Clinical Research Directory

Cawthorne-Cooksey Exercises and Frenkel Exercises on Balance and Coordination in Stroke

Stroke, often caused by cerebral circulation disruption can lead to transient or permanent brain function deficit it is a leading cause of disability and death globally, with a particularly high burden in low- and middle-income countries like Pakistan. Balance and coordination impairments are common post-stroke, severely impacting patients' mobility and quality of life. While Cawthorne-Cooksey and Frenkel exercises are low-cost rehabilitation techniques known to aid balance and coordination, there is limited evidence comparing their effectiveness in stroke patients. This study aims to evaluate and compare the effects of Cawthorne-Cooksey and Frenkel exercises on improving balance and coordination in post-stroke patients. Specific goals include determining which protocol leads to faster and more sustained improvements and providing evidence-based recommendations for stroke rehabilitation.

Dynamic Neuromuscular Stability Exercises With and Without Rhythmic Auditory Stimulation in Lateral Ankle Sprain

To examine the effects of Dynamic Neuromuscular Stability exercises with and without Rhythmic Auditory Stimulation on balance, proprioception, and functional performance in badminton players with lateral ankle sprain.

Acute Effects of Fibular Repositioning Taping on Balance, Jumping, and Sprint Performance

This randomized controlled trial aims to investigate the acute effects of fibular repositioning taping on balance, jumping, and sprint performance in healthy individuals. Eligible participants are randomly allocated to one of three groups: fibular repositioning taping, sham taping, or control. Physical performance and dynamic balance are assessed at baseline and after the intervention using functional outcome measures, including jumping tests, a 10-meter sprint test, and the Y Balance Test. The study is designed to determine whether fibular repositioning taping produces short-term changes in selected performance parameters compared with sham taping and no intervention.

OTAGO Exercises in Diabetes Mellitus Examining Its Effectiveness

Diabetes Mellitus (DM) is a chronic metabolic disease characterized by hyperglycemia, which occurs in insulin deficiency or when the body cannot effectively use the insulin produced. Moreover, according to the "Global Report on Diabetes" data published by the World Health Organization (WHO) in 2016, it is an important public health problem, one of the four priority non-communicable diseases (1, 2). In addition to the high mortality rates caused by complications due to DM, it is also known that it can cause low quality of life and many other additional problems in individuals. Possible complications are chronic and serious problems such as heart attack, risk of stroke, kidney failure, vision loss and nerve damage. One of the most common and most disabling complications is neuropathy. It should also be noted that approximately half of diabetic neuropathy is asymptomatic and patients diagnosed with DM may have neuropathy due to causes other than diabetes (2). These complications and damage that DM can cause can lead to decreased blood flow combined with neuropathy; As a result, foot ulcers and infections may occur; Amputation rates may increase. In addition to such additional complications that diabetic neuropathy may cause, due to all these; Loss of protective plantar sensation may also occur (3). This loss of protective sensation may lead to cutaneous deficits in the lower extremities, loss of muscle strength and reflexes, and gait and balance disorders (4). The mechanism that makes an important contribution to functional joint stability and the continuity of this stability, along with the feedback mechanisms required to ensure neuromuscular control, is proprioception, which includes joint movement (kinesthesia) and joint position sense (EPH) and is a subunit of the somatosensory system (5-7). . Rehabilitation with various injuries and other clinical conditions; Clinical studies to determine its effects on joint proprioception, neuromuscular control and balance have mostly focused on knee and ankle joints (5). The main reason for this can be attributed to the great importance of the knee and ankle joints in the lower extremities in maintaining general body kinematics and balance (8). Additionally, it has been reported in the literature that EPH and plantar sensory loss are observed in individuals diagnosed with DM, and these complications may cause additional problems (10, 12, 18-22). Additionally, many studies in the literature on this subject have been conducted in individuals with diabetic neuropathy, and changes in functional parameters such as plantar sensation, proprioception, muscle strength and balance have been examined (10, 19, 20, 22, 23). However, it has been found that not only individuals with neuropathy but also individuals diagnosed with DM without neuropathy have balance disorders (24). There are many studies in the literature about the effects of different exercise training on proprioception. In general, studies have reported that exercise training without weight bearing on the extremity has no effect on proprioception, but as a result of exercises performed with weight bearing on the extremity, a significant improvement was noted in both proprioceptive performance and muscle strength (25). In one of the most recent studies on this subject, it was stated that proprioceptive sensitivity increased in individuals with knee osteoarthritis with 8-week squat strengthening training performed by transferring weight to the extremity (26). Additionally, there are studies in the literature reporting different results regarding the effects of stretching exercises on proprioceptive performance. Some studies have reported that static stretching has no effect on proprioception, while others have reported that it has a positive effect on proprioception (27,28). The Otago Exercise Program is an evidence-based, home-based, individually tailored strength and balance retraining program. Research shows that the Otago Exercise Program is effective in reducing the risk of death and the incidence of falls in older adults over a one-year period. In one study, falls were reduced by 35% in older adults has been reported(29) This study was planned to examine the effectiveness of balance exercises given as a home program to individuals diagnosed with Type 2 DM.

