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 dynamic balance, functional mobility, gait performance, and fall-related concern in patients with Parkinson's disease.
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 under direct supervision in a controlled rehabilitation/clinic setting. 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. All functional assessments will be performed at approximately the same time of day and in the participant's usual "ON" medication state, preferably 1-2 hours after antiparkinsonian medication intake, where feasible. Medication timing will be recorded at each assessment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
68
The participants in the study group will perform the eye-exercise program in a standardized seated position under supervision by trained study personnel in a rehabilitation/clinic setting. The exercises will be administered face-to-face and will include progressive visual fixation, smooth pursuit, saccadic eye movements, convergence/divergence, gaze stabilization, and combined eye-head coordination tasks. Progression will be based on increases in movement speed, number of repetitions, task complexity, and participant tolerance, while maintaining the standardized seated position and ensuring safety throughout the intervention.
Pardis specialized wellness institute
Isfahan, Iran
Change in dynamic balance
Dynamic balance will be assessed using the Mini-BESTest total score. The Mini-BESTest evaluates anticipatory postural adjustments, reactive postural control, sensory orientation, and dynamic gait. Higher scores indicate better dynamic balance and postural control.
Time frame: Baseline and 8 weeks
Change in functional mobility
Assessed with the Timed Up and Go test. Shorter completion times indicate better functional mobility.
Time frame: Baseline and 8 weeks
Change in gait speed
Assessed with the 10-Meter Walk Test. Faster walking speed indicates better gait performance.
Time frame: Baseline and 8 weeks
Change in fall-related concern
Assessed with the Falls Efficacy Scale-International (FES-I). Higher scores indicate greater concern about falling.
Time frame: Baseline and 8 weeks
Change in walking endurance
Assessed with the 6-Minute Walk Test. Greater distance indicates better walking endurance and physical function.
Time frame: Baseline and 8 weeks
Number of participants with adverse events during the intervention period
Adverse events will include dizziness, nausea, headache, eye strain, worsening balance, near-falls, falls, musculoskeletal discomfort, or any event requiring session termination or medical evaluation.
Time frame: Baseline and 8 weeks
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