Walking in fully immersive virtual environments: an evaluation of potential adverse effects in older adults and individuals with Parkinson's disease.

Thirty-three participants is small, and the groups had only 11 people each. Participants with Parkinson's disease were mostly in modified Hoehn and Yahr stage 1 to 3 and had mild to moderate motor scores, so this says little about more advanced disease. The virtual task was a straight sidewalk with no turns, doorways, thresholds, or other common gait challenges for people with Parkinson's disease. The simulator sickness and mood questionnaires were validated in healthy adults, and the simulator sickness cutoff of 15 was established in healthy younger adults. The sample had more women than men in the healthy older and Parkinson's disease groups, which does not match the higher prevalence of Parkinson's disease in men. Because all participants received the same single VR exposure, the study cannot show that the virtual environment alone caused the small increases in Mini-BESTest scores or walking speed. The authors note that the Mini-BESTest increase did not reach the minimal detectable change for people with Parkinson's disease.

The funding statement names the National Institute of Child Health and Human Development. The supplied text does not list other conflicts of interest.

Do not read the higher mini-BESTest scores and walking speeds as proof that VR gait training works. This study tested one 20-minute exposure for adverse effects, not repeated training, and the mini-BESTest increase did not reach the minimal detectable change.