Project to Test Virtual Reality Weight-Shifting Strategies for Gait Freezing

A three-year U.K. project will investigate whether weight-shifting strategies, developed and tested using virtual reality, can help people with Parkinson’s disease to overcome freezing of gait — when patients feel like their feet are “glued” to the floor and can’t move forward.

If these strategies prove successful in the researchers’ state-of-the-art lab, the team will then travel to people with Parkinson’s and use wireless shoe insoles to determine if weight-shifting training works in patients’ real-world “freezing hotspots.”

The project, led by scientists at Exeter University, has received a £246,000 grant (about $348,000) from Parkinson’s UK, a patient advocacy organization, according to a university press release.

“This exciting project … brings together leading researchers and cutting-edge technology in a unique collaboration that has the potential to affect real change in the lives of those affected by this disease,” said Toby de Burgh of Cineon Training, a spin-off company of the University of Exeter’s sport and health sciences department.

Gait, described simply as a person’s manner of walking, often is impaired in Parkinson’s due to the body’s inability to coordinate movement. Freezing of gait is a relatively common problem for patients, and consists of brief periods in which a person cannot start or continue walking. Although related to anxiety, as well as to the duration and severity of Parkinson’s, its root cause remains unclear.

However, according to the Exeter researchers, freezing of gait and anxiety are two areas identified by people with Parkinson’s as priorities for future research.

“This project is first and foremost born from the suggestions and ongoing guidance of people with Parkinson’s, their family, friends and carers,” said William Young, PhD, the study’s principal investigator.

The three-phase program will use virtual reality strategies to investigate whether weight shifting can free a patient from frozen gait.

In the first phase, Cineon Training will develop teaching materials to help patients learn such weight-shifting strategies. Patients who experience freezing, their family members, and medical specialists will collaborate in designing these materials.

In the second phase, investigators at Exeter’s VSimulators research facility will induce freezing in patients to evaluate how the training influences their ability to step out from a freeze. In this “free navigation task,” participants will walk in a virtual reality environment, while a force-sensing platform measures various aspects of walking and freezing.

The research facility has the world’s largest force-sensing platform, according to Exeter. It will “provide unprecedented access to measurements of walking and freeze events that will undoubtedly progress our understanding” of freezing of gait.

“VSimulators is a unique facility providing a core hub for collaboration and inter-disciplinary research between academic communities and commercial partners,” said James Brownjohn, an engineering professor who led the development of the VSimulators facility.

Finally, the researchers will assess whether this training can be used safely in real-world and everyday settings, including after Parkinson’s medications have worn off. For this, they will travel to patients and measure balance using wireless insoles placed inside the participants’ shoes.

As anxiety might influence freezing and a patient’s ability to use self-taught strategies, the researchers also will conduct interviews to explore any anxiety-related thoughts during these home visits.

The researchers expressed their thanks to Parkinson’s UK for its financial support of the project.

“This project,” Young said, “is about us all working together as a multidisciplinary team and using the state-of-the-art facilities in VSimulators to better understand freezing of gait and develop strategies that are low-cost, effective and practical to use in daily life to help people overcome freezing.”