Vibrotactile Foot Device for Freezing of Gait in Parkinson's Disease: A Pilot Study
Shanshan Cen MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorJinghong Ma MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorHong Sun MD, PhD
National Clinical Research Center for Geriatric Disorders, Beijing, China
Search for more papers by this authorHui Zhang MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorYuan Li MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorWei Mao MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorErhe Xu MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorShanshan Mei MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorJagadish K. Chhetri PhD
National Clinical Research Center for Geriatric Disorders, Beijing, China
Search for more papers by this authorZheng Ruan MD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorHui Wang MD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorCorresponding Author
Kailiang Wang MD, PhD
Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, China
Correspondence to: Dr. Kailiang Wang, Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, #45 Changchun Street, 100053 Beijing, China; E-mail: [email protected]; Prof. Piu Chan, Department of Neurology and Neurobiology, Xuanwu Hospital of Capital Medical University, #45 Changchun Street, 100053 Beijing, China; E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Piu Chan MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
National Clinical Research Center for Geriatric Disorders, Beijing, China
Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory on Parkinson's Disease, Parkinson's Disease Center for Beijing Institute on Brain Disorders, Clinical and Research Center for Parkinson's Disease of Capital Medical University, Beijing, China
Correspondence to: Dr. Kailiang Wang, Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, #45 Changchun Street, 100053 Beijing, China; E-mail: [email protected]; Prof. Piu Chan, Department of Neurology and Neurobiology, Xuanwu Hospital of Capital Medical University, #45 Changchun Street, 100053 Beijing, China; E-mail: [email protected]
Search for more papers by this authorShanshan Cen MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorJinghong Ma MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorHong Sun MD, PhD
National Clinical Research Center for Geriatric Disorders, Beijing, China
Search for more papers by this authorHui Zhang MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorYuan Li MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorWei Mao MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorErhe Xu MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorShanshan Mei MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorJagadish K. Chhetri PhD
National Clinical Research Center for Geriatric Disorders, Beijing, China
Search for more papers by this authorZheng Ruan MD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorHui Wang MD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Search for more papers by this authorCorresponding Author
Kailiang Wang MD, PhD
Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, China
Correspondence to: Dr. Kailiang Wang, Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, #45 Changchun Street, 100053 Beijing, China; E-mail: [email protected]; Prof. Piu Chan, Department of Neurology and Neurobiology, Xuanwu Hospital of Capital Medical University, #45 Changchun Street, 100053 Beijing, China; E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Piu Chan MD, PhD
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
National Clinical Research Center for Geriatric Disorders, Beijing, China
Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory on Parkinson's Disease, Parkinson's Disease Center for Beijing Institute on Brain Disorders, Clinical and Research Center for Parkinson's Disease of Capital Medical University, Beijing, China
Correspondence to: Dr. Kailiang Wang, Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, #45 Changchun Street, 100053 Beijing, China; E-mail: [email protected]; Prof. Piu Chan, Department of Neurology and Neurobiology, Xuanwu Hospital of Capital Medical University, #45 Changchun Street, 100053 Beijing, China; E-mail: [email protected]
Search for more papers by this authorAbstract
Background
Vibrotactile stimulation has been studied in its efficacy of reducing freezing of gait (FOG) in patients with Parkinson's disease (PD). However, the results are still controversial. We evaluated the efficacy of a newly developed vibrotactile foot device on freezing severity and gait measures in PD patients with FOG.
Objective
To evaluate the efficacy of vibrotactile foot device on PD patients with FOG.
Methods
Thirty-three PD patients with FOG were examined during their “off” medication state. The efficacy of the vibrotactile foot device was evaluated using a gait protocol comprising walking trials with vibrotactile stimulation “off” and “on.” Walking trials were videotaped for the offline rating by two movement disorder specialists. The Opal inertial sensor unit (128 Hz; Mobility Lab; APDM Inc., Portland, OR, USA) was used for quantitative gait analysis.
