Virtual Reality for Freezing of Gait in Parkinson's Disease

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: Dementia, Stroke, Severe gait impairments, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to address freezing of gait, a troubling symptom in Parkinson's disease where patients suddenly can't start or continue walking. Researchers will study brain activity during walking episodes using virtual reality tasks, including Dual Task, External Cueing, and VR Freezing Task, to learn more about this issue. Participants should have Parkinson's disease with a specific deep brain stimulation device and be able to walk indoors without assistance. Half of the participants will regularly experience freezing of gait, while the other half will not. The goal is to develop better treatment strategies for this challenging symptom. As an unphased trial, this study offers participants the chance to contribute to groundbreaking research that could lead to improved treatments for Parkinson's disease.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that these interventions are safe for addressing freezing of gait in Parkinson's disease?

Research shows that the treatments under study—Dual Task, External Cueing, and VR Freezing Task—are generally safe for people with Parkinson's disease.

For Dual Task treatments, previous studies indicate that people with Parkinson's can manage them well, even though multitasking might be challenging. These studies aim to improve walking, suggesting it's a practical approach.

External Cueing uses signals to guide walking and has shown promising results in improving walking patterns. Research highlights that patients usually don't experience increased brain activity, indicating the cues work effectively without causing extra stress.

Virtual Reality (VR) tasks study and understand freezing of gait in Parkinson's. They provide a safe way to explore and train walking behavior. Studies show that VR can help improve balance and walking, indicating it's a well-tolerated method.

Overall, these treatments focus on improving walking and appear safe based on current research. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using virtual reality (VR) for treating freezing of gait in Parkinson's disease because it offers a novel, immersive way to address this challenging symptom. Unlike traditional treatments like medication and physical therapy, which often have limited success in managing freezing episodes, VR provides a unique platform for dual-task training and external cueing, which are believed to improve motor control and brain plasticity. This innovative approach could lead to more effective and engaging interventions, potentially improving mobility and quality of life for Parkinson's patients.

What evidence suggests that this trial's treatments could be effective for freezing of gait in Parkinson's disease?

Research has shown that virtual reality (VR) and cueing strategies might help manage walking difficulties in people with Parkinson's disease. In this trial, participants will engage in various interventions, including the VR Freezing Task, Dual Task, and External Cueing. Studies have found that augmented reality (AR) cues can improve walking, although they might not directly reduce freezing episodes. One study discovered that VR can affect walking patterns, especially when using detailed VR environments and large spaces. Another study suggested that performing two tasks simultaneously, along with touch-based cues, might improve walking speed and step length. These findings indicate that VR and cueing strategies could benefit managing walking issues in Parkinson's, but more research is needed to confirm their effectiveness. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for individuals with Parkinson's Disease who experience freezing of gait, which is when they can't start or continue walking. Participants should be able to walk and have a deep brain stimulation (DBS) device implanted.

Inclusion Criteria

The other half of patients will not have freezing of gait as defined by self-report on question 1 of the New Freezing of Gait Questionnaire

I have Parkinson's and a Medtronic DBS device in my brain.

Half of patients will have disabling freezing of gait as defined by freezing more than once per day by self-report on questions 1 & 2 of the New Freezing of Gait Questionnaire

Exclusion Criteria

Clinical diagnosis of dementia or severe cognitive impairment (MOCA < 21)

I have had a stroke, brain injury, or another neurologic disorder, but not Parkinson's disease.

I have not had any serious heart problems in the last 6 months.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Baseline neurophysiology and kinematics measurements are taken during initial gait interventions

1 week

1 visit (in-person)

Experimental Intervention

Participants undergo gait interventions with neurophysiology and kinematics measurements in a virtual reality environment

2 days

2 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after interventions

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Dual Task
• External Cueing
• VR Freezing Task

Trial Overview The study aims to understand the 'freezing of gait' in Parkinson's by recording brain signals during episodes. It tests if tasks that divide attention (dual task) and external cues combined with Virtual Reality can help manage this symptom.

How Is the Trial Designed?

Group I: Experimental Experimental Treatment 3 Interventions

Neurophysiology and kinematics are measured during gait interventions

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

National Institute of Neurological Disorders and Stroke (NINDS)

Collaborator

Trials

1,403

Recruited

655,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12099459/

Effects of augmented reality cueing strategies on freezing ... Primary outcomes included percent time frozen and freeze rate. Percent time frozen represents time frozen/total task duration. Time frozen and ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S2590112524000550

The effect of tactile cueing on dual task performance in ... The meta-analysis provides weak evidence that tactile cueing may enhance walking speed and step length in DT conditions in PD.

3. nature.com nature.com/articles/s41531-025-01017-9

Effects of virtual reality on spatiotemporal gait parameters ... Results revealed that a detailed VR replica and large walking area reduced the effect of VR on gait parameters compared to previous reports.

4. ieeexplore.ieee.org ieeexplore.ieee.org/document/7270983/

Dual Motor-Cognitive Virtual Reality Training Impacts ... The primary outcome measures were pre- and post-intervention differences in motor (stepping time, symmetry, rhythmicity) and cognitive (accuracy ...

5. consultqd.clevelandclinic.org consultqd.clevelandclinic.org/augmented-reality-cueing-reduces-parkinsons-related-gait-freezing

AR Cueing Reduces Parkinson's Related Gait Freezing Previous studies have shown people exhibited better walking patterns with the help of AR cueing but they did not impact or reduce freezing, says ...

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37574744/

Freezing of Gait in Parkinson's Disease: Implications for Dual ... People with Parkinson's disease (PwPD) exhibit difficulty with DT, and DTC may be particularly pronounced in PwPD with freezing of gait (FOG).

7. clinicaltrials.gov clinicaltrials.gov/study/NCT01375413

NCT01375413 | Dual Task Practice in Parkinson's Disease Based on the literature and our previous experience, we anticipate that DTT will improve with an average of 20% and STT with 5% of baseline dual task gait speed ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S0966636224006465

Dual-task performance during the Timed Up and Go test in ... Dual-task interference (DTI) on gait is well documented in Parkinson's disease (PD), but how dual-tasks affect functional mobility is less known.

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11119953/

Dual-Task vs. Single-Task Gait Training to Improve ... Dual-Task vs. Single-Task Gait Training to Improve Spatiotemporal Gait Parameters in People with Parkinson's Disease: A Systematic Review and Meta-Analysis

10. stacks.cdc.gov stacks.cdc.gov/view/cdc/230829

Dual-Task Interference During Gait on Irregular Terrain in ... Background: Gait impairments in people with Parkinson's disease (PD) are accentuated in dual-task conditions. Most PD studies on dual-task gait have ...