Effects of virtual reality on spatiotemporal gait parameters and freezing of gait in Parkinson’s disease

Virtual reality (VR) is increasingly used to study freezing of gait (FOG) in Parkinson’s disease (PD). However, overground gait in VR typically exhibits shorter, wider, and slower steps than real-world gait in both healthy and PD populations. This altered gait behavior raises the question of whether VR also alters the FOG phenomenon. We investigate the effects of naturalistic VR on gait and FOG characteristics in PD patients. Patients walked in a real-world environment and its VR replica under conditions that provoke FOG. Spatiotemporal gait parameters and FOG episodes were compared between environments. Results revealed that a detailed VR replica and large walking area reduced the effect of VR on gait parameters compared to previous reports. Additionally, FOG was provoked by similar triggers with comparable frequency, suggesting VR effectively replicates FOG heterogeneity. This work demonstrates the feasibility of VR to study gait and FOG in PD and informs future VR applications.