Augmented reality rehabilitation at home for adults with Parkinson's disease: a feasibility study

Background Parkinson’s is a neurodegenerative condition causing movement impairments and increasing peoples’ risk of falls. People with Parkinson’s (PwP) are advised to exercise regularly to maintain their mobility and balance, specifically using sensory cueing, which is beneficial for freezing of gait, one of the most difficult apsects of living with Parkinson’s. Maintaining an exercise programme to achieve the effective dose of rehabilitation can be challenging and becomes more difficult over time, leading to reduced function and deteriorating quality of life. Objective This study aimed to investigate the use of Strolll, a novel cueing-based rehabilitation programme for PwP, delivered through augmented reality headsets at home. Methods Thirty PwP were recruited. Each participant had baseline and follow-up assessments in clinic. Individual game-based rehabilitation was prescribed for home use for 6 weeks with remote monitoring and weekly telephone appointments. The primary outcome measure was the Timed-Up-and-Go (TUG). Secondary outcome measures included the Lindop Parkinson’s Assessment Scale (LPAS). Statistical analysis comprised parametric and non-parametric methods appropriate to the data. Results Twenty-eight participants completed 6 weeks’ rehabilitation; two participants withdrew. Mean TUG improved from 13.2s to10.3s (p < 0.001) and LPAS improved from 27 to 29 (p < 0.01). No falls, near falls or other adverse events were reported. Conclusion Novel game-based exercises through augmented reality were successfully used to deliver rehabilitation for PwP in their homes with participants’ mobility improved and no adverse effects reported. A multi-site randomised controlled trial (NIHR206530) based on the results of this feasibility trial has started, which will investigate the clinical- and cost-effectiveness of this technology. Trial Registration: ClinicalTrials.gov No.: NCT05794542 Registered 29-10-2023