Overview
This study aims to determine the effects of aerobic exercise as a primer to add-on virtual reality (VR)-based rehabilitation on balance, postural control and neuroplasticity (ability of brain to adapt in structure and function) in individuals with Parkinson's disease (PD). This study will utilize two groups - one group will receive the exercise and VR, while the other group will receive stretching exercise and VR over eight weeks. The study team will administer outcomes at baseline, post-intervention (8 weeks) and follow-up (6 weeks after post-assessment).
Description
This study will enroll individuals diagnosed with Parkinson's disease who will be randomly assigned to 2 groups: 1) high intensity endurance exercise and virtual reality (experimental) or 2) stretching and virtual reality (control) for eight weeks (three sessions, thrice weekly). Outcomes will include balance and gait measures, blood-based biomarkers, neuroplasticity measures (assessed by transcranial magnetic stimulation), spinal reflex excitability (measured by H reflex) and quality of life.
Eligibility
Inclusion Criteria:
- Diagnosis of idiopathic PD (ages 18 -85) in Hoehn and Yahr stages 2 - 3.
- Subjects need to demonstrate a score of equal to or greater than 23 on the Mini Mental State Examination.
- Subjects who have a score of ≤21.5 on the Mini Balance Evaluations Systems Test (miniBESTest).
Exclusion Criteria:
- Subjects with a history of other neurological diseases (i.e., stroke, multiple sclerosis).
- Subjects with a history of severe cardiopulmonary disease, uncontrolled hypertension, orthostatic hypotension, uncontrolled diabetes, severe osteoporosis, severe arthritis affecting their lower extremity joints.
- Subjects with a history of PD-specific surgical procedures such as deep brain stimulation etc.
- Subjects with a history of head injury.
- Subjects with a history of seizures or epilepsy.
- Subjects who are currently pregnant.
- Individuals who use of medications that could alter corticomotor excitability or increase risk of seizure.
- Individuals with skull abnormalities, fractures or unexplained, recurring headaches.