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

Abstract

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.

Treadmill Training Plus Semi-Immersive Virtual Reality in Parkinson’s Disease: Results from a Pilot Study

“…Moreover, our results showed some improvements also in risk and fear of falling (FES-I). As confirmed by other studies [13][14][15]42], treadmill training with VR can be considered a valid approach to reducing the risk of falls in PD patients. In fact, the high incidence of falls in these patients is primarily induced by cholinergic hypofunction that increases the risk of falls [43].…”

“…They suggested that this approach could be a valid way to reduce the risk of falling, also in patients with freezing of gait. According to Gulcan et al [ 15 ], treadmill training plus augmented VR decreased the severity of motor symptoms, improving confidence in balance perception and gait, after 6 weeks of training. However, there is still not enough evidence about the use of treadmills with VR in improving gait and balance functions.…”

Comparing the effects of augmented virtual reality treadmill training versus conventional treadmill training in patients with stage II-III Parkinson’s disease: the VIRTREAD-PD randomized controlled trial protocol

“…For these reasons, AVR is considered an emerging and promising therapeutic tool in neurorehabilitation ( 15 ). In this regard, positive results emerged from the clinical trial of Gulcan et al ( 16 ) in which AVR-VR TT has been demonstrated to be effective in PD on most of spatial–temporal gait parameters compared to conventional physical therapy.…”

Effectiveness of Virtual Reality Rehabilitation versus Conventional Physical Therapy on Quality-of-Life function and Balance in Parkinson's Disease Patients: A Randomized Controlled Trial

“…Physical rehabilitation aims to restore physical health, maintain functional independence, and enhance QoL (7,8). In this regard, physiotherapy emerges as a critical adjunct to pharmacotherapy in PD management, offering potential to improve and maintain motor control and possibly delay the progression of motor impairments (9,10). The advent of virtual reality (VR) in rehabilitation introduces a novel approach.…”