Efficacy of C-Mill gait training for improving walking adaptability in early and middle stages of Parkinson’s disease

Wang, Yongshi; Gao, Lei; Yan, None Hongjiao; Jin, Zhaohui; Fang, Jinping; Lin, Qi; Zhen, Qiao-Xia; Liu, Cui; Wang, Ping; Liu, Yonghong; Wang, Ruidan; Liu, Yanjun; Su, Yuan; Liu, Aixian; Fang, Boyan

doi:10.1016/j.gaitpost.2021.10.010

Cited by 11 publications

(16 citation statements)

References 35 publications

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“…When the literature is reviewed, it is seen that the number of studies evaluating the effects of AR and/or VR gait training on balance in PD using posturography is insufficient [ 9 ]. For this reason, our study stands out as a study that evaluates the effect of AR and VR gait training on postural stability in Parkinson's patients using posturography.…”

Section: Discussionmentioning

confidence: 99%

“…The level of statistical significance was set at p < 0.05. The sample size calculation was based on the significant improvement of the BBS after similar intervention study in PD [ 9 ]. To achieve %80 power with a two-sided level of 5%, the sample size required per group was 14 using G*Power software (version 3.1.9.7; Heinrich Heine Universitat, Dusseldorf, Germany).…”

Section: Methodsmentioning

confidence: 99%

“…When the literature is examined, it is seen that VR practices generally focus on standing balance training, while the use of VR during gait training is a newer technology, and studies are limited in PD [ 6 – 9 ]. In these studies, it was shown that the spatio-temporal features of walking [ 6 , 8 ] and functional mobility [ 7 , 9 ] improved with VR training. In only one of these studies, in which different VR walking platforms were used, it was seen that VR and AR were used together in gait training [ 9 ].…”

Section: Introductıonmentioning

confidence: 99%

“…In these studies, it was shown that the spatio-temporal features of walking [ 6 , 8 ] and functional mobility [ 7 , 9 ] improved with VR training. In only one of these studies, in which different VR walking platforms were used, it was seen that VR and AR were used together in gait training [ 9 ].…”

Section: Introductıonmentioning

confidence: 99%

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The effects of augmented and virtual reality gait training on balance and gait in patients with Parkinson’s disease

et al. 2022

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Objective Augmented reality (AR) and virtual reality (VR) facilitate motor learning by enabling the practice of task-specific activities in a rich environment. Therefore, AR and VR gait training may improve balance and gait in Parkinson’s Disease (PD). Methods Thirty patients with PD were randomly divided into study ( n = 15) and control ( n = 15) groups. The study group was given AR and VR gait training combined with conventional training. The control group was given conventional training only. The training was applied to both groups 3 days a week for 6 weeks. Motor symptoms with the Unified Parkinson Disease Rating Scale-Motor Examination (UPDRS-III), balance with posturography and Berg Balance Scale (BBS), perceived balance confidence with Activity-Specific Balance Confidence Scale (ABC), gait with spatio-temporal gait analysis, and functional mobility with Timed Up and Go Test (TUG) were assessed. Results At the end of the study; UPDRS-III, posturography measurements, BBS, ABC, spatio-temporal gait parameters, and TUG improved in the study group ( p < 0.05), while BBS, ABC, and only spatial gait parameters (except for step width) improved in the control group ( p < 0.05). There was no change in posturography measurement, temporal gait parameters, and TUG in control group ( p > 0.05). When the developed parameters in both groups were compared, the amount of improvement in BBS and ABC was found similar ( p > 0.05), while the improvement in the other parameters was found higher in the study group ( p < 0.05). Conclusion It was concluded that AR and VR gait training provides the opportunity to practice walking with different tasks in increasingly difficult environments, thus improving balance and walking by facilitating motor learning.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductıonmentioning

confidence: 99%

Section: Introductıonmentioning

confidence: 99%

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The effects of augmented and virtual reality gait training on balance and gait in patients with Parkinson’s disease

et al. 2022

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“…The use of augmented reality as an adjuvant to traditional physical therapy has been shown to enhance both trunk balance (Maciaszek et al, 2014 ; Cho et al, 2015 ) and walking performance (Yang et al, 2008 ; Mirelman et al, 2009 ; Stanton et al, 2011 ; Pedreira da Fonseca et al, 2017 ) in persons with cortical stroke. Further, the use of virtual-based feedback during treadmill walking facilitates walking in older adults (Franz et al, 2014 ), persons with spinal cord injury (Yen et al, 2014 ), and Parkinson’s disease (Jellish et al, 2015 ; Wang et al, 2022 ). These results emphasized the benefits of MR technology to enhance recovery of functional walking.…”

Section: Discussionmentioning

confidence: 99%

A Wearable Mixed Reality Platform to Augment Overground Walking: A Feasibility Study

Evans

Dass

Muter

et al. 2022

Front. Hum. Neurosci.

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Humans routinely modify their walking speed to adapt to functional goals and physical demands. However, damage to the central nervous system (CNS) often results in abnormal modulation of walking speed and increased risk of falls. There is considerable interest in treatment modalities that can provide safe and salient training opportunities, feedback about walking performance, and that may augment less reliable sensory feedback within the CNS after injury or disease. Fully immersive virtual reality technologies show benefits in boosting training-related gains in walking performance; however, they lack views of the real world that may limit functional carryover. Augmented reality and mixed reality head-mount displays (MR-HMD) provide partially immersive environments to extend the virtual reality benefits of interacting with virtual objects but within an unobstructed view of the real world. Despite this potential advantage, the feasibility of using MR-HMD visual feedback to promote goal-directed changes in overground walking speed remains unclear. Thus, we developed and evaluated a novel mixed reality application using the Microsoft HoloLens MR-HMD that provided real-time walking speed targets and augmented visual feedback during overground walking. We tested the application in a group of adults not living with disability and examined if they could use the targets and visual feedback to walk at 85%, 100%, and 115% of each individual’s self-selected speed. We examined whether individuals were able to meet each target gait speed and explored differences in accuracy across repeated trials and at the different speeds. Additionally, given the importance of task-specificity to therapeutic interventions, we examined if walking speed adjustment strategies were consistent with those observed during usual overground walking, and if walking with the MR-HMD resulted in increased variability in gait parameters. Overall, participants matched their overground walking speed to the target speed of the MR-HMD visual feedback conditions (all p-values > 0.05). The percent inaccuracy was approximately 5% across all speed matching conditions and remained consistent across walking trials after the first overall walking trial. Walking with the MR-HMD did not result in more variability in walking speed, however, we observed more variability in stride length and time when walking with feedback from the MR-HMD compared to walking without feedback. The findings offer support for mixed reality-based visual feedback as a method to provoke goal-specific changes in overground walking behavior. Further studies are necessary to determine the clinical safety and efficacy of this MR-HMD technology to provide extrinsic sensory feedback in combination with traditional treatments in rehabilitation.

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Total knee arthroplasty improves gait adaptability in osteoarthritis patients; a pilot study

Booij

Royen

Nolte

et al. 2022

Journal of Orthopaedics

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Efficacy of C-Mill gait training for improving walking adaptability in early and middle stages of Parkinson’s disease

Cited by 11 publications

References 35 publications

The effects of augmented and virtual reality gait training on balance and gait in patients with Parkinson’s disease

The effects of augmented and virtual reality gait training on balance and gait in patients with Parkinson’s disease

A Wearable Mixed Reality Platform to Augment Overground Walking: A Feasibility Study

Total knee arthroplasty improves gait adaptability in osteoarthritis patients; a pilot study

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