Results
The results demonstrated 33.1% reduction in number of FOG episodes (P < 0.001) and 32.6% reduction of freezing episodes (P < 0.001). Quantitative gait analysis showed a significant increase in step length (P = 0.033). A moderate negative correlation was observed between the change of percent time frozen and age (r = −0.415, P = 0.016). 73% of participants reported minimal to substantial improvement in walking with this vibrating stimulation delivered by the vibrotactile foot device.
Conclusions
The vibrotactile foot device is an efficient device that could significantly reduce freezing severity and provide gait regulation to patients with PD experiencing frequent freezing. It could potentially be used in the home environment for improving the quality of life.
Supporting Information
Filename | Description |
---|---|
mdc314177-sup-0001-TableS1.docxWord 2007 document , 13.7 KB | Table S1. Correlations between the change in outcome measures and demographic and clinical characteristics of all participants. |
mdc314177-sup-0002-TableS2.docxWord 2007 document , 12.4 KB | Table S2. Freezing measure changes with vibrotictile stimulation. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- 1Nonnekes J, Snijders AH, Nutt JG, Deuschl G, Giladi N, Bloem BR. Freezing of gait: a practical approach to management. Lancet Neurol 2015; 14(7): 768–778.
- 2Mancini M, Bloem BR, Horak FB, Lewis SJG, Nieuwboer A, Nonnekes J. Clinical and methodological challenges for assessing freezing of gait: future perspectives. Mov Disord 2019; 34(6): 783–790.
- 3Delgado-Alvarado M, Marano M, Santurtun A, Urtiaga-Gallano A, Tordesillas-Gutierrez D, Infante J. Nonpharmacological, nonsurgical treatments for freezing of gait in Parkinson's disease: a systematic review. Mov Disord 2020; 35(2): 204–214.
- 4Sweeney D, Quinlan LR, Browne P, Richardson M, Meskell P, Ólaighin G. A technological review of wearable cueing devices addressing freezing of gait in Parkinson's disease. Sensors (Basel) 2019; 19(6): 1277.
- 5Redgrave P, Rodriguez M, Smith Y, et al. Goal-directed and habitual control in the basal ganglia: implications for Parkinson's disease. Nat Rev Neurosci 2010; 11(11): 760–772.
- 6Lee SJ, Yoo JY, Ryu JS, Park HK, Chung SJ. The effects of visual and auditory cues on freezing of gait in patients with Parkinson disease. Am J Phys Med Rehabil 2012; 91(1): 2–11.
- 7Barthel C, Nonnekes J, van Helvert M, et al. The laser shoes: a new ambulatory device to alleviate freezing of gait in Parkinson disease. Neurology 2018; 90(2): e164–e171.
- 8Arias P, Cudeiro J. Effect of rhythmic auditory stimulation on gait in parkinsonian patients with and without freezing of gait. PLoS One 2010; 5(3):e9675.
- 9Pereira MP, Gobbi LT, Almeida QJ. Freezing of gait in Parkinson's disease: evidence of sensory rather than attentional mechanisms through muscle vibration. Parkinsonism Relat Disord 2016; 29: 78–82.
- 10Rossi S, Lisini Baldi T, Aggravi M, et al. Wearable haptic anklets for gait and freezing improvement in Parkinson's disease: a proof-of-concept study. Neurol Sci 2020; 41(12): 3643–3651.
- 11Alvarado O, Chacón B, Robles F. A low-cost vibratory stimulus system to mitigate freezing of gait in Parkinson's disease. 2016 IEEE ANDESCON, Arequipa, Peru, IEEE; 2016; pp. 1-4.
- 12Rosenthal L, Sweeney D, Cunnington AL, Quinlan LR, Ólaighin G. Sensory electrical stimulation cueing may reduce freezing of gait episodes in Parkinson's disease. J Healthc Eng 2018; 2018:4684925.
- 13Mancini M, Smulders K, Harker G, Stuart S, Nutt JG. Assessment of the ability of open- and closed-loop cueing to improve turning and freezing in people with Parkinson's disease. Sci Rep 2018; 8(1): 12773.
- 14Klaver EC, van Vugt JPP, Bloem BR, van Wezel RJA, Nonnekes J, Tjepkema-Cloostermans MC. Good vibrations: tactile cueing for freezing of gait in Parkinson's disease. J Neurol 2023; 270(7): 3424–3432.
