Virtual Reality–enhanced Rhythmic Auditory Cueing Versus Conventional Physiotherapy for Balance and Gait in Parkinson’s Disease: A Randomized Trial

Abstract

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that can impair balance, gait, coordination, and posture. These impairments increase the risk of falls, restrict safe and independent mobility, and reduce quality of life. Virtual reality (VR) and rhythmic auditory stimulation (RAS) are increasingly used in rehabilitation to support motor learning and mobility. Objective: To compare the effects of virtual reality combined with rhythmic auditory stimulation (VR + RAS) and conventional physiotherapy on balance, gait, functional mobility, fear of falling, and quality of life in patients with Parkinson’s disease. Methods: This randomised comparative experimental study used a pre-test–post-test design and included 26 patients with idiopathic Parkinson’s disease classified as Hoehn and Yahr stages I–III. Participants were randomly allocated to the VR + RAS group (n = 13) or the conventional physiotherapy group (n = 13). Both groups received supervised treatment for 45–60 min per day, five days per week, for eight weeks. Outcomes were assessed using the Berg Balance Scale (BBS), Timed Up and Go (TUG) Test, 10-Metre Walk Test (10MWT), Falls Efficacy Scale–International (FES-I), and Parkinson’s Disease Questionnaire-39 (PDQ-39). Data were analysed using paired and independent-samples t-tests, with statistical significance set at p < 0.05. Results: Both groups showed significant changes in all outcome measures after eight weeks (p < 0.01). However, the VR + RAS group demonstrated significantly greater changes than the conventional physiotherapy group in balance, gait speed, functional mobility, fear of falling, and quality of life (p < 0.001 for all between-group comparisons). Conclusion: Virtual reality combined with rhythmic auditory stimulation produced greater changes in balance, gait, functional mobility, fear of falling, and quality of life than conventional physiotherapy in this sample. VR + RAS may therefore be considered an adjunct to standard neurorehabilitation programmes for patients with Parkinson’s disease.