Kim Aram, Darakjian Nora, Finley James M
Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E. Alcazar St, CHP 155, Los Angeles, CA, 90033, USA.
J Neuroeng Rehabil. 2017 Feb 21;14(1):16. doi: 10.1186/s12984-017-0225-2.
Virtual reality (VR) has recently been explored as a tool for neurorehabilitation to enable individuals with Parkinson's disease (PD) to practice challenging skills in a safe environment. Current technological advances have enabled the use of affordable, fully immersive head-mounted displays (HMDs) for potential therapeutic applications. However, while previous studies have used HMDs in individuals with PD, these were only used for short bouts of walking. Clinical applications of VR for gait training would likely involve an extended exposure to the virtual environment, which has the potential to cause individuals with PD to experience simulator-related adverse effects due to their age or pathology. Thus, our objective was to evaluate the safety of using an HMD for longer bouts of walking in fully immersive VR for older adults and individuals with PD.
Thirty-three participants (11 healthy young, 11 healthy older adults, and 11 individuals with PD) were recruited for this study. Participants walked for 20 min while viewing a virtual city scene through an HMD (Oculus Rift DK2). Safety was evaluated using the mini-BESTest, measures of center of pressure (CoP) excursion, and questionnaires addressing symptoms of simulator sickness (SSQ) and measures of stress and arousal.
Most participants successfully completed all trials without any discomfort. There were no significant changes for any of our groups in symptoms of simulator sickness or measures of static and dynamic balance after exposure to the virtual environment. Surprisingly, measures of stress decreased in all groups while the PD group also increased the level of arousal after exposure.
Older adults and individuals with PD were able to successfully use immersive VR during walking without adverse effects. This provides systematic evidence supporting the safety of immersive VR for gait training in these populations.
虚拟现实（VR）最近已被探索作为一种神经康复工具，使帕金森病（PD）患者能够在安全的环境中练习具有挑战性的技能。当前的技术进步使得使用价格合理、完全沉浸式的头戴式显示器（HMD）用于潜在的治疗应用成为可能。然而，虽然先前的研究已在PD患者中使用HMD，但这些仅用于短时间的行走。VR用于步态训练的临床应用可能需要在虚拟环境中长时间暴露，这有可能使PD患者因其年龄或病理状况而经历与模拟器相关的不良反应。因此，我们的目的是评估在完全沉浸式VR中让老年人和PD患者长时间行走时使用HMD的安全性。
本研究招募了33名参与者（11名健康年轻人、11名健康老年人和11名PD患者）。参与者通过HMD（Oculus Rift DK2）观看虚拟城市场景时行走20分钟。使用迷你BESTest、压力中心（CoP）偏移测量以及针对模拟器不适症状（SSQ）的问卷和压力与唤醒测量来评估安全性。
大多数参与者成功完成了所有试验，没有任何不适。在接触虚拟环境后，我们所有组的模拟器不适症状或静态和动态平衡测量均无显著变化。令人惊讶的是，所有组的压力测量值均下降，而PD组在接触后唤醒水平也有所提高。
老年人和PD患者能够在行走过程中成功使用沉浸式VR，且无不良反应。这提供了系统的证据，支持在这些人群中使用沉浸式VR进行步态训练的安全性。
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