Virtual reality brings real life Parkinson’s awareness

Neuroscientist Kaylena Ehgoetz Martens
Neuroscientist Kaylena Ehgoetz Martens

Canadian neuroscientist Kaylena Ehgoetz Martens has more than an academic interest in uncovering the reasons why almost half of everyone in the advanced stages of Parkinson’s disease experiences terrifying moments of being unable to move.

For three years, Ehgoetz Martens worked at an exercise rehabilitation program with a woman with Parkinson’s disease who experienced severe freezing of her gait. Three times a week, she helped the woman master a series of sensory-based and coordination exercises at the Movement Disorders Research and Rehabilitation Centre at Wilfrid Laurier University. At the end of their work together, the woman went from being largely wheelchair bound to walking short distances. More importantly, her less frequent falls and increased independence improved her outlook on life.

“It totally changed her mood,” Ehgoetz Martens says. “Whenever she was able to walk unassisted, her mouth would be open, smiling from ear-to-ear. It was really important to me that we were able to change how independent and worthwhile she felt for those last few years.”

The woman has since died, but she inspired the neuroscientist’s determination to pursue a research career focused on freezing of gait. Ehgoetz Martens pursued a PhD that demonstrated the link between anxiety and freezing.

Using virtual reality tools, she studied the gait of people with Parkinson’s who walked across a plank that was lying on the floor. When participants wore a headset that created a virtual environment, the program would suddenly “drop” the floor from under the plank, so the participants appeared to be walking nine metres above a deep pit.

Subjects involved in the study included a control group of people without Parkinson’s, and two groups of people who have Parkinson’s: those that experienced freezing of their gait; and those that did not. The latter group were classified as either high anxiety or low anxiety, through a questionnaire. Those with low anxiety reacted closer to people without Parkinson’s, and those with high anxiety reacted similar to those people with Parkinson’s who experience freezing of gait.

“The study demonstrated that anxiety provokes movement breakdown, slower walking and freezing in Parkinson’s disease,” says Ehgoetz Martens. Researchers are beginning to investigate more how the non-motor symptoms of Parkinson’s have an impact on the motor symptoms of the disease.

Last fall Ehgoetz Martens co-authored a research paper with Eric Beck and Dr. Quincey Almeida titled: “Freezing of Gait in Parkinson’s disease: An Overload Problem?”1. Partially funded by Parkinson Canada, the study involved a series of experiments to better understand the underlying causes of freezing of gait and to explore the interaction between cognitive function and sensory-perceptual influences, in this case visual cues. Beck was the primary investigator of the experiments at Wilfrid Laurier University, which were part of his ambitious undergraduate thesis.

Experiment pathways with and without visual cues and a devise to block the sight of leg movements.
Experiment pathways with and without visual cues and a devise to block the sight of leg movements.

Two groups of people with Parkinson’s – one group of “freezers” and one group of “non-freezers” – walked a straight path towards and through, a doorway. In one instance they also had to count the number of times they heard two digits spoken aloud while they walked (dual-task.) Sometimes the path they walked was marked into segments (visual cues) and sometimes the view of their legs moving was blocked from their vision. (See photo, right.) The gait and gaze of the participants was measured during these tasks.

The study found that freezing of gait (FOG) in people with Parkinson’s may be the result of an overload of processing resources in the brain. “The basal ganglia section of the brain, which is affected by Parkinson’s, contains a lot of our “core processors,” explains Ehgoetz Martens. “If they are damaged, our processing capacity is diminished. Visual cues may decrease the demand on the basal ganglia’s processing resources by promoting gait control though alternative pathways in the brain.”  However, Ehgoetz Martens acknowledges that most of us eventually “habitualize” visual cues, so they may no longer be helpful. Further investigation may help with effective strategies to alleviate freezing.

While attending an International Movement Disorder Congress in 2013, Ehgoetz Martens met associate professor Simon Lewis of the University of Sydney and director of the Parkinson’s Disease Research Clinic at the Brain & Mind Research Institute. The Australian researchers are some of the leaders in freezing of gait, reports Ehgoetz Martens.

When she completed her PhD in Canada, Ehgoetz Martens investigated research positions in Australia. She was awarded a two-year, $80,000 Basic Research Fellowship from Parkinson Canada’s National Research Program and is now living and working in Australia at the University of Sydney. “This funding from Parkinson Canada is absolutely critical,” says Ehgoetz Martens. “I could not have pursued this research without it and I am incredibly grateful!”

She will be investigating how anxiety triggers freezing in Parkinson’s by conducting research on patients participating in virtual reality scenarios while they are in a functional magnetic resonance imaging machine. As they manipulate foot pedals to simulate walking, the fMRI will scan their brains to chart the brain structures active during freezing.

