Influence of cueing, feedback and directed attention on cycling in a virtual environment: Preliminary findings in healthy adults and persons with Parkinson's disease

Evidence based virtual environments that incorporate motor learning and compensatory strategies such as feedback and cueing may change motor behavior while also being engaging and motivating. Although virtual environments have been used for exercise promotion in healthy people and persons with stroke, its use for fitness in persons with PD has not been investigated. Further a specific understanding of embedding cueing and feedback in a virtual environment is absent. METHOD: We tested two groups of participants, older adults (n=4) and people with Parkinson's disease (n=4) as they cycled on a stationary bicycle while interacting with a virtual environment. Participants cycled under 4 conditions; auditory cueing, visual cueing, feedback, and directed attention. Data between groups were analyzed using a 2 × 2 factorial RM ANOVA and within groups using a RMANOVA with post-hoc t-tests corrected for multiple comparisons. RESULTS: There were no between group differences, however, within groups healthy older adults increased their cycling speed in the auditory cueing (F 21.59, p=0.000) and directed attention conditions (F 6.04, p=0.030). For people with PD pedaling rate increased in the auditory cueing (F 4.78, p=0.029, visual cueing (F 26.48, p<0.000), feedback (F 18.77, p<0.000), and directed attention conditions (F 27.65, p<0.000). These data serve as preliminary validation of embedding cues, feedback to alter cycling speed in a VE. Further, the role of directing attention to the cues enhances cycling performance.