Gait Analysis by Induced Disorientation in a VR Environment

Study Overview
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Brief Summary
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The aim of the study is to investigate whether the effect of disorientation on physical motion and gait among dementia patients, can be reliably measured in a laboratory environment, by means of a virtual reality (VR) experimental setup.

Detailed Description
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Challenges in wayfinding and orientation are early symptoms of MCI and dementia. These deficits decrease mobility which again leads to further cognitive decline. In a field study, we developed a pattern recognition model of disorientated behaviour based on accelerometric data. However, it is questionable if phases of disorientation also affect gait parameters. Furthermore, there is growing evidence that impaired cognitive functioning is associated with changes in gait performance, e.g. gait variability, measured in dual-task walking conditions. Increases in heart rate and skin conductance have also been reported during instances of disorientation. Hence, We implemented a 3D environment of a familiar city centre in the GRAIL, which combines a fully instrumented treadmill with a synchronized VR environment. We record gait parameters through the motion capture system, and accelerometric and physiological data using wearable sensors (movisens), for comparability with the SiNDeM field study. Young and old healthy adults will participate in the first phase of the study, while Mild dementia or MCI patients will participate in the later phases. Phases of disorientation will be induced by changing the virtual environment.We aim to assess gait, accelerometric and physiological parameters during instances of disorientation, using the GRAIL (Gait Real-Time Analysis Interactive Lab, Motekforce Link). The results will further enable the automatic detection of disorientation based on gait parameters, physiological and accelerometric data. This is necessary for the development of a situation-aware assistive system which supports persons with dementia in autonomous outdoor mobility.

Official Title
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Evaluation of a Navigation Experiment in the Gait Real-Time Analysis Interactive Lab: Gait Analysis by Induced Disorientation in a VR Environment

Conditions
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Mild Cognitive Impairment, Mild Dementia, Disorientation, Young Adults, Older Adults

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Within the required age bracket Mobile Dementia Exclusion Criteria: Other neurological conditions besides dementia Inability to understand task instructions, deaf-mute, blindness

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Young Adults<br>Neurologically healthy young adults between ages 18 and 40 | |
| Older Adults<br>Neurologically healthy older adults between ages 60 and 85 | |
| Mild Cognitive Impairment/Mild Dementia<br>Older adults between ages 60 and 85 with Mild Cognitive Impairment or Mild Dementia | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Spatial disorientation | Incidences of disorientation will be captured in a video record during the experiment, and then later identified in an off-line annotation procedure using a customized annotation scheme | Up to 3 years from start of the study | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gait variability | Incidences of change in gait pattern will be measured using the gait capturing system of the GRAIL (gait real-time analysis interactive lab) | Up to 3 years from start of the study | 
| Spatial orientation ability | Older adult participants' spatial orientation ability will be evaluated using the Perspective taking spatial orientation test (PTSOT). No predefined range. Lower scores indicate better spatial orientation ability. Formula: sum of true angles - sum of expressed angles | Up to 3 years from start of the study | 
| Heart rate variability | Rate of change in heart rate will be measured using a wearable electrocardiographic sensor | Up to 3 years from start of the study | 
| Skin conductance | Rate of change in electrodermal response will be measured using a wearable electrodermal activity sensor | Up to 3 years from start of the study | 
| Accelerometery | Incidences of change in walking pattern will be measured using accelerometers | Up to 3 years from start of the study | 
| Apolipoprotein E4 status | Presence of the variants Apo-E2, E3 and -E4 in the blood samples | Up to 3 years from start of the study | 
| Visuospatial function | Older adult participants' visual constructive ability will be evaluated using the figure copy part of the Rey-Osterrieth complex figure test (ROCF). Higher scores indicate better visual constructive ability. Range 0-31 | Up to 3 years from start of the study | 
| Memory function | Older adult participants' spatial memory will be evaluated using the figure recall part of the Rey-Osterrieth complex figure test (ROCF). Higher scores indicate better memory. Range 0-31 | Up to 3 years from start of the study | 
| Executive function | Older adult participants' executive function will be evaluated using the Trail making test (TMT A/B). Lower scores indicate better executive function. No predefined range | Up to 3 years from start of the study |