Objective: The purpose of this quality improvement (QI) project is to determine the feasibility of using a virtual reality boxing program (VRBP) in Parkinson disease (PD).

Background: PD is characterized by progressive motor and cognitive decline. Physical exercise has a positive impact on PD, improving muscle strength, balance, posture, gait, cognition, mood, and quality of life. Multiple exercise modalities have been tested including boxing program. However, these typically require visits to a facility, which may not be accessible to all patients and may not suit those with poor strength and motivation. VR-based physical activities can be more engaging, easily accessible, and effective compared to conventional exercise regimen. This study aims to determine the feasibility of using VRBP in PD patients.

Method: Subjects with PD seen at Parkinson’s Disease Research, Education and Clinical Center, Michael E. DeBakey Veterans Affairs Medical Center, were offered VRBP participation. The VR equipment included a headset and two controllers, with WIFI needed only for data download. All sessions were supervised with patients seated. Following the four-minute session, participants completed a satisfaction survey.

Results: Eleven individuals participated. Accuracy data was captured for seven subjects. Mean Hoehn and Yahr (H&Y) stage was 2.5. Average accuracy for hitting the ball in VRBP was 95.82%±3.15%. The minimum accuracy was 88.4% (participant with H&Y stage 2.5), and the maximum was 98.78% (participant with H&Y Stage 2.0). No adverse effects were reported. Survey results using a 5-point scale showed: Enjoyability (Mean = 4.72±0.62), likelihood to recommend to others for PD treatment (Mean=4.63±0.88), quality of exercise (Mean=4.54±0.78), future participation (Mean = 4.82±0.57). For future sessions, 63.6% preferred a hybrid option of VR and in-person (IP) therapy. 27.3% preferred VR only, and 9.1% preferred IP therapy only.

Conclusion: VRBP can be used safely and effectively in the clinic and was positively received by participants in this QI study.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/virtual-reality-boxing-program-for-individuals-with-parkinsons-disease-a-quality-improvement-project/