The use of virtual reality to modify and personalize interior home features in Parkinson's disease

As the second most common progressive neurodegenerative disorder with increased prevalence in the aging population, Parkinson's disease (PD) affects more than 10 million individuals worldwide with approximately 60,000 new cases occurring each year only in the US. While daily living abilities deteriorate in people with PD, they spend a significant amount of time in their homes. Unfortunately, most existing guidelines for home modification design reflect a standardized, singular plan. This study aimed to demonstrate the feasibility of using a virtual reality (VR) system for persons with PD to virtually walk through different home modifications and to adapt and personalize interior features. A sample of 15 participants with idiopathic PD and 24 healthy adults ambulated on a pressure mat, while using a VR headset and hand controller. Both groups envisioned walking through a virtual doorway from a simulated bedroom into its attached bathroom. Design features for the intervention included doorway width and door-frame color. Each participant was randomly assigned to one of three intervention conditions: (1) standard design, (2) enhanced design, and (3) co-design. The codesign module allowed participants to manipulate design features using a hand controller. We recorded 4 movement variables. Participants completed three questionnaires assessing anxiety, system usability, and satisfaction. Healthy control adults revealed no differences in movement or subjective assessment between the three intervention conditions. However, there were significant differences in the PD group between co-design and the other conditions. The changes were appreciated in the baseline measures of gait distance and strikes as well as in the composite gait component score. This study showed that using VR as a participatory design tool for persons with PD is safe and feasible. Additionally, the self-determination of interior design conditions may possibly affect movement performance measures and merits additional controlled trials.