The Effects of Augmented Reality Visual Cues on Turning in Place in Parkinson's Disease Patients With Freezing of Gait
Background: Turning in place is particularly bothersome for patients with Parkinson's disease (PD) experiencing freezing of gait (FOG). Cues designed to enforce goal-directed turning are not yet available.Objectives: Assess whether augmented reality (AR) visual cues improve FOG and turning in p...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00185/full |
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| author | Sabine Janssen Sabine Janssen Jaap de Ruyter van Steveninck Hizirwan S. Salim Helena M. Cockx Bastiaan R. Bloem Tjitske Heida Richard J. A. van Wezel Richard J. A. van Wezel |
| author_facet | Sabine Janssen Sabine Janssen Jaap de Ruyter van Steveninck Hizirwan S. Salim Helena M. Cockx Bastiaan R. Bloem Tjitske Heida Richard J. A. van Wezel Richard J. A. van Wezel |
| author_sort | Sabine Janssen |
| collection | DOAJ |
| description | Background: Turning in place is particularly bothersome for patients with Parkinson's disease (PD) experiencing freezing of gait (FOG). Cues designed to enforce goal-directed turning are not yet available.Objectives: Assess whether augmented reality (AR) visual cues improve FOG and turning in place in PD patients with FOG.Methods: Sixteen PD patients with FOG performed a series of 180° turns under an experimental condition with AR visual cues displayed through a HoloLens and two control conditions (one consisting of auditory cues and one without any cues). FOG episodes were annotated by two independent raters from video recordings. Motion data were measured with 17 inertial measurement units for calculating axial kinematics, scaling, and timing of turning.Results: AR visual cues did not reduce the percent time frozen (p = 0.73) or the number (p = 0.73) and duration (p = 0.78) of FOG episodes compared to the control condition without cues. All FOG parameters were higher with AR visual cues than with auditory cues [percent time frozen (p = 0.01), number (p = 0.02), and duration (p = 0.007) of FOG episodes]. The AR visual cues did reduce the peak angular velocity (visual vs. uncued p = 0.03; visual vs. auditory p = 0.02) and step height (visual vs. uncued p = 0.02; visual vs. auditory p = 0.007), and increased the step height coefficient of variation (visual vs. uncued p = 0.04; visual vs. auditory p = 0.01) and time to maximum head–pelvis separation (visual vs. uncued p = 0.02; visual vs. auditory p = 0.005), compared to both control conditions.Conclusions: The AR visual cues in this study did not reduce FOG, and worsened some measures of axial kinematics, and turn scaling and timing. Stimulating goal-directed turning might, by itself, be insufficient to reduce FOG and improve turning performance.Trial Registration: This study was registered in the Dutch trial registry (NTR6409; 2017-02-16). |
| first_indexed | 2024-12-11T04:38:14Z |
| format | Article |
| id | doaj.art-d4fca4e263824bd2801056fc185fa1f8 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-11T04:38:14Z |
| publishDate | 2020-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-d4fca4e263824bd2801056fc185fa1f82022-12-22T01:20:41ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-03-011110.3389/fneur.2020.00185514952The Effects of Augmented Reality Visual Cues on Turning in Place in Parkinson's Disease Patients With Freezing of GaitSabine Janssen0Sabine Janssen1Jaap de Ruyter van Steveninck2Hizirwan S. Salim3Helena M. Cockx4Bastiaan R. Bloem5Tjitske Heida6Richard J. A. van Wezel7Richard J. A. van Wezel8Biomedical Signals and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, NetherlandsRadboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, NetherlandsDepartment of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, NetherlandsBiomedical Signals and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, NetherlandsDepartment of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, NetherlandsRadboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, NetherlandsBiomedical Signals and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, NetherlandsBiomedical Signals and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, NetherlandsDepartment of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, NetherlandsBackground: Turning in place is particularly bothersome for patients with Parkinson's disease (PD) experiencing freezing of gait (FOG). Cues designed to enforce goal-directed turning are not yet available.Objectives: Assess whether augmented reality (AR) visual cues improve FOG and turning in place in PD patients with FOG.Methods: Sixteen PD patients with FOG performed a series of 180° turns under an experimental condition with AR visual cues displayed through a HoloLens and two control conditions (one consisting of auditory cues and one without any cues). FOG episodes were annotated by two independent raters from video recordings. Motion data were measured with 17 inertial measurement units for calculating axial kinematics, scaling, and timing of turning.Results: AR visual cues did not reduce the percent time frozen (p = 0.73) or the number (p = 0.73) and duration (p = 0.78) of FOG episodes compared to the control condition without cues. All FOG parameters were higher with AR visual cues than with auditory cues [percent time frozen (p = 0.01), number (p = 0.02), and duration (p = 0.007) of FOG episodes]. The AR visual cues did reduce the peak angular velocity (visual vs. uncued p = 0.03; visual vs. auditory p = 0.02) and step height (visual vs. uncued p = 0.02; visual vs. auditory p = 0.007), and increased the step height coefficient of variation (visual vs. uncued p = 0.04; visual vs. auditory p = 0.01) and time to maximum head–pelvis separation (visual vs. uncued p = 0.02; visual vs. auditory p = 0.005), compared to both control conditions.Conclusions: The AR visual cues in this study did not reduce FOG, and worsened some measures of axial kinematics, and turn scaling and timing. Stimulating goal-directed turning might, by itself, be insufficient to reduce FOG and improve turning performance.Trial Registration: This study was registered in the Dutch trial registry (NTR6409; 2017-02-16).https://www.frontiersin.org/article/10.3389/fneur.2020.00185/fullParkinson Diseasecuesaugmented realityfreezing of gaittreatmentrehabilitation |
| spellingShingle | Sabine Janssen Sabine Janssen Jaap de Ruyter van Steveninck Hizirwan S. Salim Helena M. Cockx Bastiaan R. Bloem Tjitske Heida Richard J. A. van Wezel Richard J. A. van Wezel The Effects of Augmented Reality Visual Cues on Turning in Place in Parkinson's Disease Patients With Freezing of Gait Frontiers in Neurology Parkinson Disease cues augmented reality freezing of gait treatment rehabilitation |
| title | The Effects of Augmented Reality Visual Cues on Turning in Place in Parkinson's Disease Patients With Freezing of Gait |
| title_full | The Effects of Augmented Reality Visual Cues on Turning in Place in Parkinson's Disease Patients With Freezing of Gait |
| title_fullStr | The Effects of Augmented Reality Visual Cues on Turning in Place in Parkinson's Disease Patients With Freezing of Gait |
| title_full_unstemmed | The Effects of Augmented Reality Visual Cues on Turning in Place in Parkinson's Disease Patients With Freezing of Gait |
| title_short | The Effects of Augmented Reality Visual Cues on Turning in Place in Parkinson's Disease Patients With Freezing of Gait |
| title_sort | effects of augmented reality visual cues on turning in place in parkinson s disease patients with freezing of gait |
| topic | Parkinson Disease cues augmented reality freezing of gait treatment rehabilitation |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00185/full |
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