virtual reality for gait training in parkinson´s disease: a feasibility study

creepytreatmentAI and Robotics

Nov 14, 2013 (3 years and 8 months ago)

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VIRTUAL REALITY FOR GAIT TRAINING IN PARKINSON´S
DISEASE: A FEASIBILITY STUDY


Mirelman, A.
1,2
, Maidan, I.
1
, Jacobs, A.
1
, Mirelman, D.
1
, Giladi,
N.
3,4
, Hausdorff, J.
1,2,5

1
Gait and Neurodynamics Laboratory, Movement Disorders
Unit, Dept of Neurology, Tel
Aviv Sourasky Medical Center, Tel
Aviv, Israel,

2
Harvard School of Medicine, Boston, MA, USA,

3
Department of Neurology, Tel Aviv Sourasky Medical Center,

4
Dept of Neurology, Sackler Faculty of Medicine,

5
Dept of Physical Therapy, Sackler Faculty of Medic
ine, Tel Aviv
University, Tel Aviv, Israel


Background:
Gait disturbances are common in patients with
Parkinson's disease (PD). Traditional

gait training approaches
are limited in motivating and challenging the patients. Virtual
reality (VR)

delivers an ex
citing and enjoyable training that also
allows for real
-
time modification of task difficulty

based on motor
improvement. Yet, there are no reported gait training studies
with VR in PD. In this

study, we evaluated the feasibility of using
VR to improve walk
ing while negotiating obstacles in PD.

Methods:
Ten patients with PD received 18 training sessions
consisting of walking on a treadmill with

virtual obstacles. The
virtual scene was projected on a wall or via 3
-
D glasses.
Outcome measures

included gait par
ameters, missteps,
balance and attention as well as subjective measures of affect

and quality of life.

Results:
Age was 68.4±6.05 yrs, disease duration 10.6±4 yrs
(Hoehn&Yahr 2
-
3). All patients

completed the training with no
adverse responses, reported enj
oyment and were highly
motivated.

Training duration increased by 54% (from 19 min to
43 min) and walking speed during training

increased by 39%
(0.7m/s to 1.15m/s). The number of obstacles successfully
avoided significantly

improved and patients experience
d less
missteps (near
-
falls) during the study.

Conclusions:
To our knowledge, this is the first time that VR
has been used for gait training in PD.

Interim analysis of this
feasibility study supports the utility of VR for training gait and
obstacle

negotia
tion in PD. Further analysis is underway to
assess quality of gait, transfer to over
-
ground

performance, and
the mediating role of cognitive function.