Abstract
Trunk control and postural instability remain critical markers of functional status in Parkinson’s Disease (PD). As pharmacological and invasive neuro-stimulation interventions provide only limited benefits for trunk and postural control, exercise-based interventions may provide the only effective path to improving functional outcomes for balance in PD. We describe the framework for a virtual reality (VR) graded exercise-based intervention focused on improving trunk mobility and control, including preliminary outcomes on perceptions and motion capabilities of individuals with PD. The study collected whole-body motion capture from 11 PD participants (8M, 3F; H&Y Stage I–III) as they performed tasks within a custom-designed set of VR therapies. Therapies involved static interactions (e.g., matching a cube sequence set to anthropometrically relevant locations to elicit specific trunk motions—Matchality), and more dynamic tasks (e.g., intercepting virtual fish jumping from a lake—Fishality, or a virtual session of dodgeball—Dodgeality). Participants were able to safely complete all tasks while performing trunk excursions requiring functionally relevant ranges of motion, and which altered across VR environment (F(1,10) = 8.319, p = 0.016). Overall, satisfaction with the MoVR therapy suite was high with 96% of responses showing agreement to questions relating to ‘immersion,’ ‘fun,’ and elements of player engagement. These results provide early safety, usability, and feasibility outcomes for VR interventions that require specific trunk excursions. Future work should confirm the effectiveness of VR interventions longitudinally on PD-specific trunk outcomes (e.g., trunk rigidity) and global balance/mobility measures associated with improved functional status.
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Abbreviations
- ABC:
-
Activities of Balance Confidence Scale
- FES:
-
Falls Efficacy Scale
- IK:
-
Inverse Kinematics
- IP:
-
Intersection Plane
- miniBEST:
-
Mini (short form) Balance Evaluation Systems Test
- MDS-UPDRS:
-
Movement Disorders Society Unified Parkinson’s Disease Rating Scale
- MoCA:
-
Montreal Cognitive Assessment
- NASA-TLX:
-
NASA Task Load Index
- PD:
-
Parkinson’s Disease
- SUS:
-
System Usability Scale
- VR:
-
Virtual Reality
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Acknowledgements
The authors would like to thank Anne Johnson and Kamali Charles for their generous assistance during data collection.
Funding
AS was supported by NIH R01HD088417 and VCU Parkinson’s and Movement Disorders Center Pilot Grant. JST and CRF were supported by NIH R01AT006978, R01HD088417. MU and SV were supported by NIH R01HD088417. National Center for Research Resources (Grant No. UL1TR002649)
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JST and AS conceived the study. JST and AS designed the study. MU led game development and VR implementation. AS, MU and SV collected the data. AS performed the analysis. AS produced the first draft of the manuscript. AS, LJC, PP, MB, RH, CRF, SV and JST contributed to the interpretation of data, critical review of the manuscript and approval of the final version of this manuscript.
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Stamenkovic, A., Underation, M., Cloud, L.J. et al. Assessing perceptions to a virtual reality intervention to improve trunk control in Parkinson’s disease: a preliminary study. Virtual Reality 27, 465–479 (2023). https://doi.org/10.1007/s10055-022-00657-z
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DOI: https://doi.org/10.1007/s10055-022-00657-z