Whole-Body Vibration in Parkinson Disease

The aim of this study is to evaluate the effects of different frequencies of Whole Body Vibration (WBV) application on balance, gait, cognitive functions, and dual-task performance in patients with Parkinson's disease. Study Hypotheses: H0.1 - There is no effect of different frequencies of WBV application on balance performance in patients with Parkinson's disease. H1.1 - There is an effect of different frequencies of WBV application on balance performance in patients with Parkinson's disease. H0.2 - There is no effect of different frequencies of WBV application on gait performance in patients with Parkinson's disease. H1.2 - There is an effect of different frequencies of WBV application on gait performance in patients with Parkinson's disease. H0.3 - There is no effect of different frequencies of WBV application on cognitive functions in patients with Parkinson's disease. H1.3 - There is an effect of different frequencies of WBV application on cognitive functions in patients with Parkinson's disease. H0.4 - There is no effect of different frequencies of WBV application on dual-task performance in patients with Parkinson's disease. H1.4 - There is an effect of different frequencies of WBV application on dual-task performance in patients with Parkinson's disease. H0.5 - There is no effect of different frequencies of WBV application on reaction time in patients with Parkinson's disease. H1.5 - There is an effect of different frequencies of WBV application on reaction time in patients with Parkinson's disease. H0.6 - There is no significant difference between medium-frequency and low-frequency WBV in terms of balance performance in patients with Parkinson's disease. H1.6 - There is a significant difference between medium-frequency and low-frequency WBV in terms of balance performance in patients with Parkinson's disease. H0.7 - There is no significant difference between medium-frequency and low-frequency WBV in terms of gait performance in patients with Parkinson's disease. H1.7 - There is a significant difference between medium-frequency and low-frequency WBV in terms of gait performance in patients with Parkinson's disease. H0.8 - There is no significant difference between medium-frequency and low-frequency WBV in terms of cognitive functions in patients with Parkinson's disease. H1.8 - There is a significant difference between medium-frequency and low-frequency WBV in terms of cognitive functions in patients with Parkinson's disease. H0.9 - There is no significant difference between medium-frequency and low-frequency WBV in terms of dual-task performance in patients with Parkinson's disease. H1.9 - There is a significant difference between medium-frequency and low-frequency WBV in terms of dual-task performance in patients with Parkinson's disease. H0.10 - There is no significant difference between medium-frequency and low-frequency WBV in terms of reaction time in patients with Parkinson's disease. H1.10 - There is a significant difference between medium-frequency and low-frequency WBV in terms of reaction time in patients with Parkinson's disease.

Figure-of-eight Backward Walk Test in Elderly

Mobility is a fundamental element of healthy aging. Balance is a necessary function during mobility for all movements throughout life in elderly individuals. Falls due to balance disorders in elderly individuals cause a decrease in the quality of life. Studies in the literature indicate that 13% of individuals aged 65-69 experience falls, and this rate rises to 46% in individuals over 85. Lower extremity muscle volume and strength gradually decrease with aging. This decreased muscle strength directly impacts individuals' activities of daily living.Normal walking speed for elderly individuals is related to balance and overall health performance. However, walking assessments generally focus on walking activities in a forward direction and in a straight line. However, in daily life, we may need to sit on a chair, walk backward to navigate a narrow space, or change direction suddenly due to obstacles or environmental cues. Walking backward requires more complex motor control, and these gait training programs are known to be effective in improving balance and walking skills.Clinically, balance assessments in the elderly persons are commonly measured by using the TUG, 10-meter walk test, functional reach test, 4-square step test, and Berg balance scale. The methods used to assess balance are still not fully standardized. The best test for assessing dynamic balance and fall risk is still up for debate, especially when it comes to elderly individuals who live freely in the community. Further research is needed to determine whether lateral walking tests can identify those at high risk of falling in elderly adults. The purpose of this study was to determine the reliability, validity, and minimal detectable change (MDC) of the Figure-of-8 backward walking test in healthy elderly adults.

