Gómez-Jordana Luis I, Stafford James, Peper C Lieke E, Craig Cathy M
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.
School of Psychology, Queens University Belfast, David Kier Building, 18-30 Malone Road, Belfast BT7 1NN, UK.
Parkinsons Dis. 2018 Aug 9;2018:2957427. doi: 10.1155/2018/2957427. eCollection 2018.
Studying freezing of gait (FOG) in the lab has proven problematic. This has primarily been due to the difficulty in designing experimental setups that maintain high levels of ecological validity whilst also permitting sufficient levels of experimental control. To help overcome these challenges, we have developed a virtual reality (VR) environment with virtual doorways, a situation known to illicit FOG in real life. To examine the validity of this VR environment, an experiment was conducted, and the results were compared to a previous "real-world" experiment. A group of healthy controls ( = 10) and a group of idiopathic Parkinson disease (PD) patients without any FOG episodes ( = 6) and with a history of freezing (PD-f, = 4) walked under three different virtual conditions (no door, narrow doorway (100% of shoulder width) and standard doorway (125% of shoulder width)). The results were similar to those obtained in the real-world setting. Virtual doorways reduced step length and velocity while increasing general gait variability. The PD-f group always walked slower, with a smaller step length, and showed the largest increases in gait variability. The narrow doorway induced FOG in 66% of the trials, while the standard doorway caused FOG in 29% of the trials. Our results closely mirrored those obtained with real doors. In short, this methodology provides a safe, personalized yet adequately controlled means to examine FOG in Parkinson's patients, along with possible interventions.
在实验室中研究步态冻结（FOG）已被证明存在问题。这主要是由于难以设计出既能保持高度生态效度又能允许足够实验控制水平的实验装置。为了帮助克服这些挑战，我们开发了一个带有虚拟门道的虚拟现实（VR）环境，这是一种在现实生活中已知会引发FOG的情境。为了检验这个VR环境的效度，我们进行了一项实验，并将结果与之前的“现实世界”实验进行了比较。一组健康对照者（n = 10）、一组没有任何步态冻结发作的特发性帕金森病（PD）患者（n = 6）以及一组有步态冻结病史的患者（PD-f，n = 4）在三种不同的虚拟条件下行走（无门道、窄门道（肩宽的100%）和标准门道（肩宽的125%））。结果与在现实世界环境中获得的结果相似。虚拟门道会减小步长和速度，同时增加总体步态变异性。PD-f组总是走得更慢，步长更小，并且步态变异性增加幅度最大。窄门道在66%的试验中引发了步态冻结，而标准门道在29%的试验中导致了步态冻结。我们的结果与使用真实门道获得的结果非常相似。简而言之，这种方法提供了一种安全、个性化且控制得当的手段来检查帕金森病患者的步态冻结情况以及可能的干预措施。
