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CLINICAL TRIAL article

Front. Neurol.
Sec. Movement Disorders
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1373740
This article is part of the Research Topic High-Tech Personalized Healthcare in Movement Disorders View all 9 articles

Remotely prescribed, monitored and tailored home-based gait-and-balance exergaming intervention using augmented-reality glasses: a clinical feasibility study in people with Parkinson's disease

Provisionally accepted
Lotte Hardeman Lotte Hardeman 1*Daphne Geerse Daphne Geerse 1Eva Hoogendoorn Eva Hoogendoorn 1Jorik Nonnekes Jorik Nonnekes 2,3Melvyn Roerdink Melvyn Roerdink 1
  • 1 Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, VU Amsterdam, Amsterdam, Netherlands
  • 2 Center of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
  • 3 Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, Netherlands

The final, formatted version of the article will be published soon.

    BACKGROUND: Exergaming has the potential to increase adherence to exercise through play, individually tailored training and (online) remote monitoring. Reality DTx ® is a digital therapeutic software platform for augmented-reality glasses (AR) that enables a home-based gait-and-balance exergaming intervention specifically designed for people with Parkinson's disease (pwPD). OBJECTIVE: The primary objective was to evaluate the feasibility and potential efficacy of Reality DTx ® AR-exergaming intervention for improving gait, balance and walkingadaptability fall-risk indicators. The secondary objective was to evaluate potential AR-glasses superiority (Magic Leap 2 [ML2] vs. HoloLens 2 [HL2]). METHODS: This waitlist-controlled clinical feasibility study comprised three laboratory visits (baseline; pre-intervention; post-intervention), a home visit and a 6-week AR-exergaming intervention. Five complementary gait-and-balance exergames were remotely prescribed (default five sessions/week of 30 active minutes/session), monitored and tailored. Feasibility was assessed in terms of safety, adherence and user experience. During laboratory visits, gaitand-balance capacity was assessed using standard clinical gait-and-balance tests and advanced walking-adaptability fall-risk assessments. RESULTS: 24 pwPD participated. No falls and four near falls were reported. Session adherence was 104%. User Experience Questionnaire scores for Reality DTx ® ranged from above average to excellent, with superior scores for HL2 over ML2 for Perspicuity and Dependability. Intervention effects were observed for the Timed-Up-and-Go test (albeit small), the Five-Times-Sit-to-Stand test and walking speed. Walking-adaptability fall-risk indicators all improved post-intervention. CONCLUSIONS: Reality DTx ® is a safe, adherable, usable, well-accepted and potentially effective intervention in pwPD. These promising results warrant future RCTs on the (cost-)effectiveness of home-based AR exergaming interventions for improving gait, balance and fall risk. Trial registration: ClinicalTrials.gov, NCT05605249, Registered 4 November 2022, https://clinicaltrials.gov/ct2/show/NCT05605249

    Keywords: Parkinson's disease, Augmented-Reality, Gait, balance, Walking adaptability, exergaming, digital therapeutics

    Received: 20 Jan 2024; Accepted: 04 Mar 2024.

    Copyright: © 2024 Hardeman, Geerse, Hoogendoorn, Nonnekes and Roerdink. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Lotte Hardeman, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, VU Amsterdam, Amsterdam, Netherlands

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.