Balance-Cognitive-Strength Training for Balance, Inhibitory Control, and Gait in Preschool Children

This randomized controlled study evaluated whether an 8-week balance-cognitive-strength training program improved balance ability, inhibitory control, and gait performance in preschool children aged 3 to 6 years. Children completed balance tests, single-task walking tests, dual-task walking tests, and an iPad-based Go/No-Go task before and after the intervention. The intervention group received exercise-cognitive integrated training 3 times per week for 8 weeks, and the control group maintained usual daily activities.

Robotic-Assisted System in Enhancing Balance, Postural Stability, Functional Gait and Fall Efficacy in Older Adults

Our study aims to investigate the effectiveness of a more individualized and personalized feedback-oriented approach using a Robotic Assisted System, the Hunova Movendo Robotic System. This system is tailored to specific needs of individuals and is dynamically adjustable relative to patients' balance and functional demands. It will be compared to Otago Exercise Programme which is more generalized. Given the generalized nature of the Otago Exercise Programme, we aim to compare it with the Robotic Assisted Systems in the enhancement of Balance, Postural Stability, Functional Gait and Fall Efficacy in older adults.

Core Endurance and Throw Performance in Young Judokas

This cross-sectional study aims to investigate the association between core endurance, medicine ball throw performance, and static balance in young male judokas aged 10-13 years. Core endurance will be assessed using McGill's isometric core endurance protocol, including trunk flexion, trunk extension, and lateral bridge tests. Explosive performance will be evaluated using the backward overhead medicine ball throw test, while static balance will be assessed using the Flamingo Balance Test. Correlation and regression analyses will be conducted to examine the relationships between core endurance and performance variables. The findings may contribute to understanding the role of core endurance in youth judo performance.

Wearable Sensory Prosthesis to Improve Coordination, Walking, and Physical Activity

The goal of this clinical trial is to investigate whether sensory stimulations from a neuroprosthesis device (Walkasins®) can increase physical activity and improve gait quality in persons with peripheral neuropathy (PN). The main question it aims to answer is whether Walkasins enhances habitual activity patterns in adults with peripheral neuropathy. Participants will do the following as part of the study: * Complete a sensation and balance assessment to determine eligibility for the study. * Answer questions about their medical history, physical function, balance confidence, and sleep. * Perform various balance and walking tasks on three separate occasions. One of the tests involves walking for six minutes without a cane or walker. * Wear an activPAL activity monitor for ten days on three separate occasions and return it to the researcher as directed. * Wear Walkasins for ten weeks as part of their daily routine. Walkasins consists of two parts: 1) an insole that fits inside the shoe and 2) a strap that secures around the ankle.

Core Stability, Functional Capacity, Balance, Strength, and Fatigue in Pediatric Demyelinating Diseases

This study aims to evaluate balance ability, core stability, functional capacity, lower extremity muscle strength, and fatigue levels in children diagnosed with central nervous system demyelinating diseases, in order to contribute to the development of evidence-based and individualized rehabilitation strategies.

Wunda Chair vs Mat Pilates: Balance Effects

The goal of this study is to compare the acute effects of Wunda Chair Pilates and mat-based Pilates exercises on balance performance in healthy adult women. It will also examine which type of Pilates exercise provides a more immediate improvement in balance. The main questions it aims to answer are: Do Wunda Chair Pilates exercises lead to greater improvements in balance compared to mat-based Pilates after a single session? Are there differences between the two exercise approaches in terms of static balance, dynamic balance, and functional mobility? Researchers will compare Wunda Chair Pilates with mat-based Pilates to determine which method is more effective in enhancing acute balance performance. Participants will: Be randomly assigned to either a Wunda Chair Pilates group or a mat-based Pilates group Perform a single 45-minute exercise session according to their assigned group Complete balance assessments (Single Leg Stance Test, Timed Up and Go Test, and Y-Balance Test) before and immediately after the exercise session

Balance, Fall Risk, and Gait in Women With Total Knee Arthroplasty

Total knee arthroplasty (TKA) is a commonly performed surgical procedure aimed at reducing pain, restoring joint function, and improving quality of life, particularly among older women. Despite improvements in pain and functional outcomes following TKA, findings regarding balance, fall risk, and gait performance remain inconsistent. Impairments in these parameters may adversely affect daily activities, independence, and overall quality of life. Unlike previous studies that have primarily focused on one or two outcomes, this study will comprehensively evaluate balance, fall risk, gait performance, and quality of life in postmenopausal women who have undergone TKA. The findings are expected to provide a more holistic understanding of long-term functional outcomes following TKA and contribute to the planning of rehabilitation programs. Therefore, the aim of this study is to compare balance, fall risk, gait performance, and quality of life between postmenopausal women who have undergone TKA and healthy postmenopausal women.

