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Journal of NeuroEngineering and Rehabilitation

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Open Access 01-12-2019 | Tremor | Research

Advantages of using 3D virtual reality based training in persons with Parkinson’s disease: a parallel study

Authors: Imre Cikajlo, Karmen Peterlin Potisk

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2019

Abstract

Background

Parkinson’s disease (PD) is a slowly progressive neurodegenerative disease. There are mixed reports on success of physiotherapy in patients with PD. Our objective was to investigate the functional improvements, motivation aspects and clinical effectiveness when using immersive 3D virtual reality versus non-immersive 2D exergaming.

Methods

We designed a randomized parallel study with 97 patients, but only 20 eligible participants were randomized in 2 groups; the one using 3D Oculus Rift CV1 and the other using a laptop. Both groups participated in the 10-session 3 weeks training with a pick and place task in the virtual world requiring precise hand movement to manipulate the virtual cubes. The kinematics of the hand was traced with Leap motion controller, motivation effect was assessed with modified Intrinsic Motivation Inventory and clinical effectiveness was evaluated with Box & Blocks Test (BBT) and shortened Unified Parkinson’s disease rating scale (UPDRS) before and after the training. Mack-Skilling non-parametrical statistical test was used to identify statistically significant differences (p < 0.05) and Cohen’s U3 test to find the effect sizes.

Results

Participants in the 3D group demonstrated statistically significant and substantially better performance in average time of manipulation (group x time, p = 0.009), number of successfully placed cubes (group x time, p = 0.028), average tremor (group x time, p = 0.002) and UPDRS for upper limb (U3 = 0.35). The LCD and 3D groups substantially improved their BBT score with training (U3 = 0.7, U3 = 0.6, respectively). However, there were no statistically significant differences in clinical tests between the groups (group x time, p = 0.2189, p = 0.2850, respectively). In addition the LCD group significantly decreased the pressure/tension (U3 = 0.3), the 3D did not show changes (U3 = 0.5) and the differences between the groups were statistically different (p = 0.037). The 3D group demonstrated important increase in effort (U3 = 0.75) and perceived competences (U3 = 0.9).

Conclusions

The outcomes of the study demonstrated that the immersive 3D technology may bring increased interests/enjoyment score resulting in faster and more efficient functional performance. But the 2D technology demonstrated lower pressure/tension score providing similar clinical progress. A study with much larger sample size may also confirm the clinical effectiveness of the approaches.

Trial registration

The small scale randomized pilot study has been registered at ClinicalTrials.gov Identifier: NCT03515746, 4 May 2018

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Title: Advantages of using 3D virtual reality based training in persons with Parkinson’s disease: a parallel study
Authors: Imre Cikajlo
Karmen Peterlin Potisk
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Tremor
Parkinson's Disease
Published in: Journal of NeuroEngineering and Rehabilitation / Issue 1/2019
Electronic ISSN: 1743-0003
DOI: https://doi.org/10.1186/s12984-019-0601-1

At a glance: The STEP trials

Springer Medicine

Advantages of using 3D virtual reality based training in persons with Parkinson’s disease: a parallel study

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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