Background and Rationale: Parkinson’s disease (PD), the second-most prevalent neurodegenerative disease globally, is characterised by a range of motor and non-motor symptoms that affect function, independence and quality of life. Despite the known benefits of exercise and physical activity, research has found that people living with Parkinson’s disease are often less active and lonelier than the general population.(1, 2) To motivate exercise participation, access to options that are beneficial, enjoyable, inclusive and social are needed.3 However, barriers such as location, time constraints, resource challenges and a lack of transport or support can impede participation. Research has demonstrated the feasibility and perceived benefits of home-based physical exercise programs delivered via telehealth-based approaches.(4) As digital technologies improve, and new telehealth related innovations become available and more affordable, there are opportunities to address some of the barriers in more informed ways. Anticipatory technology assessments can prove effective in creating a space in bringing together diverse disciplines from healthcare, technological science, technology governance and policy to collaborate in assessing the complexities of potential emerging applications. MotiVerseP is an approach that brings together a variety of experts to work on an anticipatory technology assessment for the use of the metaverse as a therapeutic virtual space for movement-focused therapies for people living with PD. Continuing with the potential benefits of digital technologies and applications for health the emerging innovation of the Web 4.0, Virtual-Worlds and metaverses are gaining more consideration as a potential high-value (therapeutic) strategy (WEF).
Using the metaverse presents tangible opportunities to deliver virtual health care in a high-level immersive virtual environment that could benefit patient, practitioners and service providers. The appeal of the metaverse as a therapeutic space is most evident in that the metaverse has the potential to provide a new high-quality immersive virtual experience. The high-quality experience can be easily created into a form deemed to be most suitable to the requirements and can be created in many forms, for example, a virtual digital twin of an existing physical space such as a familiar setting. Hence, the virtual surroundings of the therapeutic metaverse offer many potential positives. Moreover, the technical and cost requirements to access the metaverse are anticipated to be low to moderate given that a person’s smartphone will most likely facilitate connectivity and some processing aspects. The accessibility and safe use of the metaverse in a therapeutic setting requires comparatively less training and investment in part due to the functionality of the metaverse as a realistic recreation of the physical world and physical spaces. Furthermore, the use of the metaverse offers the potential to enable greater access to an enhanced rehabilitation experience for people living with Parkinson’s disease by providing a multisensory shared rehabilitation experience, thereby encouraging participation, peer support, health and wellbeing.
In advance of exploring this novel solution, key challenges and opportunities need to be identified to create person-centred recommendations for future research and practice. The proposed research will carry out an anticipatory technology assessment (TA) for the proposed use of the metaverse for people living with Parkinson’s disease. In addition, we will involve people living with Parkinson’s disease and transdisciplinary expertise to document points of concern, as well as what they note as high value opportunities to formulate a context-specific risk/benefits informed framework that can act as an initial tool to lay the ground for subsequent more detailed assessments regarding the suitability of the metaverse as a platform to support people living with Parkinson’s disease.
Aim: To identify the barriers, risks and opportunities in research and practice in the use of the metaverse in rehabilitation for people living with Parkinson’s disease and to consider the key ethical considerations involved in its use, which will inform a key set of recommendations for future research and practice.
Methods: Our MotiVerseP Working Group (WG) will advance its work through series of online meetings and in-person workshops. We will undertake a scoping review to identify and map the existing literature in the area and use Transparent Expert Consultation methods to identify key priorities during the online and in-person workshops. Findings on the use, feasibility and potential quality of the metaverse as an experiential virtual space for motivating therapeutic engagement will be discussed by the WG members, and our Public and Patient Involvement (PPI) panel of advisors will be involved in the discussion and interpretation of the results of these exercises.
Outcome: Our WG will produce a report that contains an initial TA framework, guidelines and recommendations that will act as reference points for the wider research community in planning and delivering future studies and relevant research questions to be tackled in the future.
