Patients and methods: The three-arm, randomized controlled study was conducted between July 2017 and March 2019. Forty-five patients (25 males, 20 females; mean age: 65.7±8.3 years; range, 40 to 75 years) were randomized into three groups. The first group underwent a conventional rehabilitation program. The second group underwent a conventional rehabilitation program + robot-assisted arm training. The third group underwent conventional rehabilitation + robot-assisted arm training + recreational activities. Before and after the rehabilitation program, handgrip strength, pinch strength, nine-hole peg test, Frenchay arm test, Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson`s Disease Questionnaire-39 (PDQ-39), rapid alternating movements, fine finger movements, Disabilities of the Arm, Shoulder, and Hand, and Fatigue Severity Scale were investigated.

Results: In the first and second group, success was achieved in UPDRS mentation, behavior and mood, activities of daily living, motor examination subscales, PDQ-39 total score, emotional well-being, and activities of daily living subscales. Handgrip strength and nine-hole peg test performance also improved significantly. Tip pinch strength, fine finger movements test, and Frenchay arm test showed greater improvement in the third group.

Conclusion: Activities of daily living, upper extremity motor function, muscle strength, mental and emotional well-being improved in patients with Parkinson disease treated with robot-assisted arm in addition to conventional rehabilitation. Hand fine motor skills were improved in patients who attended to recreational activities in addition to conventional rehabilitation and robot-assisted arm training. Keywords : Neurological rehabilitation, Parkinson disease, recreational activities, robot-assisted arm, upper extremity functions