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BACKGROUND: Parkinson's Disease (PD) is the second most common progressive neurodegenerative disorder, mostly affecting balance and motor function caused mainly by a lack of dopamine in the brain. The use of virtual reality (VR) and motor imagery (MI) is emerging as an effective method of rehabilitation for people with Parkinson's disease. Motor imagery and virtual reality have not been compared in patients with Parkinson's disease. This randomized clinical trial is unique to compare the effects of virtual reality with routine physical therapy, motor imagery with routine physical therapy, and routine physical therapy alone on balance, motor function, and activities of daily living in patients with Parkinson's disease. METHODS: A total of sixty patients with Parkinson's disease were randomized into three groups using lottery method; twenty with virtual reality therapy in addition to physical therapy (group A = VR + RPT), twenty with imagery therapy in addition to physical therapy (group B = MI + RPT), and twenty were treated with only routine physical therapy (group C = RPT). All patients were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) for motor function and activities of daily living, the Berg balance scale (BBS) for balance, and the Activities-specific Balance Confidence Scale (ABCs) for balance confidence at baseline, six and twelve weeks, and one month after treatment discontinuation. The one-way ANOVA was used to compare the outcomes between three groups, and the repeated measures ANOVA was used to compare the outcomes within each of the three groups at a significance level of p-value = 0.05. RESULTS: According to UPDRS III, the VR + RPT group showed significant improvement in motor function, compared to the MI + RPT and RPT groups, as the Mean ± SD at baseline was 33.95 ± 3.501 and at the 12-week assessment was 17.20 ± 9.451 with a p-value = 0.001. In the VR + RPT group, the BBS score at baseline was 37.15 ± 3.437 and at 12th week was 50.10 ± 4.897 with a p-value = 0.019. Among the VR + RPT group, the ABCS score showed significant improvement as the M ± SD at baseline was 57.95 ± 4.629, and at the 12th week was 78.59 ± 6.386 with a p-value = 0.010. At baseline, the UPDRS II for activities of daily living in the VR + RPT group was 25.20 ± 3.036 and at 12th week it was 15.30 ± 2.364 with p-value of 0.000. CONCLUSION: The current study found that the combination of VR and RPT proved to be the most effective treatment method for improving balance, motor function, and activities of daily living in patients with Parkinson's disease when compared to MI + RPT or RPT alone.

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Family-centered care is widely considered as best practice in pediatric rehabilitation. We aimed to investigate parents' perception of the family-centeredness of health care services for their children with cerebral palsy (CP) using the Arabic Measure of Processes of Care-20 (AR-MPOC-20). We also explored factors related to the child (sex, secondary impairments, and gross motor classification system level) and environment (family and residential region) that may influence the family-centeredness of services in Saudi Arabia. This was a cross-sectional study of 223 children with CP (age 6 months-18.2 years, M = 6.2 + 3.7 years) and their parents. Generally, parents perceived services as less family-centered. The lowest average score was for 'Providing General Information' (M = 2.9 ± 1.5), while 'Respectful and Supportive Care' had the highest average (M = 4.6 ± 1.8). Factors influencing the provision of family-centered care included being a female child and a mother's educational level. In addition, all subscales of AR-MPOC-20 differed by region, p < 0.001, except for 'Providing Specific Information' which did not significantly differ by region p = 0.163. Clinicians should consider the families' need for information regarding their children's condition and available services, with special attention to the mothers of female children and mothers with low levels of education.

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BACKGROUND: Falls are a major concern for people of all ages, especially older adults with declining physical functions and deteriorating muscle strength. The Five Times Sit to Stand Test is used for the assessment of lower limb strength along with balance and postural control. Therefore, the systematic review at hand aimed to determine the optimal procedure and characteristics among older adults. METHODS: The following databases served as the primary sources through which the target studies were searched for and obtained for review. They included Google Scholar, Pedro, BIOMED Central, Cochrane Library, MEDLINE, PUBMED and Science DIRECT. With the aim of fulfilling the eligibility criteria, 16 full-text studies were included and the quality assessment was performed. using the Thomas Tool. RESULTS: The total number of the subjects who participated in the included studies was 15,130 and the ages of the aforementioned participants ranged from 60 to 80 years. In 15 of the studies, a stopwatch was used as the scoring method where the mean chair height of 42 cm was reported. Two studies reported that no significant influence of the arm position (P = .096) on the time allocated for test completion was identified. However, posterior foot placement (P < .001) led to shorter times of completion. Individuals who are unable to complete the test are more susceptible to activities of daily living related disabilities (P < .01) when compared to fall risk (P = .09). CONCLUSION: The Five Times Sit-to-Stand Test is a safe test, providing added value to apply risk for falls in people at moderate risk and in healthy populations using standardized chair heights and stopwatches.

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