AR Gait Training for Parkinson's Disease

Condition(s) studied

Investigational drug(s) / intervention(s)

AR gait training: Participants will walk on a pathway projected in augmented reality (AR), following the instructions provided on the pathway Each session will last for 60 minutes, conducted three times per week, over a period of six weeks.

Study summary

Gait disorders in Parkinson's disease (PD), particularly in complex environments or under stress, present challenges for accurate evaluation and classification, such as in cases of freezing of gait. Traditional clinical and laboratory settings often fail to replicate the complexity needed for precise classification, making effective rehabilitation difficult. This study aims to address these challenges by developing an augmented reality (AR)-based environment that mimics real-world stressors and dynamically adapts to the patient's condition. The AR system is designed to facilitate individualized gait training and rehabilitation by modifying environmental difficulty based on real-time feedback from gait performance and stress levels.

Building on Gentile's taxonomy of tasks, the investigators have incorporated PD-specific factors, such as cognitive dual tasks, into our environment classification system. Preliminary results suggest that this system effectively elicits varying gait and heart rate variability (HRV) responses, indicating different stress levels.

This trial will further test the AR environment's ability to classify patients based on their responses to complex, interactive environments, while also investigating the effects of adaptive AR-based gait training on both gait and stress management in individuals with PD.

Eligibility

Primary outcome measure(s)

• Walking Speed — Baseline, 6 weeks, 8 weeks
  The time taken by participants to walk a standardized distance, typically expressed in centimeters per second (cm/s).
• Step Length — Baseline, 6 weeks, 8 weeks
  The linear distance between the two ankles, typically expressed in centimeter(cm).
• Step Time — Baseline, 6 weeks, 8 weeks
  The duration taken for one complete step, measuring from foot-off of one foot to the next foot-off of the same foot, usually expressed in seconds.
• Time-Domain Index of Heart Rate Variability (HRV)：Standard deviation of RR intervals (SDRR) — Baseline, 6 weeks, 8 weeks
  SDRR is the standard deviation of all recorded RR intervals (the time between successive heartbeats) over a specific period, usually expressed in milliseconds. This measure captures the total variability in heart rate, representing the physiological responses to a variety of internal and external stimuli. High SDRR values generally indicate greater heart rate variability, which is associated with good cardiovascular health and resilience to stress.
• Time-Domain Index of HRV：pNN50 — Baseline, 6 weeks, 8 weeks
  Percentage of successive RR intervals that differ by more than 50 ms. pNN50 reflects beat-to-beat variance in heart rate and is considered an indicator of parasympathetic nervous system activity, specifically linked to vagal tone. A higher pNN50 typically indicates better heart rate variability and healthier autonomic function.
• Time-Domain Index of HRV：Root mean square of successive RR interval differences (RMSSD) — Baseline, 6 weeks, 8 weeks
  RMSSD is the square root of the mean of the squares of successive differences between adjacent RR intervals. It emphasizes the high-frequency variations in heart rate that are typically mediated by the parasympathetic nervous system
• Frequency-Domain Index of HRV: Low Frequency (LF) — Baseline, 6 weeks, 8 weeks
  The LF component typically represents the power of the HRV spectrum in the frequency range of 0.04 to 0.15 Hz. It is measured in milliseconds squared (ms²) or normalized units and is often interpreted as reflecting both sympathetic and parasympathetic activity,
• Frequency-Domain Index of HRV: High Frequency (HF) — Baseline, 6 weeks, 8 weeks
  HF typically covers the frequency range from 0.15 to 0.40 Hz and is associated with the respiratory cycle. HF power is usually measured in milliseconds squared (ms²) or normalized units and is indicative of the modulation of heart rate by the parasympathetic nervous system during breathing.
• Frequency-Domain Index of HRV: Ratio of LF to HF Power — Baseline, 6 weeks, 8 weeks
  The ratio of LF (low frequency) to HF power in the HRV spectrum. Since LF can represent both sympathetic and parasympathetic activity, comparing it to HF offers insights into the sympathetic-parasympathetic balance
• Total Time to Complete the Time Up and Go test — Baseline, 6 weeks, 8 weeks
  The time, in seconds, it takes for a participant to complete the TUG test from the initial sitting position to returning to the seated position.

Trial sites (1)

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