Abstract：
BACKGROUND: Declines in instrumental activities of daily living (IADLs) have been proposed as a prodromal marker of Parkinson\'s disease (PD). The Cleveland Clinic Virtual Reality Shopping (CC-VRS) platform combines an omnidirectional treadmill with a virtual reality headset to create a virtual grocery store that a user physically walks through and completes a shopping task. The primary aim of this project was to determine the known-group validity of the CC-VRS platform in discriminating IADL performance and to characterize specific motor and cognitive declines responsible for PD-related IADL impairments.
METHODS: Sixteen individuals with PD and 15 healthy adults completed traditional motor, cognitive, and IADL assessments and the CC-VRS task. Group differences were evaluated using Welch\'s t-test.
RESULTS: There were no between-group differences in traditional performance measures of motor, cognitive, or IADL function. Regarding CC-VRS performance, participants in the PD group completed the task significantly slower than controls (690 vs. 523 sec, respectively). Participants with PD spent 25 % more time walking and turning and were stopped 46 % longer than controls. Average gait speed when viewing the shopping list, a measure of dual-task performance, was significantly slower in the PD group compared to controls (0.26 vs. 0.17 m/s, respectively).
CONCLUSIONS: Unlike traditional performance measures of motor, cognitive, and IADL function, the CC-VRS discriminated participants with PD from healthy older adults. For the PD group, motor and dual-task declines contributed to diminished CC-VRS performance. Identifying underlying contributors to IADL declines supports using ecological assessments, such as the CC-VRS, for the routine clinical evaluation of IADLs.
METHODS: Sixteen individuals with PD and 15 healthy adults completed traditional motor, cognitive, and IADL assessments and the CC-VRS task. Group differences were evaluated using Welch\'s t-test.
RESULTS: There were no between-group differences in traditional performance measures of motor, cognitive, or IADL function. Regarding CC-VRS performance, participants in the PD group completed the task significantly slower than controls (690 vs. 523 sec, respectively). Participants with PD spent 25 % more time walking and turning and were stopped 46 % longer than controls. Average gait speed when viewing the shopping list, a measure of dual-task performance, was significantly slower in the PD group compared to controls (0.26 vs. 0.17 m/s, respectively).
CONCLUSIONS: Unlike traditional performance measures of motor, cognitive, and IADL function, the CC-VRS discriminated participants with PD from healthy older adults. For the PD group, motor and dual-task declines contributed to diminished CC-VRS performance. Identifying underlying contributors to IADL declines supports using ecological assessments, such as the CC-VRS, for the routine clinical evaluation of IADLs.
摘要：
背景：日常生活工具活动（IADL）的下降已被认为是帕金森病（PD）的前驱标志。克利夫兰诊所虚拟现实购物（CC-VRS）平台将全方位跑步机与虚拟现实耳机相结合，以创建用户实际走过并完成购物任务的虚拟杂货店。该项目的主要目的是确定CC-VRS平台在区分IADL表现方面的已知组有效性，并表征导致PD相关IADL损伤的特定运动和认知下降。
方法：16名PD患者和15名健康成年人完成了传统运动，认知，以及IADL评估和CC-VRS任务。使用Welcht检验评估组差异。
结果：传统的运动表现指标没有组间差异，认知，或IADL函数。关于CC-VRS性能，PD组的参与者完成任务的速度明显慢于对照组(690vs.523秒,分别)。患有PD的参与者花费的步行和转弯时间比对照组多25%，停止时间比对照组多46%。查看购物清单时的平均步态速度，衡量双重任务绩效的指标，与对照组相比，PD组明显更慢(0.26vs.0.17m/s,分别)。
结论：与传统的运动性能测量不同，认知，和IADL函数，CC-VRS将PD参与者与健康老年人区分开来.对于PD组来说，电机和双任务下降导致CC-VRS性能下降。确定IADL下降的潜在原因支持使用生态评估，例如CC-VRS，用于IADLs的常规临床评估。
方法：16名PD患者和15名健康成年人完成了传统运动，认知，以及IADL评估和CC-VRS任务。使用Welcht检验评估组差异。
结果：传统的运动表现指标没有组间差异，认知，或IADL函数。关于CC-VRS性能，PD组的参与者完成任务的速度明显慢于对照组(690vs.523秒,分别)。患有PD的参与者花费的步行和转弯时间比对照组多25%，停止时间比对照组多46%。查看购物清单时的平均步态速度，衡量双重任务绩效的指标，与对照组相比，PD组明显更慢(0.26vs.0.17m/s,分别)。
结论：与传统的运动性能测量不同，认知，和IADL函数，CC-VRS将PD参与者与健康老年人区分开来.对于PD组来说，电机和双任务下降导致CC-VRS性能下降。确定IADL下降的潜在原因支持使用生态评估，例如CC-VRS，用于IADLs的常规临床评估。
