The Impact of a Novel Immersive Virtual Reality Technology Associated with Serious Games in Parkinson's Disease Patients on Upper Limb Rehabilitation: A Mixed Methods Intervention Study.

Patricia Sánchez-Herrera-Baeza,Roberto Cano-De-La-Cuerda,Juan Nicolas Cuenca-Zaldivar,Edwin Daniel Oña-Simbaña,Alicia Cuesta-Gomez,Alberto Jardón-Huete,Javier Gueita-Rodriguez,Domingo Palacios-Ceña,Carlos Balaguer-Bernaldo De Quirós,Jorge Pérez-Corrales

doi:10.3390/s20082168

Abstract

Background: Parkinson’s disease is a neurodegenerative disorder that causes impaired motor functions. Virtual reality technology may be recommended to optimize motor learning in a safe environment. The objective of this paper was to evaluate the effects of a novel immersive virtual reality technology used for serious games (Oculus Rift 2 plus leap motion controller—OR2-LMC) for upper limb outcomes (muscle strength, coordination, speed of movements, fine and gross dexterity). Another objective was to obtain qualitative data for participants’ experiences related to the intervention. Methods: A mixed methods intervention (embedded) study was used, with a qualitative design after a technology intervention (quantitative design). The intervention and qualitative design followed international guidelines and were integrated into the method and reporting subheadings. Results: Significant improvements were observed in strength (p = 0.028), fine (p = 0.026 to 0.028) and gross coordination dexterity, and speed movements (p = 0.039) in the affected side, with excellent compliance (100%) and a high level of satisfaction (3.66 ± 0.18 points out of the maximum of 4). No adverse side effects were observed. Qualitative findings described patients’ perspectives regarding OR2-LMC treatment, facilitators and barriers for adherence, OR2-LMC applications, and treatment improvements. Conclusions: The intervention showed positive results for the upper limbs, with elements of discordance, expansion, and confirmation between qualitative and quantitative results.

Highlights

Parkinson’s disease (PD) is a neurodegenerative disorder that predominately affects dopamine-producing neurons in the substantia nigra [1]
It remains unclear exactly how immersive virtual reality (VR) technology can be optimally used in PD patients with impaired upper limb (UL) dexterity
We report our results in the following order: (1) quantitative and intervention results, (2) qualitative results, and (3) mixed methods findings [53]

Summary

Introduction

Parkinson’s disease (PD) is a neurodegenerative disorder that predominately affects dopamine-producing neurons in the substantia nigra [1]. VR technology can engage patients in long-term exercise programs, providing a challenging and motivating training environment while replicating real-life scenarios that facilitate the transition to the functional activities of daily living [8,9]. It remains unclear exactly how immersive VR technology can be optimally used in PD patients with impaired upper limb (UL) dexterity. For upper limb outcomes (muscle strength, coordination, speed of movements, fine and gross dexterity) Another objective was to obtain qualitative data for participants’ experiences related to the intervention. The intervention and qualitative design followed international guidelines and were integrated into the method and reporting subheadings

Objectives

Methods

Results

Conclusion