An immersive virtual reality shopping task detects declines in instrumental activities of daily living in individuals with Parkinson's disease

Declines in instrumental activities of daily living (IADLs) have been proposed as a prodromal marker of Parkinson's disease (PD). The Cleveland Clinic Virtual Reality Shopping (CC-VRS) platform combines an omnidirectional treadmill with a virtual reality headset to create a virtual grocery stor...

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Bibliographic Details
Published in:Parkinsonism & related disorders 2024-08, Vol.125, p.107019, Article 107019
Main Authors: Rosenfeldt, Anson B., Waltz, Colin, Zimmerman, Eric, Davidson, Sara, Hastilow, Karissa, Alberts, Jay L.
Format: Article
Language:English
Subjects:
Dual-task
Instrumental activities of daily living
Parkinson's disease
Virtual reality
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Summary:Declines in instrumental activities of daily living (IADLs) have been proposed as a prodromal marker of Parkinson's disease (PD). The Cleveland Clinic Virtual Reality Shopping (CC-VRS) platform combines an omnidirectional treadmill with a virtual reality headset to create a virtual grocery store that a user physically walks through and completes a shopping task. The primary aim of this project was to determine the known-group validity of the CC-VRS platform in discriminating IADL performance and to characterize specific motor and cognitive declines responsible for PD-related IADL impairments. Sixteen individuals with PD and 15 healthy adults completed traditional motor, cognitive, and IADL assessments and the CC-VRS task. Group differences were evaluated using Welch's t-test. There were no between-group differences in traditional performance measures of motor, cognitive, or IADL function. Regarding CC-VRS performance, participants in the PD group completed the task significantly slower than controls (690 vs. 523 sec, respectively). Participants with PD spent 25 % more time walking and turning and were stopped 46 % longer than controls. Average gait speed when viewing the shopping list, a measure of dual-task performance, was significantly slower in the PD group compared to controls (0.26 vs. 0.17 m/s, respectively). Unlike traditional performance measures of motor, cognitive, and IADL function, the CC-VRS discriminated participants with PD from healthy older adults. For the PD group, motor and dual-task declines contributed to diminished CC-VRS performance. Identifying underlying contributors to IADL declines supports using ecological assessments, such as the CC-VRS, for the routine clinical evaluation of IADLs. •IADL declines precede PD diagnosis; thus, ecological, objective assessment is vital.•The CC-VRS integrates VR with an omnidirectional treadmill for IADL assessment.•CC-VRS, but not traditional assessments, discriminated between PD and control groups.•The greatest differences were exhibited between the motor and dual-task domains.
ISSN:1353-8020
1873-5126
1873-5126
DOI:10.1016/j.parkreldis.2024.107019