Examining virtual reality's influence on kinetic variables for obstacle crossing in Parkinson's disease

Abstract

Background: Individuals with Parkinson's disease (PD) commonly experience postural instability during walking and obstacle crossing. Previous research has explored virtual reality (VR) as a rehabilitation tool that affects gait.

Research question: How does a virtual reality environment influence the kinetic characteristics of gait during obstacle crossing in individuals with Parkinson's disease compared to real-world conditions?

Methods: The study included 15 individuals with PD and 17 matched healthy control participants. The moment and power of lower extremity joints during walking and obstacle crossing conditions in real and VR environments were measured using three-dimensional motion analysis and force platforms.

Results: The results indicate that individuals with PD demonstrated higher hip extensor moments during normal gait (NG) and obstacle crossing (OBS) tasks, accompanied by lower hip flexor moments compared to the control group. Moreover, PD individuals exhibited increased internal rotation hip joint moments during VR obstacle crossing (VR-OBS) tasks compared to NG.

Conclusion: Walking in a VR environment altered the kinetic status in both groups, potentially due to cautious walking to maintain stability. The greatest difference between the two groups was observed in the magnitude of joint moment in the sagittal plane, likely influenced by differences in walking speed. These findings underscore the unique joint moment patterns exhibited by PD patients during various tasks. Walking in a VR environment impacts the kinetic parameters of gait, which may have implications for designing rehabilitation programs aimed at improving gait stability in PD individuals. Clinically, these kinetic alterations highlight VR's potential as a safe modality for gait rehabilitation and fall prevention in PD.

Keywords: Gait; Obstacle crossing; Parkinson's disease; Virtual reality.