Parkinson’s disease is a progressive neurodegenerative disease that affects nearly 200,000 people in France. Beyond drug treatment, rehabilitation plays a central role in maintaining patients’ autonomy. Among the emerging approaches, virtual reality is attracting growing interest in the community of physiotherapists and occupational therapists. What does science really say about its effectiveness? This article takes stock of the available clinical data and the concrete applications of the H’ability device for your Parkinson’s patients.

Parkinson’s rehabilitation in virtual reality: why should you be interested?

Parkinson’s disease is characterized by a triad of motor symptoms : tremors at rest, muscle rigidity, and bradykinesia (slowness of movement). In addition to these symptoms, there are problems with balance, walking and cognitive functions that considerably increase the risk of falls and loss of autonomy.

However, conventional rehabilitation faces two major obstacles. On the one hand, it requires intensive repetition of exercises to induce long-lasting neuroplasticity. On the other hand, patients’ motivation tends to erode over the course of the sessions, which reduces treatment compliance in the medium term.

This is precisely where virtual reality comes in. Indeed, it makes it possible to combine training intensity, real-time feedback and patient engagement in an immersive environment that diverts attention from motor impairment.

What the studies say about VR and Parkinson’s

The scientific literature on this subject is now solid. For example, a meta-analysis published in 2023 in the Journal of NeuroEngineering and Rehabilitation (Kwon, Park & Koh) confirms that virtual reality rehabilitation significantly improves balance function in Parkinson’s patients compared to conventional treatments alone. This meta-analysis analysed all available randomised controlled trials up to May 2022.

In addition, a randomized controlled trial by Feng et al. (2019) on Parkinson’s patients shows that VR rehabilitation improves BBS (Berg Balance Scale), TUGT (Timed Up and Go Test) and UPDRS3 (motor assessment) scores compared to conventional physiotherapy alone. In addition, patients who received VR had a better quality of life at the end of the protocol.

Finally, a more recent study by Kashif et al. (2024) compares three therapeutic approaches in Parkinson’s patients: VR alone, motor imagery alone, and routine physiotherapy. The result: the combination of VR + routine physiotherapy is the most effective in improving balance, motor function and activities of daily living.

What are the concrete benefits for your patients?

Beyond the figures, here is what virtual reality vestibular rehabilitation brings to the management of Parkinson’s disease:

• Improved balance and walking: Immersive exercises engage the proprioceptive system and postural reflexes in varied and progressive conditions, reducing the risk of falling.
• Neurological stimulation: a 2024 study (Skrzatek et al.) shows that exergaming training induces positive changes in brain functional connectivity in sensorimotor and attentional networks.
• Dual cognitive and motor tasks: VR games naturally integrate cognitive components (attention, mental flexibility) simultaneously with motor exercises, which corresponds to the real deficit of the Parkinson’s patient in his daily life.
• Maintaining motivation: Gamified scores and visible progress encourage the patient to maintain regular sessions, including outside the office.
• Objective monitoring data: the H’ability device records kinematic data, reaction times and scores at each session, allowing precise and documented monitoring of the patient’s progress.

How to integrate VR into your Parkinson’s protocol?

The H’ability device offers several categories of exercises directly applicable to Parkinson’s patients:

• Static and dynamic balance (sitting or standing, 180° or 360°) to work on postural control and support transfers.
• Cognitive functions : divided attention, working memory, mental flexibility, and visual exploration—particularly relevant for patients with hemineglect or mild cognitive decline.
• Upper limb motor skills : joint mobility, coordination, fine grip — adapted to tremors and rigidity.
• Lower limbs : thanks to the Pico 4 ankle trackers, H’ability offers specific exercises for the rehabilitation of the lower limbs, particularly useful for the rehabilitation of Parkinson’s walking.

One point of attention: severe postural instability

Some advanced Parkinson’s patients have significant postural instability that requires enhanced supervision during VR sessions. The mixed reality mode integrated into the H’ability device is particularly suitable in this context: the patient sees his or her real environment constantly, which reduces the risk of imbalance and reassures reluctant patients. In addition, the H’ability device is not indicated for patients with severe behavioral disorders.

« Avec H’ability, la personne peut effectuer des mouvements dans un environnement sécurisé. C’est souvent source d’émerveillement pour eux de réaliser qu’ils ont réussi un geste, et sans avoir eu mal, sans qu’ils s’en soient rendu compte pendant l’exercice. »

— Ninon Playe, occupational therapist, LADAPT de l’Aube

FAQ — Frequently asked questions about Parkinson’s rehabilitation in virtual reality

What is Parkinson’s rehabilitation in virtual reality?
Parkinson’s rehabilitation in virtual reality consists of using a VR headset to offer the patient immersive exercises targeting balance, walking, fine motor skills and cognitive functions. In other words, it complements conventional physiotherapy by providing motivation, objective feedback and neurological stimulation.

Is virtual reality effective for Parkinson’s disease?
Yes. A meta-analysis by Kwon et al. (2023) confirms that virtual reality rehabilitation significantly improves balance in Parkinson’s patients compared to conventional treatments alone. In addition, several randomized controlled trials show improvements in walking and motor skills.

What Parkinson’s symptoms can VR improve?
Virtual reality mainly affects balance, step length, walking speed, upper limb motor skills and cognitive functions. Some studies also show effects on neuroplasticity and brain functional connectivity. However, the results on walking speed alone remain less significant according to the protocols.

How many VR sessions does it take for a Parkinson’s patient?
The protocols studied vary between 10 and 36 sessions, at a rate of 3 to 5 sessions per week. In practice, the first improvements are usually seen after 4 to 6 weeks of regular rehabilitation. That’s why consistency is a key factor for success.

Does VR replace conventional physiotherapy for Parkinson’s?
No, virtual reality is not a substitute for physiotherapy. It completes it by bringing an immersive, motivating and objective dimension. On the other hand, the best results are obtained by combining VR and conventional physiotherapy, as shown by several randomized controlled trials, including that of Kashif et al. (2024).

References:

• Kwon, S. H., Park, J. K., & Koh, Y. H. (2023). A systematic review and meta-analysis on the effect of virtual reality-based rehabilitation for people with Parkinson’s disease. Journal of NeuroEngineering and Rehabilitation, 20(1), 94. Read the study
• Kashif, M., Albalwi, A. A., Zulfiqar, A., Bashir, K., Alharbi, A. A., & Zaidi, S. (2024). Effects of virtual reality versus motor imagery versus routine physical therapy in patients with Parkinson’s disease: a randomized controlled trial. BMC Geriatrics, 24(1), 229. Read the study
• Feng, H., Li, C., Liu, J., Wang, L., Ma, J., Li, G., Gan, L., Shang, X., & Wu, Z. (2019). Virtual Reality Rehabilitation Versus Conventional Physical Therapy for Improving Balance and Gait in Parkinson’s Disease Patients: A Randomized Controlled Trial. Medical Science Monitor, 25, 4186–4192. Read the study