EFFECTS OF DEEP WATER CORE EXERCİSES ON BALANCE AND MUSCLE STRENGTH İN SEDENTARY WOMEN

The aim of these clinical trials is to investigate the current effects of a 12-week deep-sea exercise program on sedentary, balance, and muscle strength. The key questions the study aimed to answer were: * Does deep-sea exercise improve the development of sedentary dynamic and static balance? * Does deep-sea exercise increase upper and lower extremity muscle strength? Researchers compared an exercise group to a control group to assess exercise performance. The experimental groups performed deep-sea exercises three times a week for 12 weeks. Dynamic balance, static balance, and muscle strength measurements were assessed at baseline, week 4, week 8, and week 12.

"Effects of a Combined Repetitive Transcranial Magnetic Stimulation and Physical Therapy Protocol on Motor Function, Balance, and Quality of Life in Chronic Post-Stroke Hemiplegia: A Case Series"

Chronic post-stroke hemiplegia frequently results in persistent motor deficits, impaired balance, and reduced quality of life. Conventional physical therapy is fundamental for functional recovery; however, motor improvement often plateaus during the chronic phase. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique that has shown potential to enhance motor recovery by modulating cortical excitability and promoting neuroplasticity. This case series aims to investigate the effects of a combined protocol of repetitive transcranial magnetic stimulation and conventional physical therapy on motor function, balance, and quality of life in individuals with chronic post-stroke hemiplegia. Participants will undergo rTMS applied to the motor cortex in conjunction with a structured physical therapy program. Clinical outcomes will be assessed before and after the intervention to explore feasibility, safety, and potential functional benefits of the combined approach.

Figure-of-8 Walk Test in Individuals With Motoric Cognitive Risk Syndrome

This observational study aims to investigate the validity and reliability of the Figure-of-8 Walk Test (8FWT) in individuals with Motoric Cognitive Risk Syndrome (MCRS). The study will evaluate test-retest reliability, measurement error (SEM, MDC), and construct validity by examining the relationship between 8FWT performance and functional mobility measures. The findings are expected to provide evidence for the clinical applicability of 8FWT in assessing dynamic balance, gait performance, and cognitive-motor interaction in older adults.

Effects of Turning Based Dual Task Training on Balance and Mild Cognitive Impairment in Diabetic Peripheral Neuropathy

Diabetic Peripheral Neuropathy (DPN) is a common complication of diabetes, characterized by impaired sensory and motor function, often leading to balance dysfunction and an increased risk of falls. Additionally, individuals with DPN are at heightened risk for mild cognitive impairment (MCI), which further compromises functional independence. This study aims to determine the effects of turning-based dual-task training compared to conventional dual-task training on balance, cognitive function, and fall risk in individuals with DPN. Pre- and post-intervention assessments will be conducted using the Berg Balance Scale (BBS), Montreal Cognitive Assessment (MoCA), and Timed Up and Go Test (TUGT) to evaluate balance, cognition, and fall risk respectively.

Effects of Wiifit vs Conventional Vestibular Rehabilitation on Dizziness and Balance in Patients With Unilateral Peripheral Vestibular Dysfunction

Unilateral Peripheral Vestibular Dysfunction (UPVD) causes dizziness, imbalance, vertigo, and reduced quality of life. Conventional Vestibular Rehabilitation Therapy (cVRT) is effective, while WiiFit-based virtual reality training may further enhance motivation and neuroplasticity. This study aims to compare WiiFit-based training with conventional rehabilitation in improving balance and reducing dizziness in UPVD patients. A randomized controlled trial will include participants aged 18-65 meeting specific inclusion and exclusion criteria. Participants will be randomly divided into two groups: Group A receiving conventional therapy (40 minutes, 3 sessions/week) and Group B receiving WiiFit-based exercises for 4 weeks. Outcomes will be assessed using DHI, Mini-BESTest, and VADL before and after intervention.

Inspiratory Muscle Training in Children With Cerebral Palsy: Effects on Respiratory and Motor Functions

This study investigates the effect of inspiratory muscle training on respiratory parameters, trunk control, upper extremity function and swallowing in patients with cerebral palsy aged 5-18 years. The results of the study aim to provide a clinical perspective for clinicians working with patients diagnosed with cerebral palsy between the ages of 5-18 years and to contribute to the literature.

Effectiveness of Dance Therapy in Stroke Patients.

