Abstract
Parkinson’s disease (PD) is a neurodegenerative condition often associated with reduced balance and gait control. Virtual reality (VR) is a promising intervention for enhancing rehabilitation efficiency and may assist in overcoming functional limitations. The objective of this study was to evaluate the feasibility, safety and efficacy of a 5-weeks VR intervention in increasing mobility smoothness in participants with PD. Participants were assessed using functional mobility tasks - Timed Up and Go (TUG) and 10-meter walking test (10MWT) and cognitive function tests. A total of 23 participants with a diagnosis of PD were randomly assigned to groups of VR or control interventions. In the VR group, for each session, participants received a VR–based balance training, for 20 minutes, preceded by 8 minutes of total body warm-up (total of 10 sessions over five weeks). Participants in the control group received 20 minutes of psychoeducation without a structured exercise program (twice a week). All screened participants engaged and completed a total of 10 VR-based intervention sessions. VR-based balance training caused no significant improvement in mobility smoothness for TUG or 10MWT (p > 0.05). Similarly, cognitive function was not affected by the VR intervention (p > 0.05). The outcomes of this study suggest that ten-twenty minutes of VR-based intervention is a feasible and safe rehabilitation activity. However, it was insufficient to promote improvement in mobility smoothness and cognitive function in participants with PD. A combination of task-specific training in the virtual and physical environments is warranted for future study designs.
Highlights
Parkinson’s disease is one of the most common neurodegenerative disorders worldwide (Bellou et al, 2016), which is associated with motor and cognitive impairments
We found that participants with Parkinson’s disease (PD) and freezing of gait (FOG) presented reduced smoothness compared to healthy controls
For spectral arc length (SPARC) metrics, we found a group effect only for SPARC linear total, where Virtual reality (VR) participants presented greater smoothness compared to the control group (Supplementary Figure 2C, Supplementary Table 3)
Summary
Parkinson’s disease is one of the most common neurodegenerative disorders worldwide (Bellou et al, 2016), which is associated with motor and cognitive impairments. Virtual reality (VR) is a relatively new technology used by researchers to explore novel and optimized rehabilitation and training strategies (Imam and Jarus, 2014; Weiss et al, 2014; Flores et al, 2018). In such VR-based rehabilitation, patients are immersed in interactive scenarios mimicking real-world environments, and this immersion may offer a more straightforward transfer from the rehabilitation to activities of daily living (Rose et al, 2000; Schultheis and Rizzo, 2001). VR has been used for rehabilitation following stroke (Souza Barbosa de et al, 2011; Imam and Jarus, 2014), cerebral palsy (Ravi et al, 2017), and several neurodegenerative disorders (Dockx et al, 2016; Doniger et al, 2018; Maggio et al, 2019), including PD
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