Physical Therapy

Researchers are investigating how balance and walking abilities relate to detailed movement measurements in people with Multiple Sclerosis MS. This observational study focuses on understanding the connection between clinical tests of function and objective biomechanical data. The goal is to identify which movement characteristics best reflect balance, gait, and physical performance challenges faced by individuals with MS. Participants will attend a single laboratory session where they undergo biomechanical analysis using the Vicon motion capture system. They will complete functional assessments of balance, gait, and physical performance, as well as questionnaires about fear of falling and fatigue. Spasticity in the lower limbs will also be assessed during this visit. During the session, participants will perform tests such as the mini-BESTest for balance, Functional Gait Assessment, Short Physical Performance Battery, and a 2-minute walk test. Questionnaires like the Fall Efficacy Scale and Fatigue Severity Scale will be completed. Researchers will analyze these collected data to explore how biomechanical and functional measures relate, aiming to improve assessment tools for MS rehabilitation.

This observational study investigates how self-compassion and self-efficacy relate to symptom severity, functional ability, and quality of life in adults diagnosed with Parkinsons disease. The research aims to better understand these psychological factors in people living with Parkinsons disease stages 1 to 3, within an age range of 40 to 85 years. Participants will complete a set of self-report questionnaires during one session to assess their levels of self-compassion, self-efficacy, symptom severity, functional status, and quality of life. No therapeutic treatments or interventions are provided. The study collects data at a single time point to analyze associations among these outcomes. During the study visit, participants will be assessed with various scales and tests including the Self-Compassion Scale, Self-Efficacy for Managing Chronic Disease scale, Unified Parkinsons Disease Rating Scale, Timed Up and Go test, Six-Minute Walk test, Mini-Balance Evaluation Systems Test, and Parkinsons Disease Questionnaire-39. These assessments help evaluate physical function, symptoms, and quality of life. The study is led by Acibadem University and participation involves completing questionnaires and physical tests in one session.

Researchers are evaluating the Turkish version of the Heat Sensitivity Scale in individuals with Parkinsons disease. This cross-sectional observational study aims to examine the scales validity and reliability, including its internal consistency, test-retest reliability, and construct validity. The goal is to provide a trustworthy tool for assessing temperature sensitivity in Turkish-speaking people diagnosed with Parkinsons disease aged 40 to 85. Participants will complete assessments that include the Heat Sensitivity Scale and the Parkinsons Disease Questionnaire-39 PDQ-39. These measurements will be taken at baseline to evaluate their psychometric properties. No interventions or treatments are administered as part of this observational study. During the study, participants will attend assessments at the Movement Disorders Outpatient Clinic, where cognitive and communication abilities will be evaluated to ensure they can complete the questionnaires. Researchers will measure the Heat Sensitivity Scale total score and PDQ-39 total and subscale scores at the time of questionnaire completion. The study spans from May 2026 to May 2027, with the primary outcome measured at baseline.

This research aims to evaluate a 6-month community walking program called the 10,000 Step Club 10KSC for people with Parkinsons disease PD and their caregivers in Las Vegas, Nevada. The program focuses on increasing physical activity, reducing sedentary behavior, fear of falling, loneliness, and social isolation among participants. It is designed to encourage connection among people with PD and promote accountability for reaching a goal of 10,000 steps per day. Participants will join one of three weekly walking groups held in local parks across the Las Vegas valley. Each group, led by University of Nevada, Las Vegas physical therapy students, will meet once a week for a 60-minute walk using Nordic walking poles to support stability and posture. Participants will receive a step watch to track their daily steps in real-time and may attend additional walking sessions if desired. The program is offered in English and Spanish and includes an incentive system to motivate participants. During the study, participants will be assessed before and after the 6-month program. Researchers will monitor daily average step counts, fear of falling avoidance behavior, social isolation, loneliness, and self-efficacy. They will also evaluate the programs feasibility, safety, and diversity of enrollment. The total participation time is 6 months, with ongoing encouragement to increase physical activity while fostering social connections among people with Parkinsons disease.

Researchers are evaluating the optimization of 18F-DOPA PETCT imaging in specific patient groups including pediatric patients with congenital hyperinsulinism or neuroblastoma, pediatric and adult patients with neuroendocrine tumors or brain tumors, and adults suspected of Parkinsons disease or Lewy body dementia. The study aims to improve image quality using a new digital PETCT scanner and intravenous furosemide, while also exploring gallbladder activity patterns related to dopaminergic degeneration. Participants will receive an intravenous injection of 18F-DOPA, with some also receiving a single intravenous dose of furosemide. The study includes a primary objective of assessing image quality improvements in the pelvis area and a secondary objective examining gallbladder activity patterns using dynamic imaging in a subgroup. Imaging data will be compared to previous scans with older technology. During the study, participants will undergo PETCT scans, with measurements of lesion size and activity, bladder activity, and image artifact scoring. A questionnaire will screen for gallbladder disease history. The research team will analyze the imaging results and gallbladder activity patterns, with follow-up assessments occurring within one to three months. The total planned enrollment is 800 patients over approximately five years, with detailed monitoring of image optimization and gallbladder activity.

