This prospective, randomized, assessor-blinded clinical trial aims to compare the effects of robot-assisted gait training and quadriceps neuromuscular electrical stimulation (NMES) when added to a standard exercise rehabilitation program in patients with Parkinson disease.
Participants will be randomly assigned to two parallel groups. Both groups will receive a standard rehabilitation program, while one group will additionally undergo robot-assisted gait training and the other group will receive quadriceps NMES. The interventions will be administered five days per week for six weeks.
Clinical outcomes, including balance, functional mobility, gait performance, and disease severity, will be evaluated at baseline, post-treatment, and follow-up (week 14). In addition, ultrasound-based assessments of quadriceps muscle thickness and cross-sectional area will be performed to investigate muscle adaptations.
The results of this study are expected to provide comparative evidence regarding the effectiveness of these two rehabilitation approaches and contribute to optimizing rehabilitation strategies in Parkinson disease.
Diagnosis of Parkinson's disease according to established clinical criteria
Age between 40 and 80 years
Hoehn and Yahr stage II-III
Ability to walk independently with or without assistive devices
Severe cognitive impairment or inability to follow instructions
Hoehn and Yahr stage IV-V Parkinson's disease
Severe musculoskeletal disorders affecting gait (e.g., advanced osteoarthritis, recent fracture)
History of lower extremity surgery within the last 6 months
Parallel
Quadriceps Neuromuscular Electrical Stimulation (NMES)
Other interventionQuadriceps neuromuscular electrical stimulation (NMES) applied to the quadriceps muscle in addition to a standard rehabilitation program including posture exercises, balance and coordination training, relaxation, and functional gait training in patients with Parkinson's disease. This intervention specifically targets improvement of quadriceps muscle strength and neuromuscular activation.
robot -assisted gait training
DeviceRobot-assisted gait training applied in addition to a standard rehabilitation program including posture exercises, balance and coordination training, relaxation, and functional gait training in patients with Parkinson's disease. This intervention is designed to improve gait performance, balance, and functional mobility.
Timed Up and Go Test (TUG)
Assessment of functional mobility and balance using the Timed Up and Go test in patients with Parkinson's disease. Lower completion times indicate better functional mobility.
Berg Balance Scale
Evaluation of balance performance using the Berg Balance Scale (0-56 points; higher scores indicate better balance performance) in patients with Parkinson's disease.
Quadriceps Muscle Thickness
Ultrasound-based assessment of quadriceps muscle thickness (mm) in patients with Parkinson disease.
Quadriceps Cross-Sectional Area
Ultrasound-based assessment of quadriceps cross-sectional area (cm²) in patients with Parkinson disease.
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