It is hoped that the research will result in a new model to determine what causes freezing of gait and new ways to treat and reduce the anxiety that triggers it because part of improving quality of life and even disease severity, comes from treating these non-motor symptoms.
You can read more about this research, along with profiles of other projects funded by Parkinson Canada, at www.parkinson.ca.


1 Beck EN, Ehgoetz Martens KA, Almeida QJ (2015) Freezing of Gait in Parkinson’s Disease: An Overload Problem? PLoS ONE 10(12):e0144986. doi: 10.1371/journal.pone.0144986

Communities are stepping up for Parkinson Awareness Month this April

It Takes a Community to educate, advocate for, and support people living with Parkinson’s and their families, as well as continue the search for a cure. From advertising to webinars and from a wing-eating contest to a research presentation, Parkinson communities across the country are gearing up now for Parkinson Awareness Month this April.

Celina Chavannes, MP Whitby and parliamentary secretary to the Prime Minister, will make a statement in the House of Commons on April 11, World Parkinson Day. Several MPPs and MLAs and a senator are being asked to make statements recognizing Parkinson Awareness Month. Local Parkinson Canada groups are also approaching municipal officials to publicly proclaim April as Parkinson Awareness Month.  For a more complete schedule of what’s happening in your community, visit the interactive map on our website for local event listings.

You may see Parkinson Canada ads in your local newspaper or on TV. You may hear them on your favourite radio station. There may be posters in your neighbourhood, promoting local awareness, education and fundraising events throughout April. The following are just a sampling of the many events planned across the country for next month. Take note that some require advance registration as spaces fill up quickly.

Join us online for a cross-Canada webinar. Voice and communications therapies in Parkinson’s disease: Evidence, timing and techniques. Presented by Dr. Angela Roberts, speech-language pathologist and Parkinson Canada-funded researcher. April 15, noon to 1 p.m. EDT. Computer required. Advance registration required.

Celebrating Life art gala. Friday, April 15, 7 to 9 p.m. Saskatoon Inn, 2002 Airport Dr., Saskatoon, SK. $25 per person. For more details, visit the online event calendar and to register, contact michelle.carlson@parkinson.ca or 306-933-4481. Registration deadline is April 8.

Celebrating Life education conference. Saturday, April 16, 9:30 a.m. to 3 p.m. Saskatoon Inn, 2002 Airport Dr., Saskatoon, SK. $65 per person. For more details, visit the online event calendar and to register, contact michelle.carlson@parkinson.ca or 306-933-4481. Registration deadline is April 8.

Wingin’ It for Parkinson’s. Hosted by Tim Hague Jr., who along with his father Tim Hague Sr, won the first Amazing Race Canada. This fundraising event features wing-eating relays, on Saturday, April 2 at the King’s Head Pub in Winnipeg. For more details and to register a team today, visit winginit.ca.

Contents under Pressure conference.  Enjoy expert speakers, an exercise break, good company and a hot lunch. April 23, 10:30 a.m. to 3 p.m., Viscount Gort Hotel, 1670 Portage Avenue, WinnipegRegistration and payment must be received by April 18.

Hope in Bloom. In centres large and small across Ontario, volunteers will be selling tulips, a traditional sign of spring and the international floral symbol of hope for people living with Parkinson’s. Pots of tulips and bouquets of cut stems will be sold for $10 each in public venues, raising both awareness and funds.

Comedy night for Parkinson’s. Parkinson Canada proudly partners with Yuk Yuk’s for a laugh- out-loud fundraising event, April 2, in Ottawa. Pre-show social and silent auction at 6:30 p.m. in the Atrium with cash bar and snacks for sale by Sue’s Sweets. More details and tickets at Centrepointe Theatres Box Office. To purchase accessible seating, please call 613-580-2700.

Public lecture on sleep disorders and Parkinson’s. Parkinson Canada (Québec) and the Cummings Centre (Gelber Centre) will co-present a public lecture by Dr. Ron Postuma on sleep disorders and Parkinson’s disease on Thursday, April 7, at the Cummings Centre, 5700 Westbury Avenue, Montreal. The presentation will be in English and Dr. Postuma will field questions in either English or French. Doors open at 1 p.m. and the lecture will begin at 1:30 p.m. Light refreshments will be served. Admission is $10 and advance registration is required. For more information and to register, call 514-342-1234, ext. 7201 or register online.

