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

Autor:	Hardeman LES; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands., Geerse DJ; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands., Hoogendoorn EM; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands., Nonnekes J; Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Centre of Expertise for Parkinson and Movement Disorders, Nijmegen, Netherlands.; Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, Netherlands., Roerdink M; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2024 May 30; Vol. 15, pp. 1373740. Date of Electronic Publication: 2024 May 30 (Print Publication: 2024).
DOI:	10.3389/fneur.2024.1373740
Abstrakt:	Background: Exergaming has the potential to increase adherence to exercise through play, individually tailored training, and (online) remote monitoring. Reality Digital Therapeutics (Reality DTx ® ) is a digital therapeutic software platform for augmented reality (AR) glasses 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 walking-adaptability fall-risk indicators. The secondary objective was to evaluate the potential superiority of AR glasses [Magic Leap 2 (ML2) vs. HoloLens 2 (HL2)]. Methods: This waitlist-controlled clinical feasibility study comprised three laboratory visits (baseline; pre-intervention; and 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, gait-and-balance capacity was assessed using standard clinical gait-and-balance tests and advanced walking-adaptability fall-risk assessments. Results: In total, 24 pwPD participated. No falls and four near falls were reported. Session adherence was 104%. The 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. Conclusion: Reality DTx ® is a safe, adherable, usable, well-accepted, and potentially effective intervention in pwPD. These promising results warrant future randomized controlled trials on the (cost-)effectiveness of home-based AR exergaming interventions for improving gait, balance, and fall risk. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT05605249. Competing Interests: This study was part of a collaboration between Vrije Universiteit Amsterdam and Strolll Limited, the manufacturer of Reality DTx®, which was formalized in a consortium agreement associated with their joint EUreka Eurostars grant. The Vrije Universiteit Amsterdam transferred IP related to AR cueing and data science to Strolll Limited in return for share options. MR is scientific advisor for Strolll Limited ancillary to his full-time position as Associate Professor Technology in Motion at the Vrije Universiteit Amsterdam. Anonymized information on technical issues, adherence, usability and exergame performance obtained in this study were shared with Strolll Limited for further development of Reality DTx®. (Copyright © 2024 Hardeman, Geerse, Hoogendoorn, Nonnekes and Roerdink.)
Databáze:	MEDLINE
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