CODY (Co-design for You): An Immersive Technology Tool for Experiencing and Assessing Home Alterations
Condition: Parkinson Disease (PD)
MeSH terms: Parkinson Disease
Study type: Interventional

Summary: 
      CODY (co-design for you) is a Virtual Reality (VR) tool and Application Programming Interface
      (API) which uses an immersive, interactive environment for using, experiencing and
      co-designing home alterations. The aim of this research is to assess the efficacy of using
      CODY to aid and enhance the ability of adults with Parkinson's disease (PD) to experience and
      choose appropriate home modifications.
    

Detailed description: 
      Accessible housing is a widespread need in this country. This is particularly true among
      those persons with mobility impairments and movement disorders. While design and construction
      guidebooks exist for modifying homes for people with disabilities, there are also many
      documented instances where a standard, "by-the-book" alteration or assistive technology did
      not support the need or condition of the particular individual it was intended for. Just as
      occupational therapists recognize that a critical component of successful rehabilitation
      assistance is a person-centered plan that facilitates individualized solutions, likewise
      diverse design (or home alterations/modification, referred here as HM) approaches which
      approximate a person-centered plan also provide a more effective fit for persons with
      disabilities. A "one-size-fits-all" approach is not comprehensive for the diverse disability
      community.

      This research entails the design and development of CODY (co-design for you), a Virtual
      Reality (VR) tool and Application Programming Interface (API), which uses an immersive,
      interactive environment for using, experiencing and co-designing home alterations. The
      'co-design' nature of CODY denotes that persons with movement disorders, such as Parkinson's
      disease can: virtually interact with and experience a home alteration/modification (HM) in a
      virtual, simulated environment; have multiple variations of a HM that the user can choose
      from; and is able to assess and manipulate the HM for appropriateness to one's need and
      circumstances before actually installing devices or making modifications to one's own home.
      As such, CODY is a new assistive technology that aids and enhances the ability of individuals
      with disabilities to live in adapted homes that supports their needs.

      This study focuses on movement disorders faced by persons with Parkinson's disease (PD) to
      demonstrate how effective CODY may be for those with major movement challenges, characterized
      by tremor, bradykinesia, postural instability, and freezing of gait (FoG). Collectively,
      these symptoms increase fall risk, fear of falling and impact the quality of life when
      compared to other age-matched non-PD adults. While clinical observations suggest that
      attributes of the physical interior environment may make daily activities easier or harder
      for persons with PD, few studies have actually examined the impact of specific changes in
      interior design on an individual's performance. One research study revealed that FoG, one of
      the major contributors to falls, was induced by doorways. Another study similarly revealed a
      significant increase in doorway-provoked FoG indicators by decreasing doorway width.

      The aims of this research are: (1) To develop the Virtual Reality-based CODY tool and
      corresponding API; and (2) To assess the efficacy of using CODY to aid and enhance the
      ability of persons with PD to experience and choose appropriate home modifications. The
      underlying purpose of CODY is to provide opportunities for the growing population of persons
      with movement disabilities and disorders to actively engage in decisions affecting their
      living environment. Although VR games have been used for rehabilitation and therapy purposes,
      no research studies exist that demonstrate the use or effectiveness of integrated VT
      simulations in allowing persons with disabilities to interactively design residential
      alterations. The study team's expectation is that CODY will not only be successful in this
      short-term pilot study, but will lead to further refinement, development and, potentially, a
      commercial product. The investigators envision CODY's integrated, immersive, and interactive
      simulation will be used by neurologists, rehabilitation specialists, and occupational
      therapists for working with consumers to assess and determine optimal home modifications for
      those with ambulatory and other movement impairments.
    

Intervention name(s): Doorway Width Test; Door Frame Color Test
Intervention type(s): Other; Other
Intervention description(s): The first test consists of Doorway Width. Standard level is a doorway width of 30 inches; Enhanced is doorway width of 36 inches; Co-design allows the participant to adjust the width anywhere from 26 to 48 inches.; The second test consists of Door Frame Color. Standard level is same color (hue) as light-color wall; Enhanced level is same hue but of higher color intensity for contrast; Co-design allows the participant to adjust the color intensity range from lowest (same as wall) to highest intensity (stronger contrast than in Enhanced).
Other intervention name(s): Test #1; Test #2
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: There are 3 types of door alterations in a simulated residential setting being tested: Standard (conforms to conventional residential building practices); Enhanced (conforms to Americans with Disabilities Act or ADA residential building practices or recommendations); and Co-design.
Masking: None (Open Label)
Primary purpose: Supportive Care