Researchers are investigating the long-term safety, tolerability, and effectiveness of a home-based peroneal electrical transcutaneous neuromodulation eTNM4 treatment using the URIS I12 device in people with Parkinsons disease PD or Essential Tremor ET. Earlier, a 6-week pilot study with 24 participants showed that this home treatment was safe, well tolerated, and had high adherence, with no treatment-related side effects. Although not designed to prove effectiveness, the pilot suggested improvements in tremor symptoms that lasted for weeks after treatment ended. This extension study aims to further evaluate these outcomes over a longer period. All participants will receive the peroneal eTNM treatment using the URIS I12 neurostimulator device. This device delivers electrical stimulation directly through the skin to the peroneal nerve. The study follows the same treatment procedure as previous studies but applies it over a longer timeframe to assess ongoing effects. This is an open-label, single-site study lasting 24 months, during which participants will continue home-based therapy under the study protocol. Participants will be monitored for safety and tolerability throughout the 24-month treatment period, with particular attention to any adverse events related to the therapy. Effectiveness will be assessed using patient self-reports and clinical scales measuring tremor severity and motor function. Researchers will also track participants adherence and overall experience with the home treatment. The study aims to provide comprehensive data on the long-term impact of this non-invasive neuromodulation therapy on symptoms related to movement disorders in PD and ET.

This trial investigates the use of 40 Hz flicker light stimulation to address insomnia in patients with Parkinsons disease PD, a condition marked by motor and non-motor symptoms including sleep disturbances. Current drug treatments for PD-related insomnia may not be sufficient and can cause side effects, so this study explores a non-drug method that may influence brain activity related to sleep regulation. Approximately 30 patients with PD and significant insomnia symptoms will participate in this randomized, single-blind, controlled study. Participants will be randomly assigned to one of two groups one receiving 40 Hz flicker light stimulation and the other receiving 100 Hz control light. Both groups will receive the light for 30 minutes each night at bedtime for seven consecutive nights, alongside their stable Parkinsons medication. The flicker light is delivered using a specialized device with parameters adjusted for safety and comfort. The study focuses specifically on this PD insomnia group within a larger parent protocol. Throughout the trial, participants will complete sleep assessments including the Parkinsons Disease Sleep Scale-2 PDSS-2, sleep quality questionnaires, and sleep diaries. Objective sleep measures such as total sleep time and awakenings will be collected using polysomnography when possible. Other non-motor symptoms will also be evaluated. Safety will be monitored through adverse event tracking, vital signs, and checking for any visual discomfort. The primary outcome is the change in PDSS-2 score from baseline to Day 7, with additional follow-up assessments conducted at Day 28.

Researchers are evaluating how high frequency repetitive transcranial magnetic stimulation rTMS may improve postural instability, a disabling symptom in Parkinsons disease PD that leads to frequent falls and loss of independence. This study focuses on patients aged 55 to 70 years with mild to moderate PD, aiming to assess the long-term effects of this treatment on balance and stability. Participants will be randomly assigned to one of two groups one receiving a designed physical therapy program including aerobic exercise, stretching, proprioceptive neuromuscular facilitation techniques, active exercises, gait training, and weight shifting exercises three times a week for four weeks the other receiving the same physical therapy plus 12 sessions of high frequency rTMS over the primary motor cortex also three times a week for four weeks. The rTMS sessions last 20 to 30 minutes and are delivered using a specialized device. During the study, researchers will measure balance using the Biodex balance system before treatment, immediately after, and at one-month follow-up. They will assess stability indices including overall, anteroposterior, and mediolateral balance, as well as directional control and time to complete balance tests. The study lasts for six months, with ongoing monitoring to evaluate the lasting effects of the interventions on postural stability.

Researchers are evaluating the use of 18F-MFBG PET scans to assess heart nerve activity in people with Parkinsons disease PD, multiple system atrophy MSA, dementia with Lewy bodies DLB, and Alzheimers disease AD. The study compares this method with the current standard 123I-MIBG SPECT scans, focusing on distinguishing between PD and MSA as well as DLB and AD. This is a prospective study conducted at two centers, aiming to validate the accuracy and feasibility of 18F-MFBG PET for these neurological conditions. Participants will undergo several imaging tests including dynamic cardiac 18F-MFBG PET, 123I-MIBG SPECT, and cerebral 18F-PE2I PET scans. Healthy volunteers and patients with confirmed diagnoses will be included, with groups divided by age and disease duration. A dosimetry study will also be conducted for healthy volunteers to measure radiation exposure from 18F-MFBG. Multiple visits to the hospital are required for scans and assessments. During the study, participants will have thorough neurological assessments, brain MRI scans, and blood sampling alongside PET and SPECT imaging. Researchers will evaluate diagnostic accuracy, effect size of tracer uptake changes, and relationships between heart nerve imaging and brain dopamine transporter changes and autonomic dysfunction. The study includes monitoring for safety and will analyze regional heart uptake patterns. Participants can expect 3 to 4 hospital visits with detailed imaging and clinical evaluations over the study period.

Alpha-synucleinopathies are age-related neurodegenerative disorders characterized by the build-up of alpha-synuclein in nerve cells, leading to conditions like Parkinsons disease, Multiple System Atrophy, and Dementia with Lewy Bodies. Pure Autonomic Failure is a related condition affecting the peripheral autonomic nervous system and may signal risk for developing central nervous system synucleinopathies. Researchers aim to identify biomarkers, especially changes in dopamine production in key brain areas, to predict progression from peripheral to central disease. Participants receive a radiolabeled drug called 18FF-DOPA, which is used in PET scans to study dopamine activity in the brain. Before the PET scan, patients take oral doses of carbidopa and entacapone to enhance imaging quality by reducing peripheral metabolism of 18FF-DOPA. The PET scan involves a slow injection of 18FF-DOPA followed by about 95 minutes of serial brain imaging to observe dopamine-related changes. During the study, participants undergo clinical exams to confirm diagnosis and receive the PET imaging procedure. Researchers measure differences in 18FF-DOPA uptake across patient groups 95 minutes after imaging starts to assess dopamine function. The study includes patients with autonomic failure, possible synucleinopathies, and healthy adults aged 18 and older. The study is designed to monitor safety and gather detailed imaging data over the scan period.