In a non-descript room of an eerily quiet wing of South Street Hospital, Mandar Jog’s work may look like a game to some. But the outcome could have a tremendous impact when it comes to the treatment of Parkinson’s disease and other neurological movement disorders.
Patients with Parkinson’s struggle with multitasking. Activities like answering the door or getting out of bed involve a number of decisions that can be overwhelming, which puts them at high risk for falls and reduced mobility, said the professor in the Department of Clinical Neurological Sciences at Western.
Most research is limited to assessing isolated movements, such as walking back and forth in a straight line. To capture the complexities of everyday tasks, Jog is using a technology called ‘augmented immersion virtual reality’ (AIVR), which allows patients to perform real-life tasks.
In this particular project, Jog, director of the National Parkinson Foundation Centre of Excellence at London Health Sciences Centre, is testing patients’ ability to conduct three everyday tasks: watering plants in their home, crossing the street at a cross-walk and selecting particular items from a grocery store shelf.
“We’re studying Parkinson’s in terms of how patients with this neurodegenerative condition navigate their environments,” said Jog, adding all of us navigate our physical environment with goal-directed tasks. “Research into Parkinson’s disease in terms of mobility and motion generally has been concentrated on in-laboratory assessments, which don’t simulate the reality of what the actual environment is.”
While there has been extensive work done in understanding gait, balance and navigation in the lab setting, Jog said realistically most of our tasks are in a real-world environment.
“It’s difficult in a laboratory environment to bring in such an environment, which means there’s a gap in knowledge and, potentially, a gap in how we provide service to a patient with these conditions.”
With Jog’s research, an environment has been created virtually by his team, which is then transmitted to his patients through a set of virtual reality goggles. As patients move around the room, the goggles ‘read’ a series of sensors and markers that indicate where the walls, windows and other objects are located.
Real objects, such as cereal boxes and a watering can, are also placed within the room for the patients to interact with. They are also equipped with sensors and tools to measure their balance, gait and other data.
As this project unfolds, Jog and his team will assess how patients with Parkinson’s perform within each virtual scenario and whether their performance improves with repetition. He will also assess whether the technology impedes users’ performance in any way, such as altering their sense of balance.
Jog said he received tremendous support in creating the virtual environment from Mike Katchabaw, professor and undergraduate chair in the Department of Computer Science.
While dealing with gaming technologies is his forte, using his skills for non-entertainment purposes, or what they call serious gaming, Katchabaw created the rooms markers and software used in the research.
“While the markers don’t look like they make any sense to us, the camera will recognize them and understand what that marker is and what it represents,” said Katchabaw, thus creating the augmented virtual reality feeling. “Augmented in the fact that we have this virtual world that we’ve created on the computer, but instead of completely replacing everything, we are overlaying aspects of the virtual overtop the real.
“The advantage is that it makes it easier for the patients to interact with objects.”
Katchabaw added Jog had great ideas about what he wanted to accomplish in understanding more about Parkinson’s, but not about creating the software needed.
“He came to me and it was like ‘We do this all the time,’” Katchabaw said. “It was a great opportunity to collaborate and bring together our two worlds, learn a bit from each other and create something that’s really special.”
While his research will create valuable data for better understanding neurological disorders, Jog said there is also a product component to this, with software that could soon have the involvement of industry.
“You want to be able to put out a product that has marketability, and that is usable in Chatham or Sault Ste. Marie or wherever,” Jog said. “You don’t want goggles that are $10,000 that no one can buy. This can be an off-the-shelf product that can be portable and affordable.”
He added don’t be surprised if in a couple years you will find this shrink wrapped in a box and available in a Shopper’s Drug Mart rehab store with goggles and software that therapists or hospitals can use on a multitude of patients.
“The ability to interact with technology has already entered our daily lives with devices such as the smart phone and tablet computers,” Jog said. “We are now entering a new and innovative world of augmented virtual reality to help aid in improving how rehabilitation is provided to patients with degenerative neurological disorders.”