Effects of Exercise With Visual Feedback in Parkinson's Disease

Postural control will be assessed using the Gyko wearable device. After the wearable vest is properly fitted, the participant will be asked to maintain balance for 30 seconds under four conditions: firm surface with eyes open, firm surface with eyes closed, soft surface with eyes open, and soft surface with eyes closed.

The elliptical area of center of pressure displacement (mm²) obtained from the Gyko system will be recorded for each condition and used as the primary outcome measure.

The Berg Balance Scale is used to assess functional balance. It evaluates both dynamic and static balance through 14 tasks related to different positions, postural changes, and mobility. Each task is scored between 0 and 4 based on the individual's ability to perform the task independently, for a certain period, or over a specific distance (0: unable to perform, 4: normal performance). The highest possible score on the scale is 56, and a higher score indicates greater independence.

The L Test is a functional mobility assessment. The participant starts from a seated position in a chair without armrests and, upon command, walks at a comfortable speed to a marked 3-meter point, turns right, continues walking for 7 meters, turns around, and returns to sit in the chair. The total time to complete the test (seconds) will be recorded.

The first section evaluates non-motor features, the second section assesses activities of daily living, the third section involves motor examination, and the fourth section evaluates treatment complications. The four sections total 42 items. Each item is scored from 0 (no symptoms or signs) to 4 (the most severe symptoms or signs).

For each of the 13 body segments, three diagrams are provided. The posterior view includes the head, shoulders, spine, hips, and feet, while the lateral view includes the neck, chest, shoulders, upper back, trunk, abdomen, and lumbar region. Each body segment is scored as follows: 5 points (correct posture), 3 points (moderate deviation), and 1 point (severe deviation). The total score ranges from 13 to 65. A higher score indicates better posture.

Pain intensity was assessed using the Visual Analog Scale (VAS), which consists of a 100-mm horizontal line with scores ranging from 0 to 100 mm. Participants were instructed to mark the point on the line that best represented their current pain intensity, where 0 indicated "no pain" and 100 indicated "worst imaginable pain." The distance in millimeters from the left end of the line to the marked point was measured using a ruler. Higher VAS scores indicate greater pain intensity.

Consists of a total of 16 questions related to fatigue. Participants are asked to rate their agreement with the statements on a scale from 1 to 5 (1: strongly disagree, 5: strongly agree). The test result is determined by calculating the average of the responses to all questions.

Gait speed will be assessed using the 10-Meter Walk Test. Participants will be instructed to walk a marked 10-meter distance at their usual walking speed. The time taken to complete the distance will be recorded, and walking speed (m/s) will be calculated.

It consists of 16 tasks related to daily living activities performed both indoors and outdoors. Each item is rated on a scale from 0% (no confidence) to 100% (full confidence). Scores below 67% indicate a risk of falling, while higher scores reflect greater balance confidence.

Postural stability will be assessed using the Functional Reach Test. The participant stands next to a wall with the arm closest to the wall elevated to 90° of shoulder flexion. The initial and final positions of the third finger are marked, and the reach distance (cm) is calculated.

Lower extremity strength and functional mobility will be evaluated using the Five Times Sit-to-Stand Test. Participants are instructed to stand up and sit down five times as quickly as possible from an armless chair with arms crossed. The total completion time (seconds) is recorded.

Used to assess freezing episodes in patients with Parkinson's disease. It consists of six questions, each scored on a 0 to 4 scale (0: no symptoms, 4: severe). The total score ranges from 0 to 24, with higher scores indicating more severe freezing-related impairment.

İt consists of 39 items divided into eight domains. Participants respond based on their experiences over the past month. Each question is scored on a 0 to 4 scale (0: never, 1: rarely, 2: sometimes, 3: often, 4: always).

To calculate the domain score, the total score of the questions within that domain is summed, divided by the maximum possible score for that domain, and multiplied by 100.

The total PDQ-39 score is obtained by summing the eight domain scores and dividing by 8, providing an overall quality of life measure.