French webinar for caregivers. Thursday April 28, 2016, 6:30 p.m. to 7:45 p.m. Taking care of yourself while looking after a close one can be a real challenge for caregivers. Social worker Jennifer Héroux-Bourduas meets Cecilia Gaudet, who overcomes the daily hardships of caring for someone living with an progressive neurological disease, and who has found coping strategies to keep control of her life (jointly presented with the Federation of Quebec Alzheimer Societies and the Multiple Sclerosis Society of Canada, Quebec Division). Free registration: www.lereseauaidant.ca. Information: Danielle Blain (Quebec office), tel. 514-357-4291, toll free 1-800-565-3000 ext.3397, danielle.blain@parkinson.ca.

Parkinson information and awareness day in Hawkesbury, Ontario. Parkinson Canada is evaluating the need for services and support groups around the Hawkesbury region of Eastern Ontario. Thursday, April 28: French information session 10:30 a.m. to 11:30 a.m., English information session 2:00 p.m. to 3:00 p.m., bilingual session 7:00 p.m. to 8:00 p.m. Quality Inn, 1575 Tupper Street, Hawkesbury, Ontario. Open to Ontario and Quebec residents. Please register with Ginette Trottier, gtrottier@toh.ca or 1-613-722-9238.

Mind over Matter education and awareness conference. A full day of activities broadly encompassing current neurological research, beneficial physical and mental activities, as well as helpful resources for people living with Parkinson’s. Saturday, April 2, from 8 a.m. to 5 p.m. at the Holiday Inn Harbourview, 101 Wyse Rd, Dartmouth, Nova Scotia. Register by March 19 for the early bird discounted fee of $40. Click here for more details and to register.

Coping with a Parkinson’s diagnosis

Jamie Fobert
Jamie Fobert

The details of the moment Jamie Fobert found out that he had Parkinson’s disease at 40 are etched forever in his mind. “I heard the words Parkinson’s disease. I looked down at my watch; it was 10:20 a.m., June 30, 2010. The doctor was wearing a dark dress shirt and khakis. I was bent over, my head down, my elbows on my knees and then it was a blur. The doctor kept talking, but I wasn’t hearing much.”

As a fit, active person, the young-onset Parkinson’s disease (YOPD) diagnosis was a shock. His eldest son first pointed out that he wasn’t swinging his right arm while playing soccer. Subsequent consultations with his family doctor and sports medicine specialists led him to that fateful appointment with the neurologist.

Fobert sobbed during the entire two-hour drive home to Belleville. Over the next few days, he shared his diagnosis with his family and his employers while trying to get on with his life.

Soon after, Fobert made a life-changing connection. He met Stephanie Bruder while she was volunteering at a fundraising event for Parkinson Canada in the local drugstore. Bruder, who also has YOPD, introduced him to the local Parkinson’s community, including a support group. “She’s a small person with a giant heart,” says Fobert.

A two-hour conversation with Bruder and Robert Brown, another local man living with Parkinson’s, did wonders for Fobert’s outlook. He began to understand the words: “I have Parkinson’s. It doesn’t have me.” He realized that living with Parkinson’s, he would be challenged to “step up or step aside” and he chose to step up.

Fobert continued and even increased his physical activity, playing soccer and lifting weights. He takes his medications and physician-approved supplements and monitors his diet and schedule. That’s not to say, he doesn’t slip up sometimes. “One morning I ate a new breakfast cereal without realizing it contained a lot of protein, which can inhibit the absorption of my medication. I was frozen at the kitchen table for quite some time, until my youngest son came by and helped me out.”

Fobert also made some tough decisions in his personal life. His marriage ended. He is now engaged to Beverly, his “true partner.” Between them, their family now includes 21-year-old twins, a 26-year-old son and a daughter-in-law, a 12-year-old son and a seven-year-old granddaughter. “It’s so much easier to live with Parkinson’s when you are supported by good people, who love you. I’m very lucky to have that,” says Jamie.

As a career caregiver working with children and adults with developmental challenges, it didn’t take long for Fobert to seek ways to help others. “I found out I had a talent for getting others to give; if not money, then supplies for our events.” Fobert helps organize events for Parkinson Canada and speaks to media and the public about living with the disease.

He recently became a “partner” for Parkinson Canada’s Life Lists Challenge, a new initiative this year. The Life Lists Challenge inspires others to raise funds while they undertake rewarding bucket list activities like skydiving or zip lining. The partners, all living with Parkinson’s, help to motivate participants in pursuing their adventures and their fundraising.

In his online profile for Life Lists Challenge, Fobert writes about his Superman tattoo. He refers to it as his “inner strength symbol,” explaining that most days Superman is simply Clark Kent, but Superman appears when extraordinary strength is needed. “And some days I need that inner strength when living with Parkinson’s.”

“I believe I have a responsibility to live every day to the fullest, and to not take anything for granted,” says Fobert. “A cure for Parkinson’s isn’t just going to happen; we need to go after it.”