Augmented and mixed reality for rehabilitation of people living with Parkinson’s disease: a scoping review

Background Extended reality technology, including virtual, augmented, and/or mixed reality, has the potential to create an engaging rehabilitation experience for people living with Parkinson’s disease (PwPD). Systematic reviews have explored the use of immersive virtual reality in rehabilitation for PwPD, however, studies employing mixed and augmented reality have yet to be systematically identified and mapped. As opposed to fully immersive virtual reality, mixed or augmented reality users can see their physical environments alongside digital elements, which may be beneficial in rehabilitation contexts for PwPD to reduce fall risk. Methods: Studies examining mixed or augmented reality in rehabilitation for PwPD were identified via a scoping review. Systematic searches were conducted of Scopus, Embase, PubMed, PsycInfo, and CINAHL, followed by grey literature searches of Google Scholar, ProQuest Dissertations and Theses/Conference Proceedings, Canada’s Drg Agency Grey Matters Tool, and the Overton Index. Results were screened independently by two reviewers, with two additional reviewers available for cross-checking and discussion. Results 26 studies met the inclusion criteria. 19 studies used head-mounted displays, while seven used treadmills with sensory feedback. Interventions focused most often on addressing motor symptoms via gait, balance, and task-specific training, and took place in settings including laboratories, clinical environments, and the home. Notably, long-term engagement with mixed or augmented reality technology was under-explored, with 12 out of 26 studies examining only a single session. Only one study included qualitative methods, and none of the included studies examined early-onset PD. Conclusion This scoping review identified a need for qualitative work on mixed and augmented reality in rehabilitation for PwPD, in order to better understand user experience. Additionally, longer studies are needed to examine potential long-term benefits and issues surrounding engagement with this technology over time. Future research could also explore applications of this technology for addressing non-motor symptoms, and use for people with early-onset PD.