Physical and functional effects after an Immersive Virtual Reality based exercise program: experience in a Spanish Association of Parkinson's patients

Abstract

Introduction: Physical exercise is an emerging approach in Parkinson's disease (PD) and new technologies such as immersive virtual reality (IVR) could contribute towards the development of specific programs targeting prevalent symptoms. Objective: To explore the feasibility of an IVR-based exercise program and its effect on physical and functional abilities and quality of life in a population with PD. Methodology: A sample of 20 volunteers from an association of patients diagnosed with early-stage PD (H&Y I-II) were divided into experimental ([EG] n=14; 68.50 ± 7.70 years) and control ([CG] (n=6; 65.00 ± 12.81 years) groups. Both groups continued with their usual therapeutic programs designed by the association for eight weeks, whilst the EG also completed and IVR-based intervention (two sessions/week). Results: The program was feasible (91% attendance, 98% usability, zero dropouts or adverse events). Significant pre-post intragroup improvements were observed in the EG regarding Tinetti scores for balance (p = 0.004), gait (p = 0.013) and overall (p = 0.002), and Timed Up and Go (TUG)-dual motor-cognitive task time (p = 0.000), which evaluates functionality and coordination between two tasks with independent and unrelated purposes. Some improvements were found in strength, certain aspects of quality of life and exergaming although these were not statistically significant. Conclusions: The proposed IVR-based exercise program is safe and appears to provide a feasible and valid approach to the maintenance and/or improvement of physical abilities such as balance and gait, in addition to functionality and coordination in patients with early-stage PD.

Keywords

• Parkinson's disease
• Exercise
• Virtual reality
• Physiotherapy
• Exergames
• Virtual reality exposure therapy