Virtual Reality as a Tool for Evaluation of Repetitive Rhythmic Movements in the Elderly and Parkinson's Disease Patients

Abstract

This work presents an immersive Virtual Reality (VR) system to evaluate, and potentially treat, the alterations in rhythmic hand movements seen in Parkinson's disease (PD) and the elderly (EC), by comparison with healthy young controls (YC). The system integrates the subjects into a VR environment by means of a Head Mounted Display, such that subjects perceive themselves in a virtual world consisting of a table within a room. In this experiment, subjects are presented in 1st person perspective, so that the avatar reproduces finger tapping movements performed by the subjects. The task, known as the finger tapping test (FT), was performed by all three subject groups, PD, EC and YC. FT was carried out by each subject on two different days (sessions), one week apart. In each FT session all subjects performed FT in the real world (FTREAL) and in the VR (FTVR); each mode was repeated three times in randomized order. During FT both the tapping frequency and the coefficient of variation of inter-tap interval were registered. FTVR was a valid test to detect differences in rhythm formation between the three groups. Intra-class correlation coefficients (ICC) and mean difference between days for FTVR (for each group) showed reliable results. Finally, the analysis of ICC and mean difference between FTVR vs FTREAL, for each variable and group, also showed high reliability. This shows that FT evaluation in VR environments is valid as real world alternative, as VR evaluation did not distort movement execution and detects alteration in rhythm formation. These results support the use of VR as a promising tool to study alterations and the control of movement in different subject groups in unusual environments, such as during fMRI or other imaging studies.

Analysis of autonomic modulation of heart rate in patients with Parkinson's disease and elderly individuals submitted to game therapy training

“…This was also demonstrated in a previous study that compared HRV results in the supine position in 10 young individuals and seven middle‐aged individuals before and after three months of aerobic training. Both the young and older individuals achieved significant improvements in HRV indexes in the time and frequency domains …”

“…Few previous studies have used GT as a rehabilitation tool in PD, yet there are no studies that demonstrate the effects on autonomic modulation of HR or compare protocols in healthy individuals and patients with PD. Therefore, the objective of the present study was to evaluate the influence of rehabilitation with GT on autonomic modulation of HR in patients with PD compared with healthy individuals, from HRV analysis.…”

Realidade virtual na reabilitação física de pacientes com doença de Parkinson

“…This required more visual-motor processing and execution of movement compared to reaching of static balls 26 . Perhaps the divergence found in these two studies mentioned above lies in the fact that different clinical measuring tools were used as well as different training protocols adopted in the studies.…”

Parkinson Patients’ Initial Trust in Avatars: Theory and Evidence

“…However, to the best of our knowledge, neither does a peer-reviewed scientific journal article focus on neurological patients’ interaction with avatars, nor does peer-reviewed research at the nexus of avatars and PD exist. This finding is surprising, because avatars are used in (i) computer systems that are specifically designed to evaluate PD patients [33], (ii) assistive technologies [34], and (iii) neurorehabilitation systems for PD patients [35]. …”