Abstract
BackgroundVirtual reality (VR) has recently been explored as a tool for neurorehabilitation to enable individuals with Parkinson’s disease (PD) to practice challenging skills in a safe environment. Current technological advances have enabled the use of affordable, fully immersive head-mounted displays (HMDs) for potential therapeutic applications. However, while previous studies have used HMDs in individuals with PD, these were only used for short bouts of walking. Clinical applications of VR for gait training would likely involve an extended exposure to the virtual environment, which has the potential to cause individuals with PD to experience simulator-related adverse effects due to their age or pathology. Thus, our objective was to evaluate the safety of using an HMD for longer bouts of walking in fully immersive VR for older adults and individuals with PD.MethodsThirty-three participants (11 healthy young, 11 healthy older adults, and 11 individuals with PD) were recruited for this study. Participants walked for 20 min while viewing a virtual city scene through an HMD (Oculus Rift DK2). Safety was evaluated using the mini-BESTest, measures of center of pressure (CoP) excursion, and questionnaires addressing symptoms of simulator sickness (SSQ) and measures of stress and arousal.ResultsMost participants successfully completed all trials without any discomfort. There were no significant changes for any of our groups in symptoms of simulator sickness or measures of static and dynamic balance after exposure to the virtual environment. Surprisingly, measures of stress decreased in all groups while the PD group also increased the level of arousal after exposure.ConclusionsOlder adults and individuals with PD were able to successfully use immersive VR during walking without adverse effects. This provides systematic evidence supporting the safety of immersive VR for gait training in these populations.
Highlights
Virtual reality (VR) has recently been explored as a tool for neurorehabilitation to enable individuals with Parkinson’s disease (PD) to practice challenging skills in a safe environment
Our results provide needed baseline data to support the potential use of immersive VR using commercial head-mounted display (HMD) as a gait training tool for individuals with PD
Post hoc analysis revealed that the PD group presented higher Sickness Questionnaire (SSQ) scores overall compared to Healthy young (HY) (p < 0.01) and Healthy older (HO) groups (p < 0.01)
Summary
Virtual reality (VR) has recently been explored as a tool for neurorehabilitation to enable individuals with Parkinson’s disease (PD) to practice challenging skills in a safe environment. Clinical applications of VR for gait training would likely involve an extended exposure to the virtual environment, which has the potential to cause individuals with PD to experience simulator-related adverse effects due to their age or pathology. Our objective was to evaluate the safety of using an HMD for longer bouts of walking in fully immersive VR for older adults and individuals with PD. Parkinson’s disease (PD) is a progressive neurodegenerative disorder resulting from a loss of dopaminergic cells in the substantia nigra, and affects over 1 million individuals over age 65 in the United States and over 7 million worldwide [1, 2]. Taskspecific training is often used in the clinic, it may not be possible to configure the clinical setting to recreate the
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