- 15Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord 2015; 30(12): 1591–1601.
- 16Nieuwboer A, Rochester L, Herman T, Vandenberghe W, Emil GE, Thomaes T, Giladi N. Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson's disease and their carers. Gait Posture 2009; 30(4): 459–463.
- 17Janssen S, Bolte B, Nonnekes J, et al. Usability of three-dimensional augmented visual cues delivered by smart glasses on (freezing of) gait in Parkinson's disease. Front Neurol 2017; 8: 279.
- 18Goetz CG, Tilley BC, Shaftman SR, et al. Movement Disorder Society-sponsored revision of the unified Parkinson's disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord 2008; 23(15): 2129–2170.
- 19Creavin ST, Wisniewski S, Noel-Storr AH, et al. Mini-mental state examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations. Cochrane Database Syst Rev 2016; 2016(1):Cd011145.
- 20Aiello EN, Gramegna C, Esposito A, et al. The Montreal cognitive assessment (MoCA): updated norms and psychometric insights into adaptive testing from healthy individuals in northern Italy. Aging Clin Exp Res 2022; 34(2): 375–382.
- 21Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a frontal assessment battery at bedside. Neurology 2000; 55(11): 1621–1626.
- 22Maier W, Buller R, Philipp M, Heuser I. The Hamilton anxiety scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord 1988; 14(1): 61–68.
- 23Carrozzino D, Patierno C, Fava GA, Guidi J. The Hamilton rating scales for depression: a critical review of Clinimetric properties of different versions. Psychother Psychosom 2020; 89(3): 133–150.
- 24Busner J, Targum SD. The clinical global impressions scale: applying a research tool in clinical practice. Psychiatry (Edgmont) 2007; 4(7): 28–37.
- 25Gilat M. How to annotate freezing of gait from video: a standardized method using open-source software. J Parkinsons Dis 2019; 9(4): 821–824.
- 26Cockx H, Klaver E, Tjepkema-Cloostermans M, van Wezel R, Nonnekes J. The gray area of freezing of gait annotation: a guideline and open-source practical tool. Mov Disord Clin Pract 2022; 9(8): 1099–1104.
- 27McCandless PJ, Evans BJ, Janssen J, Selfe J, Churchill A, Richards J. Effect of three cueing devices for people with Parkinson's disease with gait initiation difficulties. Gait Posture 2016; 44: 7–11.
- 28Tan T, Almeida QJ, Rahimi F. Proprioceptive deficits in Parkinson's disease patients with freezing of gait. Neuroscience 2011; 192: 746–752.
- 29Zhao Y, Nonnekes J, Storcken EJ, et al. Feasibility of external rhythmic cueing with the Google glass for improving gait in people with Parkinson's disease. J Neurol 2016; 263(6): 1156–1165.
- 30Vercruysse S, Spildooren J, Heremans E, et al. Abnormalities and cue dependence of rhythmical upper-limb movements in Parkinson patients with freezing of gait. Neurorehabil Neural Repair 2012; 26(6): 636–645.
- 31Heremans E, Nackaerts E, Vervoort G, Broeder S, Swinnen SP, Nieuwboer A. Impaired retention of motor learning of writing skills in patients with Parkinson's disease with freezing of gait. PLoS One 2016; 11(2):e0148933.
- 32Ginis P, Nackaerts E, Nieuwboer A, Heremans E. Cueing for people with Parkinson's disease with freezing of gait: a narrative review of the state-of-the-art and novel perspectives. Ann Phys Rehabil Med 2018; 61(6): 407–413.
- 33Heremans E, Nieuwboer A, Spildooren J, et al. Cognitive aspects of freezing of gait in Parkinson's disease: a challenge for rehabilitation. J Neural Transm 2013; 120(4): 543–557.
- 34Monaghan AS, Gordon E, Graham L, Hughes E, Peterson DS, Morris R. Cognition and freezing of gait in Parkinson's disease: a systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 147:105068.