Hemiparesis following a stroke is associated with persistent deficits in postural control, balance, and social participation, especially in the chronic phase. Dance therapy, as a multisensory intervention based on movement, music, and body expression, could promote sensorimotor integration and improve postural stability, complementing conventional physiotherapy. The primary objective of this pilot study is to evaluate the effect of a therapeutic dance program on postural control in individuals with chronic hemiparesis. A secondary objective is to analyze changes in functional balance and gait, as well as subjective satisfaction with the therapy. A controlled study with two parallel groups will be conducted. Sixteen participants with chronic hemiparesis will be recruited (n=8 experimental group; n=8 control group). Both groups will receive standard physiotherapy, but the experimental group will also receive an 8-week therapeutic dance program, with one 30-minute session per week to complement their usual therapy. Pre- and post-intervention assessments will be performed. ThThe experimental group is expected to show a significantly greater improvement in posturographic and clinical parameters compared to the control group. The results could support the implementation of dance therapy as a complementary intervention in community neurorehabilitation programs.

Visual Training Effects in Esports Players

This randomized controlled study aims to investigate the acute effects of a single session of web-based visual training on balance, reaction time, and cognitive function in professional e-sports players. Participants will be randomly assigned to either a web-based visual training group or a control group. The intervention group will receive a single approximately 25-minute session including eye relaxation, eye movement exercises, convergence-divergence, accommodation, figure-ground perception, and visual attention exercises. The control group will receive no intervention. Balance, reaction time, and cognitive function will be assessed at baseline and immediately after the intervention.

Keep-On-Keep-Up (KOKU)

Falls are the primary cause of fatal and non-fatal accidental injuries in older adults. Around a third of community-dwelling older adults fall per year with high associated personal and societal costs. The World Falls Prevention Guidelines recommend balance challenging, functional exercise programmes for falls prevention but there can be low uptake and adherence in community settings. A digital, NHS approved programme Keep-On-Keep-Up (KOKU) was co-developed with older adults and therapists, to provide progressive, evidence-based exercises and to raise awareness of home hazards and ways to improve bone health, nutrition and hydration. This trial aims to investigate the effectiveness of the KOKU digital strength and balance programme for improving balance, function and reducing falls risk in community dwelling older adults. Objective: The purpose of this study is to investigate the effectiveness and cost-effectiveness of an NHS (National Health Service) approved, digital falls prevention intervention; (Keep On Keep Up (KOKU) - see https://kokuhealth.com) for improving balance, maintaining function and reducing falls risk in community dwelling older adults. Design: A two-arm randomised controlled trial. Participants and setting: Community-dwelling older adults aged 65 years and older. Interventions: Digital 12-week strength and balance programme, plus standard care (falls prevention exercises advice and leaflet) against standard care only. Main outcome measures: The primary outcome measure is balance function at 12 weeks post-baseline, as assessed by the Berg Balance scale (BBS). Secondary outcomes include: healthcare utilisation and health-related quality of life, fear of falling, mobility, self-reported physical activity, falls risk, pain, mood, fatigue, and self-reported falls over a 3-month period. Randomisation will take place after participants are recruited and baseline data is collected.

Body Weight-Supported and Virtual Reality Gait Training in Stroke Patients

The aim of this study is to compare the effects of body weight-supported gait training that includes virtual reality-assisted dual-task applications with body weight-supported forward and backward gait training on functional capacity, gait parameters (such as step length, gait speed, and balance), cognitive functions and psychological status in patients with stroke. The findings of this study are expected to contribute to the development of more effective rehabilitation strategies for improving mobility in patients with stroke

Virtual Reality Training Using Wii Fit in Children With Cerebral Palsy

The goal of this clinical trial is to determine whether virtual reality (VR) training using the Nintendo Wii Fit can improve balance, gross motor function, and agility in children aged 7-14 years with spastic cerebral palsy (GMFCS Levels I-II). The main questions it aims to answer are: Does Wii Fit-based VR training improve balance more than conventional physiotherapy? Does VR training enhance gross motor skills such as standing, walking, running, and jumping? Does VR training improve agility in children with cerebral palsy? Does VR training increase enjoyment and engagement during therapy? Researchers will compare Wii Fit-based VR training with conventional physiotherapy to determine which approach leads to greater improvements in motor function. Participants will: Attend 18 sessions over 6 weeks (3 sessions per week). Perform either VR-based exercises using the Wii Fit Balance Board or traditional physiotherapy exercises. Complete pre- and post-intervention assessments using the Pediatric Balance Scale, GMFM-88 (domains D and E), BOT-2 agility subtest, and the PACES enjoyment scale. This study aims to explore a fun, cost-effective, and engaging rehabilitation strategy that may improve functional independence and overall quality of life for children with cerebral palsy.