Virtual Reality: A Practical Use in PD
by Tom Riess
 
I am 47 years old and have had PD for approximately 12 years.  Like
many other PD people I have a great deal of difficulty with dyskinesia
(uncontrolled movement) as a consequence of taking PD medications for
many years.  On the other side of the equation I have frequent OFF periods
during the day when I am completely unable to walk (akinesia or freezing).
Ever since I have had problems with akinesia I have observed that I am
very sensitive to what is called  visual cue phenomenon.   This means that
even when I am totally unmedicated and unable to walk I have no difficulty
walking up or down stairs or stepping over obstacles placed at my feet.
Gradually I discovered that placing a row of playing cards or dimes or any
other similar objects at my feet allowed me to walk, run and change
direction at will.  About a year ago I learned of a product in development
called  Virtual Vision  glasses.  This product is intended for entertainment
purposes and looks like ski glasses.  Built into the brow piece of the
glasses
is a tiny television screen and an optical system which will project a
television image into space for one eye.  The other eye sees the real world.
 
The two images are perceived as one creating the effect of projecting the
image onto the real world without hiding reality.  It occurred to me that
using such a device I might be able to superimpose my visual cues onto the
real world and thereby overcome my akinesia.  I contacted the company
and they were eager to help.  I was subsequently directed to a virtual
reality research lab affiliated with the University of Washington in Seattle
called the Human Interface Technology lab.  Over the last several months I
have worked on this project both in the lab in Seattle as well as at home.  I
 
can report that I am now able to walk while unmedicated if I am wearing
the glasses.
We are currently in the process of re-engineering the glasses to make
them more suitable for this application and refining the cueing images.
They may also be useful for PD people who can walk but suddenly freeze
up and for those who exhibit shuffling (festinating) gait.
Subjects Needed for Testing
 We are current looking for additional subjects to test the equipment.
Subjects may eventually need to go to the lab in Seattle; although initially
they could try the equipment in the San Francisco Bay Area.  If you are
interested, you should test yourself for sensitivity to visual cues.  The way
 
to do this is to first wait until you are in the OFF state.  If in the OFF
state
you are akinetic, i.e., unable to take a first step, then have someone place
a
small object such as a book or a pack of playing cards on the floor directly
in front of your feet.  If you find that looking at the object facilitates
your
talking a step you are probably sensitive to  visual cue phenomenon.   If
you have problems with freezing or with little stutter steps, then in
addition
to the first object set directly at your feet, position 7 or 8 additional
objects
in a row at approximately 2 foot intervals.  While looking at the objects try
 
walking by stepping over the objects.  If you notice significant
improvement, you are probably sensitive to  visual cue phenomenon.   If
you are a candidate for this project please contact me.
 
Tom Riess, 176 Morningside Dr., San Anselmo, CA 94960
My telephone is (415) 457-8961.
 
This appeared in the recent newsletter of YPSN of CA.  Since then Tom
participated in a meeting in San Diego on Virtual Reality in Medicine.  He
was the hit of the show.  The main reason was the applied use of VR to
make something better.  Almost all the other exhibits were ideas looking
for future applications.  One exhibitor was showing stereotactic surgery
using 3D imaging and frameless surgery.  This would be applicable to the
Pallidotomy, Thalamotomy and Fetal Tissue Transplant surgeries.
 
There have been other interesting observations made by Tom in his playing
with VR glasses.  One very interesting observation is that when in the state
of strong dyskinesia, putting on the glasses removed the dyskinesia.  This is
 
something he cannot explain.  I should add the Tom is a doctor, a
podiatrist by education, who has had to give up his profession because of
PD.  If any of you are interested in learning more, please contact Tom at
the above address.
 
Regards,
Alan Bonander ([log in to unmask])