The Effect of Eye Exercises in Parkinson's Disease

Официальное название

The Effect of Eye Exercises on Physical Function, Balance, and Fall Risk in Patients With Parkinson's Disease: A Randomized Controlled Trial

Обзор

Parkinson's disease is commonly associated with impaired gait, postural instability, reduced physical function, and increased concern about falling, all of which contribute substantially to disability and reduced quality of life. Exercise-based rehabilitation is increasingly recommended as a core non-pharmacological strategy for improving mobility and balance in people with Parkinson's disease. In parallel, recent clinical and neurorehabilitation research suggests that eye-movement and gaze-stabilization training may influence postural control, visuomotor integration, and movement performance in neurological disorders, including Parkinson's disease. This randomized controlled trial will evaluate whether a supervised in-center eye-exercise program can improve physical function, balance, and fall-related concern in patients with Parkinson's disease.

Подробное описание

Parkinson's disease is a progressive neurodegenerative disorder characterized not only by tremor and bradykinesia, but also by impaired gait, postural instability, reduced turning ability, slowed mobility, and increased fear of falling. These impairments are major contributors to functional limitation, reduced independence, and decreased quality of life in people with Parkinson's disease. Recent systematic reviews and network meta-analyses have demonstrated that exercise interventions can improve physical function, balance, gait performance, and mobility-related outcomes in this population. However, balance impairment and falls remain highly prevalent despite conventional rehabilitation approaches, highlighting the need for additional targeted non-pharmacological interventions.

Visual and oculomotor dysfunction are increasingly recognized as clinically relevant features of Parkinson's disease. Abnormalities in saccadic eye movements, smooth pursuit, gaze stabilization, and visuomotor control have been reported in patients with Parkinson's disease and may contribute to impaired postural control, gait dysfunction, and difficulties with movement coordination. Recent studies in neurorehabilitation and eye-movement research suggest that eye exercises and visually guided training may positively influence balance control, mobility, and motor-related performance by enhancing sensory integration and visuomotor coordination.

Emerging rehabilitation studies have reported promising effects of structured eye-movement interventions on dynamic balance, walking performance, and functional mobility in individuals with Parkinson's disease. In addition, recent advances in eye-tracking and oculomotor assessment research further support the potential therapeutic relevance of visually guided interventions in Parkinson's disease rehabilitation. Nevertheless, high-quality randomized controlled trials investigating supervised eye-exercise programs in clinical settings remain limited.

Therefore, the present study will investigate the effects of a structured supervised in-center eye-exercise program on physical function, dynamic balance, and fall-related concern in patients with Parkinson's disease. The intervention will be delivered face-to-face in a controlled rehabilitation setting to enhance safety, standardization, treatment fidelity, and adherence. By focusing on clinically meaningful functional outcomes, this trial aims to determine whether supervised eye exercises may represent a practical and effective adjunct rehabilitation strategy for improving mobility- and balance-related outcomes in people with Parkinson's disease.

Вмешательства

• Поведенческое Supervised In-Center Eye Exercises
  The participants in the study group will perform the eye-exercise program in a supervised rehabilitation/clinic setting. The exercises will initially be performed in a seated position, with selected tasks progressed to standing positions as tolerated and considered safe by the supervising therapist. The exercises will be administered face-to-face by trained study personnel. The program will include progressive visual fixation, smooth pursuit, saccadic eye movements, convergence/divergence, gaze

Первичные конечные точки

• Change in physical function [Срок оценки: Baseline and 8 weeks]
• Change in dynamic balance [Срок оценки: Baseline and 8 weeks]
• Change in fall-related concern [Срок оценки: Baseline and 8 weeks]

Вторичные конечные точки (3)

• Change in functional mobility [Срок оценки: Baseline and 8 weeks]
• Change in gait speed [Срок оценки: Baseline and 8 weeks]
• Change in lower-limb functional strength [Срок оценки: Baseline and 8 weeks]

