Virtual reality for movement disorder diagnosis and/or treatment

Abstract

Methods and/or systems for diagnosing, monitoring and/or treating persons at risk for falling and/or other pathological conditions. In an exemplary embodiment of the invention, people are diagnosed before they actually start falling. Optionally, the diagnosis includes trying out and identifying one or more fall triggers using virtual reality tools. Optionally or alternatively, treatment includes training the persons using situations and/or triggers which are determined to be relevant for that person.

What is claimed is: 
     
         1 . A method of training a subject, comprising:
 providing the subject with a VR (virtual reality) environment that presents the subject with at least one task to be performed during locomotion, said at least one task delivered by VR on a display, said task being one of a motor task, a cognitive task, a fall trigger, and any combination thereof, said at least one task including at least one trigger which potentially at least one of induces a loss of balance and presents at least one of at least one vertical obstacle and at least one horizontal obstacle during the locomotion;   measuring at least one of a physiological parameter and a movement parameter of the subject during performance of the at least one task;   processing said measured parameter; and   providing the subject with real-time feedback, based on said processed measured parameter, wherein said feedback includes at least one marking indicating a gait irregularity during the locomotion, said at least one marking providing the subject with a reference as to how to at least one of improve his balance and avoid the obstacle during locomotion.   
     
     
         2 . The method according to  claim 1 , wherein said presenting at least one task includes independently varying a cognitive load, a gait complexity, and a potential fall trigger associated with said at least one task. 
     
     
         3 . The method according to  claim 1 , wherein said task is one of:
 a cognitive task selected from decision making, using memory, planning, response selection, response inhibition, perception, divided attention, and sustained attention; and   
       a motor task selected from functional reach, center of mass displacement, stepping, single limb support, and clearance of a foot over a horizontal or vertical obstacle. 
     
     
         4 . The method according to  claim 1 , further including allowing the subject to at least one of correct and regulate his gait in response to said feedback. 
     
     
         5 . A method according to  claim 1 , wherein said presenting comprises presenting dual motor and cognitive tasks. 
     
     
         6 . A method according to  claim 1 , wherein said presenting comprises personalizing the presentation to at least one of a physical feature of the subject, an activity of the subject, a weakness of the subject, a functional ability of the subject, a performance of the subject, a clinical history of the subject. 
     
     
         7 . The method according to  claim 1 , further including receiving at least one input from the subject related to his locomotion. 
     
     
         8 . The method of  claim 7 , wherein said input is received by voice transmission, pressing on buttons, and contacting a touch screen. 
     
     
         9 . A method according to  claim 1 , wherein said processing includes identifying one or more parameters of a situation and/or a trigger which induces falls or near falls in the subject, wherein said training includes setting up a training program responsive to the identifying. 
     
     
         10 . The method according to  claim 1 , wherein said feedback includes at least one of biofeedback, auditory feedback, and visual feedback. 
     
     
         11 . The method according to  claim 1 , where said feedback is in a form of one of KP (knowledge of performance) and KR (knowledge of results). 
     
     
         12 . The method according to  claim 1 , wherein said providing feedback includes providing a virtual avatar indicating a pattern of movement of the subject during said locomotion. 
     
     
         13 . The method of  claim 1 , wherein said training includes a regimen that automatically progresses in difficulty level according to the feedback provided to the subject. 
     
     
         14 . The method of  claim 1 , wherein said training includes a regimen having a plurality of difficulty levels according to cognitive and motor requirements in performing the tasks. 
     
     
         15 . The method of  claim 14 , wherein said regimen includes five difficulty levels, as follows:
 a. Level A—a simulation with obstacles having a first level of difficulty, both horizontal and vertical, with at least one of a cognitive load, a perceptual load, and a motor load;   b. Level B—a simulation as in Level A, additionally including obstacles having a second level of difficulty, said second level of difficulty being higher than said first level of difficulty, and the addition of narrow pathways;   c. Level C—a simulation as in Level B, additionally including passages selected from doors, bridges, and tunnels;   d. Level D—a simulation as in Level C, additionally including auditory and visual distractions; and   e. Level E—a simulation as in Level D, additionally including combined dual task activities, obstacles having a third level of difficulty wherein said third level of difficulty is higher than said second level of difficulty, additionally including narrow passages.   
     
     
         16 . The method of  claim 1 , wherein said training is used in conjunction with teaching of alternative strategies to reduce a fall risk, said alternative strategies being at least one of cognitive, motor, and mechanical. 
     
     
         17 . The method according to  claim 1 , wherein the subject is a healthy subject and wherein said training is utilized to improve performance of said at least one task during locomotion of the healthy subject. 
     
     
         18 . The method of  claim 1 , wherein the subject has at least one of a cognitive impairment, a motor impairment, and a fall risk, and wherein said training is for the purpose of at least one of changing the subject's susceptibility to the impairment, improving gait, improving dual tasking and/or cognitive ability, and lowering a risk of falls. 
     
     
         19 . The method of  claim 18 , wherein said at least one task is selected according to the subject's cognitive impairment, motor impairment, and fall risk. 
     
     
         20 . The method of  claim 18 , wherein the subject has a cognitive impairment of one or more of executive function, attention, planning, and visual spatial processing. 
     
     
         21 . The method of  claim 18 , wherein said training includes providing a training regimen having at least one of a target number of falls or near-falls and a target misstep rate. 
     
     
         22 . The method of  claim 21 , wherein a number of tasks in said training regimen is adjusted to achieve at least one of said target number of falls or near-falls and said target misstep rate. 
     
     
         23 . The method according to  claim 1 , further including providing a training regimen personalized for the subject, said personalization including the following training parameters: training duration, frequency of training sessions, duration of each training session, and changes in these parameters over time. 
     
     
         24 . The method according to  claim 1 , wherein said VR environment includes at least one obstacle, pathway, narrow corridor, and distraction which cause the subject to modify his locomotion. 
     
     
         25 . The method of  claim 1 , wherein said VR environment includes at least one target having at least one feature that is selected according to a subject protocol. 
     
     
         26 . The method of  claim 25 , wherein said at least one feature is selected from speed, orientation, size, frequency of appearance, and shape of said target. 
     
     
         27 . The method of  claim 1 , wherein said VR environment includes at least one feature that may be adjusted to increase training complexity. 
     
     
         28 . The method of  claim 27 , wherein said at least one feature is selected from visibility, setting, and distractions. 
     
     
         29 . The method of  claim 1 , wherein said VR environment is similar to that found in everyday life of the subject. 
     
     
         30 . The method of  claim 1 , wherein the VR environment includes a treadmill on which the subject performs the at least one task during locomotion. 
     
     
         31 . A method according to  claim 1 , wherein said physiological parameter is based on change of activity in frontal lobes of the subject. 
     
     
         32 . A method according to  claim 31 , wherein said change in activity is detected using EEG. 
     
     
         33 . A method according to  claim 31 , wherein:
 an increase in blood flow to a frontal lobe indicates a gait disorder due to lack of or over activity in the frontal lobe; and   wherein a decrease in blood flow to a frontal lobe indicates a gait disorder due to frontal lobe dysfunction.   
     
     
         34 . A method according to  claim 1 , wherein said one or more physiological parameters includes an anticipatory postural adjustment.