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Leveraging Advancements in Virtual Reality Technology for the Evaluation of Neurological Disease

Lewis, Morgan McGrath
http://orcid.org/0000-0003-1368-0757
http://rave.ohiolink.edu/etdc/view?acc_num=case1685986169789549

Abstract Details

2023, Doctor of Philosophy, Case Western Reserve University, Clinical Translational Science.
A fundamental gap exists in the ecologically valid assessment of functional decline in neurological disease. Functional decline is characterized by difficulty with performance of instrumental activities of daily living, like shopping and medication management. Traditional assessments of IADLs rely on self-report questionnaires or resource-intensive performance-based tests. Virtual adaptations of performance-based tests offer advantages but neglect to incorporate the motor components inherent in everyday IADL tasks. Dual-task conditions requiring simultaneous cognitive and motor function impact performance, particularly among the aging and neurological populations; therefore, ecological IADL assessments must include both the mental and physical aspects of daily tasks. By combining immersive virtual reality with an omnidirectional walking platform, the Cleveland Clinic Virtual Reality Shopping (CC-VRS) application replicates all aspects of everyday grocery shopping and provides objective outcome measures to quantify performance. We hypothesized that CC-VRS outcomes would display convergent validity with neuropsychological tests and would discriminate performance of young adults, older adults, and individuals with Parkinson’s disease (PD). The omnidirectional platform utilized by the CC-VRS was first evaluated to investigate the relationship between overground walking and omni-platform walking (Chapter Two). Omni-platform walking was characterized by slow gait speed and short step; otherwise, relationships between biomechanical outcomes resembled those of natural gait during forward walking but differed during turning tasks. Next, the conceptualization, development, and protocol of the CC-VRS were detailed (Chapter Three). Preliminary results from PD participants provided evidence for the feasibility and usability of the CC-VRS system among individuals with neurological disease. Primary outcomes of the CC-VRS discriminated older adults from younger adults (Chapter Four), and CC-VRS outcomes significantly correlated with neuropsychological tests and motor evaluations. The cognitive, motor, and dual-task outcomes of the CC-VRS also discriminated PD participants from healthy controls (Chapter Five). Discriminatory CC-VRS outcomes were influenced primarily by disease status and age, while sex and years of education had no impact on performance. Further investigation of the CC-VRS with respect to broader populations, additional omni-platforms, and updated software features is warranted. The CC-VRS is primed for clinical integration and is a potential prodromal marker of latent neurological disease through the quantification of subtle functional deficits.
Jay Alberts (Advisor)
Jill Barnholtz-Sloan (Committee Chair)
Xin Xin Yu (Committee Chair)
Michael Fu (Committee Member)
Mark Lowe (Committee Member)
James Spilsbury (Committee Member)
173 p.
Biomedical Research; Neurosciences
Virtual Reality; Omni-Directional Treadmill; Instrumental Activities of Daily Living; Parkinson's Disease; Neurological Disease

Recommended Citations

Citations

  • Lewis, M. M. (2023). Leveraging Advancements in Virtual Reality Technology for the Evaluation of Neurological Disease [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1685986169789549

    APA Style (7th edition)

  • Lewis, Morgan. Leveraging Advancements in Virtual Reality Technology for the Evaluation of Neurological Disease. 2023. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1685986169789549.

    MLA Style (8th edition)

  • Lewis, Morgan. "Leveraging Advancements in Virtual Reality Technology for the Evaluation of Neurological Disease." Doctoral dissertation, Case Western Reserve University, 2023. http://rave.ohiolink.edu/etdc/view?acc_num=case1685986169789549

    Chicago Manual of Style (17th edition)

case1685986169789549
135
© 2023, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.