara G, Maestri R. Severe Constipation in Parkinson's Disease and in Parkinsonisms: Prevalence and Affecting Factors. Front Neurol. 2019 Jun 18;10:621. doi: 10.3389/fneur.2019.00621. eCollection 2019.

    PubMed 31275225
  • Fayyaz M, Jaffery SS, Anwer F, Zil-E-Ali A, Anjum I. The Effect of Physical Activity in Parkinson's Disease: A Mini-Review. Cureus. 2018 Jul 18;10(7):e2995. doi: 10.7759/cureus.2995.

    PubMed 30245949
  • Yu QJ, Yu SY, Zuo LJ, Lian TH, Hu Y, Wang RD, Piao YS, Guo P, Liu L, Jin Z, Li LX, Chan P, Chen SD, Wang XM, Zhang W. Parkinson disease with constipation: clinical features and relevant factors. Sci Rep. 2018 Jan 12;8(1):567. doi: 10.1038/s41598-017-16790-8.

    PubMed 29330419
  • Cataldi S, Bonavolonta V, Poli L, Clemente FM, De Candia M, Carvutto R, Silva AF, Badicu G, Greco G, Fischetti F. The Relationship between Physical Activity, Physical Exercise, and Human Gut Microbiota in Healthy and Unhealthy Subjects: A Systematic Review. Biology (Basel). 2022 Mar 21;11(3):479. doi: 10.3390/biology11030479.

    PubMed 35336852
  • Gao X, Zhang P. Exercise perspective: Benefits and mechanisms of gut microbiota on the body. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Apr 28;49(4):508-515. doi: 10.11817/j.issn.1672-7347.2024.230550. Chinese, English.

    PubMed 39019779
  • Mach N, Fuster-Botella D. Endurance exercise and gut microbiota: A review. J Sport Health Sci. 2017 Jun;6(2):179-197. doi: 10.1016/j.jshs.2016.05.001. Epub 2016 May 10.

    PubMed 30356594
  • Sohail MU, Yassine HM, Sohail A, Thani AAA. Impact of Physical Exercise on Gut Microbiome, Inflammation, and the Pathobiology of Metabolic Disorders. Rev Diabet Stud. 2019;15:35-48. doi: 10.1900/RDS.2019.15.35. Epub 2019 Aug 4.

    PubMed 31380886

Questions about this trial

What is this clinical trial studying?

A study testing C-Mill technology treadmill equipped with semi-immersive VR, C-Mill treatment without semi-immersive virtual reality (VR) and Conventional physiotherapy training in people with Parkinson Disease, run by IRCCS Centro Neurolesi Bonino Pulejo at 1 site in Italy.

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 5 inclusion and 9 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: looking for participants now, as of the sponsor's last update on 25 Feb 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 Italy. 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?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Relative abundance of bacterial and fungal taxa in fecal samples (time frame: From enrollment to the 3 months follow-up). The study lists 12 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 NCT07434089, which also lists 16 linked publications.

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 25 Feb 2026.

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