Virtual reality and motor imagery: Promising tools for assessment and therapy in Parkinson's disease

Authors

  • Anat Mirelman PhD,

    Corresponding author
    1. Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
    2. School of Health Related Professions, Ben Gurion University, Beer Sheba, Israel
    • Correspondence to: Dr. Anat Mirelman, PhD, Laboratory for Gait Analysis and Neurodynamics, Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel; anatmi@tasmc.health.gov.il

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  • Inbal Maidan MsPT,

    1. Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
    2. RiVERS Lab, Department of Rehabilitation and Movement Science, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
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  • Judith E. Deutsch PhD

    1. RiVERS Lab, Department of Rehabilitation and Movement Science, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
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  • Funding agencies: The work was supported, in part, by the European Commission (FP7 projects: V-TIME- 278169 and CuPiD-288516).

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Motor imagery (MI) and virtual reality (VR) are two evolving therapeutic approaches that make use of cognitive function to study and enhance movement, in particular, balance and mobility of people with Parkinson's disease (PD). This review examines the literature on the use of VR and MI in the assessment of mobility and as a therapeutic intervention to improve balance and gait in patients with PD. A study was eligible for inclusion if MI or VR were used to assess motor or cognitive function to improve gait, balance, or mobility in patients with PD. Data were extracted on the following categories: participants; study design; intervention (type, duration, and frequency); and outcomes. Intervention studies were evaluated for quality using the Physiotherapy Evidence Database scale. Sixteen studies were identified; 4 articles used MI and 12 used VR for assessment and treatment of gait impairments in PD. The studies included small samples and were diverse in terms of methodology. Quality of the intervention trials varied from fair for VR to good for MI. The benefits of using MI and VR for assessment and treatment were noted. Encouraging findings on the potential benefits of using MI and VR in PD were found, although further good-quality research is still needed. Questions remain on the optimal use, content of interventions, and generalizability of findings across the different stages of the disease. The possible mechanisms underlying MI and VR and recommendations for future research and therapy are also presented. © 2013 International Parkinson and Movement Disorder Society

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