Критерии участия

Критерии включения

Aged 18 years and older Clinically diagnosed idiopathic Parkinson's disease Hoehn and Yahr stage 1-3 Stable antiparkinsonian medication regimen Able to stand unaided and walk with or without an assistive device Able to provide written informed consent Able to attend supervised in-center exercise sessions Able to follow simple exercise instructions

Критерии исключения

Severe cognitive impairment Unstable cardiovascular, orthopedic, or neurologic conditions that interfere with safe participation Active infection or acute medical illness Hemodynamic instability Severe visual impairment or other sensory impairment that prevents participation Recent myocardial infarction or stroke Unstable or changing antiparkinsonian medication regimen Any other condition that, in the judgment of the study physician, makes participation unsafe

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Иран · 1 центр

• Pardis specialized wellness institute — Isfahan

Публикации

• Zhu J, Cui Y, Zhang J, Yan R, Su D, Zhao D, Wang A, Feng T. Temporal trends in the prevalence of Parkinson's disease from 1980 to 2023: a systematic review and meta-analysis. Lancet Healthy Longev. 2024 Jul;5(7):e464-e479. doi: 10.1016/S2666-7568(24)00094-1. PMID 38945129
• Niering M, Wirth C, Beurskens R, Ueding E, Fischer T, Seifert J. Effects of a treadmill and oculomotor dual-task intervention vs. -nordic walking on balance in Parkinson's disease patients - a pilot study. Clin Park Relat Disord. 2025 Sep 8;13:100392. doi: 10.1016/j.prdoa.2025.100392. eCollection 2025. PMID 41492353
• Su D, Cui Y, He C, Yin P, Bai R, Zhu J, Lam JST, Zhang J, Yan R, Zheng X, Wu J, Zhao D, Wang A, Zhou M, Feng T. Projections for prevalence of Parkinson's disease and its driving factors in 195 countries and territories to 2050: modelling study of Global Burden of Disease Study 2021. BMJ. 2025 Mar 5;388:e080952. doi: 10.1136/bmj-2024-080952. PMID 40044233
• Bailo G, Saibene FL, Bandini V, Arcuri P, Salvatore A, Meloni M, Castagna A, Navarro J, Lencioni T, Ferrarin M, Carpinella I. Characterization of Walking in Mild Parkinson's Disease: Reliability, Validity and Discriminant Ability of the Six-Minute Walk Test Instrumented with a Single Inertial Sensor. Sensors (Basel). 2024 Jan 20;24(2):662. doi: 10.3390/s24020662. PMID 38276354
• Culicetto L, Cardile D, Marafioti G, Lo Buono V, Ferraioli F, Massimino S, Di Lorenzo G, Sorbera C, Brigandi A, Vicario CM, Quartarone A, Marino S. Recent advances (2022-2024) in eye-tracking for Parkinson's disease: a promising tool for diagnosing and monitoring symptoms. Front Aging Neurosci. 2025 May 21;17:1534073. doi: 10.3389/fnagi.2025.1534073. eCollection 2025. PMID 40469846
• Lorenzo-Garcia P, Cavero-Redondo I, Nunez de Arenas-Arroyo S, Guzman-Pavon MJ, Priego-Jimenez S, Alvarez-Bueno C. Effects of physical exercise interventions on balance, postural stability and general mobility in Parkinson's disease: a network meta-analysis. J Rehabil Med. 2024 Feb 1;56:jrm10329. doi: 10.2340/jrm.v56.10329. PMID 38298133
• Yang Y, Wang G, Zhang S, Wang H, Zhou W, Ren F, Liang H, Wu D, Ji X, Hashimoto M, Wei J. Efficacy and evaluation of therapeutic exercises on adults with Parkinson's disease: a systematic review and network meta-analysis. BMC Geriatr. 2022 Oct 21;22(1):813. doi: 10.1186/s12877-022-03510-9. PMID 36271367
• Waterston JA, Hawken MB, Tanyeri S, Jantti P, Kennard C. Influence of sensory manipulation on postural control in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1993 Dec;56(12):1276-81. doi: 10.1136/jnnp.56.12.1276. PMID 8270927

Идентификаторы

NCT: NCT07525973 · PA26PKD-2-01

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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