Freezing of Gait and Balance in a Person with Parkinson’s After 6 Weeks of Virtual Reality

Abstract

This case study investigated whether reminiscence therapy (RT) could potentially mitigate freezing of gait (FOG) in an older person with Parkinson’s Disease (PD). RT and VR separately have been shown to help with anxiety and depression, potentially impacting movement issues tied to mental state. During this study, one person engaged in a 6-week program, spending 30 minutes navigating a virtual map of New York City from the 1950s. Before and after the intervention, the participant's walking patterns were evaluated using the Gait and Falls Questionnaire (GFQ), the Dynamic Parkinson Gait Scale (DPGS), video recordings, and the notes from the participant’s Occupational Therapist’s observation to assess whether the therapy effectively reduced the occurrence of FOG. Improvements were observed in various aspects related to FOG, such as the duration of FOG episodes, start hesitation, turning hesitation, destination hesitation, tight quarters hesitation, stress-induced freezing, and the feeling of being rooted to the ground. The participant also reported increased festinating gait and an additional fall during the study, possibly associated with basal ganglia dysfunction. Post-test scores on the GFQ were 14 points lower than the pre-test, and the DPGS scores showed a 3-point improvement. The Functional Reach Test, performed by the Occupational Therapist, also showed a 2-inch improvement. Video analysis demonstrated improved walking patterns characterized by more controlled steps and reduced forward lean. Results indicate a reduction in FOG in a participant with PD, showing that the combination of VR and RT may possibly help with reducing FOG symptoms.