How Does Postural Control in Patients with Functional Motor Disorders Adapt to Multitasking-Based Immersive Virtual Reality?

Autor: Gandolfi M; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.; Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), University of Verona, Verona, Italy.; Neurorehabilitation Unit, AOUI, Verona, Italy., Sandri A; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy., Menaspà Z; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy., Avanzino L; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.; Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy., Pelosin E; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.; Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy., Geroin C; Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Italy., Vidale D; Khymeia SRL, Padua, Italy., Fiorio M; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy., Tinazzi M; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Jazyk: angličtina
Zdroj: Movement disorders clinical practice [Mov Disord Clin Pract] 2024 Apr; Vol. 11 (4), pp. 337-345. Date of Electronic Publication: 2024 Jan 04.
DOI: 10.1002/mdc3.13961
Abstrakt: Background: Motor symptoms in functional motor disorders (FMDs) refer to involuntary, but learned, altered movement patterns associated with aberrant self-focus, sense of agency, and belief/expectations. These conditions commonly lead to impaired posture control, raising the likelihood of falls and disability. Utilizing visual and cognitive tasks to manipulate attentional focus, virtual reality (VR) integrated with posturography is a promising tool for exploring postural control disorders.
Objectives: To investigate whether postural control can be adapted by manipulating attentional focus in a 3D immersive VR environment.
Methods: We compared postural parameters in 17 FMDs patients and 19 age-matched healthy controls over a single session under four increasingly more complex and attention-demanding conditions: simple fixation task (1) in the real room and (2) in 3D VR room-like condition; complex fixation task in a 3D VR city-like condition (3) avoiding distractors and (4) counting them. Dual-task effect (DTE) measured the relative change in performance induced by the different attention-demanding conditions on postural parameters.
Results: Patients reduced sway area and mediolateral center of pressure displacement velocity DTE compared to controls (all, P < 0.049), but only under condition 4. They also showed a significant reduction in the sway area DTE under condition 4 compared to condition 3 (P = 0.025).
Conclusions: This study provides novel preliminary evidence for the value of a 3D immersive VR environment combined with different attention-demanding conditions in adapting postural control in patients with FMDs. As supported by quantitative and objective posturographic measures, our findings may inform interventions to explore FMDs pathophysiology.
(© 2023 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.)
Databáze: MEDLINE
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