Closed-Loop VR-Based Interaction to Improve Walking in Parkinson’s Disease

Chong, Raymond; Lee, Kyoung-Hyun; Morgan, John C.; Mehta, Shyamal H.; Griffin, Jake; Marchant, Jason; Searle, Nathan; Sims, Joey; Sethi, Kapil D.

doi:10.4172/2165-7025.1000101

Cited by 11 publications

(7 citation statements)

References 104 publications

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“…A study of visual feedback without prior instructions or prior training (36) has shown a decrease in the average time of first-step initiation (−6.2%), with smaller changes in subsequent average walking speed (−0.8%) and cadence (−1.8%). The improvement in step initiation by device use suggests a role for predictive salience and dopamine reward in movement (19).…”

Section: Medical Studiesmentioning

confidence: 99%

Virtual Sensory Feedback for Gait Improvement in Neurological Patients

Baram¹

2013

Front. Neurol.

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We review a treatment modality for movement disorders by sensory feedback. The natural closed-loop sensory-motor feedback system is imitated by a wearable virtual reality apparatus, employing body-mounted inertial sensors and responding dynamically to the patient’s own motion. Clinical trials have shown a significant gait improvement in patients with Parkinson’s disease using the apparatus. In contrast to open-loop devices, which impose constant-velocity visual cues in a “treadmill” fashion, or rhythmic auditory cues in a “metronome” fashion, requiring constant vigilance and attention strategies, and, in some cases, instigating freezing in Parkinson’s patients, the closed-loop device improved gait parameters and eliminated freezing in most patients, without side effects. Patients with multiple sclerosis, previous stroke, senile gait, and cerebral palsy using the device also improved their balance and gait substantially. Training with the device has produced a residual improvement, suggesting virtual sensory feedback for the treatment of neurological movement disorders.

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Section: Medical Studiesmentioning

confidence: 99%

Virtual Sensory Feedback for Gait Improvement in Neurological Patients

Baram¹

2013

Front. Neurol.

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“…In PD, the ability to change set is facilitated by external stimuli (Rafal, et al , 1984, Horak, et al , 1996; Burleigh-Jacobs, et al , 1997). For example, focusing on horizontal lines or contrasting features on the floor may improve gait initiation and/or overcome freezing of walking (Stern, Lander, & Lees, 1980; Chong, Lee, Morgan, Mehta, Griffin, Merchant, et al , 2011). Thus, testing the ability to change set in PD is best studied under conditions in which there is ambiguity or an absence of a distinct external stimulus or rule for guiding action.…”

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confidence: 99%

Postural adaptation to a slow sensorimotor set-changing task in Parkinson's disease¹

Chong¹,

Adams²,

Fenton³

et al. 2014

Comprehensive Psychology

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A general characteristic of Parkinson's disease (PD) is the inability to adapt and change set quickly. The goal of this study was to assess whether PD aff ects performance in which changing set occurs over minutes, i.e., a slow and continuous form of sensorimotor set-change. Recovery from the postural lean aftereff ect following prolonged stance on an inclined surface (Experiment 1) was tested to see if the addition of light-touch tactile feedback from the fi ngertips during inclined stance increased the aftereff ect (Experiment 2). The percentage of responders in healthy Young, Older, and PD groups was similar, as were characteristics of the recovery towards vertical stance, namely the initial forward lean, range, time constant, and half-life. Tactile feedback increased the responder rate in all groups. A novel response was also observed in which the aftereff ect did not dissipate; i.e., participants remained leaning forward throughout the post-incline stance period. PD does not appear to aff ect the ability to change sensorimotor set if the change is slow.

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“…Forty‐eight subjects diagnosed with idiopathic PD (5) participated in the questionnaire study which was approved by the institutional review board. Subjects were part of a study which evaluated the use of a semi‐virtual reality goggle to improve walking (6). Twenty‐seven of these subjects were in stages 1–2 of the Hoehn and Yahr (H&Y) disease scale (mean = 1.7 ± 0.4, 18 men, 9 women, 70 ± 8 years old, UPDRS section 3 total score = 16.7 ± 7.8).…”

Section: Methodsmentioning

confidence: 99%

Diagnostic value of the rapid assessment of postural instability in parkinson’s disease (RAPID) questionnaire

Chong

Lee

Morgan

et al. 2012

International Journal of Clinical Practice

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The high sensitivity of the RAPID questionnaire suggests that it may be used as an adjunct to the Pull test or solely if it is not convenient or contraindicated. The questionnaire may also be adapted for use via the telephone or internet. The limitation of the Pull test in revealing postural instability may explain the low specificity of the questionnaire, i.e. the questionnaire correctly identifies patients as unstable when the Pull test indicates normal postural control. It is hoped that the rapid identification of postural instability in PD may lead to increased awareness of the disease progression and fewer falls.

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Closed-Loop VR-Based Interaction to Improve Walking in Parkinson’s Disease

Cited by 11 publications

References 104 publications

Virtual Sensory Feedback for Gait Improvement in Neurological Patients

Virtual Sensory Feedback for Gait Improvement in Neurological Patients

Postural adaptation to a slow sensorimotor set-changing task in Parkinson's disease¹

Diagnostic value of the rapid assessment of postural instability in parkinson’s disease (RAPID) questionnaire

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Closed-Loop VR-Based Interaction to Improve Walking in Parkinson’s Disease

Cited by 11 publications

References 104 publications

Virtual Sensory Feedback for Gait Improvement in Neurological Patients

Virtual Sensory Feedback for Gait Improvement in Neurological Patients

Postural adaptation to a slow sensorimotor set-changing task in Parkinson's disease1

Diagnostic value of the rapid assessment of postural instability in parkinson’s disease (RAPID) questionnaire

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Postural adaptation to a slow sensorimotor set-changing task in Parkinson's disease¹