Virtual Reality Experience May Aid Parkinson Disease Diagnosis and Gait Evaluation

Researchers at Cleveland Clinic have developed a virtual reality (VR) experience with the intention of using the platform to identify early-stage Parkinson disease (PD) and better treat freezing of gait in individuals with PD. 

The VR platform (Infinadeck; Infinadeck, Rocklin, CA) combines an omnidirectional treadmill with state-of-the-art VR technology. Initial findings, published in the Journal of Visualized Experiments show that the platform is feasible and tolerable to use for people with PD. 

The omnidirectional treadmill reduces the nausea that often occurs as a side effect of VR technology. The omnidirectional treadmill has both a linear motion and rotary motion. Via algorithms on a computerized control system multiple belts on the treadmill keep the user centered on platform by constantly adjusting linear and rotary contributions. 

“You can think of it as a treadmill on a thousand treadmills,” says Jay Alberts, PhD, Cleveland Clinic Center for Neurological Restoration. “The design of the omnidirectional treadmill allows a subject with a VR headset to experience the same somatosensory information and sensations that that they experience during real-world walking, which allows them to physically explore the virtual world they are in without experiencing nausea or similar discomfort.”

Using the system, a Virtual Grocery Store Task can provide objective and quantitative biomechanical and cognitive outcomes related to the user's performance on activities of daily living (ADL). People being evaluated are able to walk down aisles as they would in a real store, doing everything from straight-line walking, to making turns, and changing directions as they reach for items on their shopping list.

“Good data show that a decline in instrumental ADLs may be a prodromal marker for PD and Alzheimer disease,” says Alberts. “If we could integrate virtual environment tasks using the omnidirectional treadmill into a clinical setting, we could likely identify these diseases before clinical onset of symptoms and be able to intervene earlier.” 

Ongoing studies for the platform will focus on evaluating gait freezing to fine-tune PD therapy and finding ways to safely increase rehabilitation therapy.