A novel instrumented walker for individualized visual cue setting for gait training in patients with Parkinson’s disease

Wu, Hsiao Kuan; Chen, Huang Ren; Chen, Wei‐Ying; Lu, Chia‐Feng; Tsai, Mei Wun; Yu, Chung Huang

doi:10.1080/10400435.2018.1525442

Cited by 9 publications

(11 citation statements)

References 40 publications

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“…As presented in Falvo and Earhart ( 2009 ), the Parkinson's group obtains similar results because of the subjects' impaired balance and predisposition to falls. For this reason and as presented in Mou et al ( 2012 ), Zhang et al ( 2018 ), and Wu et al ( 2020 ), devices such as SWs can help reduce the risk factors for falls and help to maintain constant kinematic parameters such as speed and cadence of the participant in very long distances.…”

Section: Discussionmentioning

confidence: 92%

“…Regarding subjects with Parkinson's disease, some studies focused on interaction strategies to improve the experience during the task (Mou et al, 2012 ; Zhang et al, 2018 ). These kinds of studies evaluated the level of assistance provided by the device and how it influenced the speed, cadence, and stability of the users (Cubo et al, 2003 ; Kegelmeyer et al, 2013 ; Wu et al, 2020 ). However, exploration of the kinematic effects of robotic walkers in this population remains scarce.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of a Robotic Walker in Older Adults With Parkinson's Disease in Daily Living Activities

Otálora

et al. 2021

Front. Neurorobot.

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The constant growth of the population with mobility impairments, such as older adults and people suffering from neurological pathologies like Parkinson's disease (PD), has encouraged the development of multiple devices for gait assistance. Robotic walkers have emerged, improving physical stability and balance and providing cognitive aid in rehabilitation scenarios. Different studies evaluated human gait behavior with passive and active walkers to understand such rehabilitation processes. However, there is no evidence in the literature of studies with robotic walkers in daily living scenarios with older adults with Parkinson's disease. This study presents the assessment of the AGoRA Smart Walker using Ramps Tests and Timed Up and Go Test (TUGT). Ten older adults participated in the study, four had PD, and the remaining six had underlying conditions and fractures. Each of them underwent a physical assessment (i.e., Senior Fitness, hip, and knee strength tests) and then interacted with the AGoRA SW. Kinematic and physical interaction data were collected through the AGoRA walker's sensory interface. It was found that for lower limb strength tests, older adults with PD had increases of at least 15% in all parameters assessed. For the Sit to Stand Test, the Parkinson's group evidenced an increase of 23%, while for the Chair Sit and Reach Test (CSRT), this same group was only 0.04 m away from reaching the target. For the Ramp Up Test (RUT), the subjects had to make a greater effort, and significant differences (p-value = 0.04) were evidenced in the force they applied to the device. For the Ramp Down Test (RDT), the Parkinson's group exhibited a decrease in torque, and there were statistically significant differences (p-value = 0.01) due to the increase in the complexity of the task. In the Timed Up and Go Test (TUGT), the subjects presented significant differences in torque (p-value of 0.05) but not in force (p-value of 0.22) due to the effect of the admittance controller implemented in the study. Finally, the results suggested that the walker, represents a valuable tool for assisting people with gait motor deficits in tasks that demanded more physical effort adapting its behavior to the specific needs of each user.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Assessment of a Robotic Walker in Older Adults With Parkinson's Disease in Daily Living Activities

Otálora

et al. 2021

Front. Neurorobot.

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“…Incorporating new technologies in the AD can add more value to it by improving movements and gait condition as addressed in recent researches [25][26][27] such as by adding further instrumentation, auditory cues to fix unusual gait freezing, and use of visual cues which can potentially improve patient safety while using the walker. Additionally, analysis of stochastic and probabilistic loading on the walker seat using biomechanics for ergonomic consideration [28] can improve its design, stability, and manoeuvrability.…”

Section: Discussionmentioning

confidence: 99%

A Walker Designed for Parkinson’s Disease Patients Based on a Survey in Dhaka, Bangladesh

Sarker

Karim

Ahamed

et al. 2020

Strojnícky Časopis - Journal of Mechanical Engineering

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A neurodegenerative disorder like Parkinson’s disease (PD) causes tremor, rigidity, postural instability and gait problems in early stages and thus poses an undetermined threat to the social and personal lives of the elderly in developing countries due to insufficient survey and research activities. However, several types of assistive devices (AD) are available in the market and the real patients’ requirements are often overlooked in their design. This paper presents the process of design and fabrication of an innovative walker for PD patients. This walker has a non-modular foldable design which incentivizes patients to stand up straight and walk without the help of others. A survey on patients battling parkinsonism and practicing doctors was performed in public hospitals in Dhaka, Bangladesh and relevant engineering data was derived from it using Quality Function Deployment (QFD) which can also help visualize further market research opportunities. A finite element analysis (FEA) was performed before the walker was constructed for safety. It was handed to several volunteers for use and their responses were satisfactory. The designed walker may serve as a low-cost AD which is likely to improve a patient’s posture and overall lifestyle and therefore, it can act as a means of rehabilitation.

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“…For instance, the VICON (VICON Motion Systems, Oxford, U.K.) and the GAITRite system (CIR Systems Inc, New Jersey, U.S.A.) (e.g. [11], [13]) are two commercially available gait performance measuring devices. However, these systems are typically employed to evaluate the effectiveness of cues, rather than being used as a feedback signal to the cueing system.…”

Section: A Monitoring Gait Parametersmentioning

confidence: 99%

“…Sensors that are portable, unintrusive, and easy to set up, such as inertial measurement units (IMU) or encoders, have been embedded onto wearable devices to measure gait metrics outside of the clinical setting and provide information for the cueing system to adjust the cues. For instance, in [13], the authors developed a laser projection system that can be mounted onto a walking frame. The system adjusts the location of the visual cues based on the movement of the person measured through encoders embedded on the walking aid to ensure that the projection is always a fixed distance ahead of the person.…”

Section: A Monitoring Gait Parametersmentioning

confidence: 99%

Human-in-the-loop Auditory Cueing Strategy for Gait Modification

Wu,

Murphy,

Chen

et al. 2020

Preprint

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External feedback in the form of visual, auditory and tactile cues has been used to assist patients to overcome mobility challenges. However, these cues can become less effective over time. There is limited research on adapting cues to account for inter and intra-personal variations in cue responsiveness. We propose a cue-provision framework that consists of a gait performance monitoring algorithm and an adaptive cueing strategy to improve gait performance. The proposed approach learns a model of the person's response to cues using Gaussian Process regression. The model is then used within an online optimization algorithm to generate cues to improve gait performance. We conduct a study with healthy participants to evaluate the ability of the adaptive cueing strategy to influence human gait, and compare its effectiveness to two other cueing approaches: the standard fixed cue approach and a proportional cue approach. The results show that adaptive cueing is more effective in changing the person's gait state once the response model is learned compared to the other methods.

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A novel instrumented walker for individualized visual cue setting for gait training in patients with Parkinson’s disease

Cited by 9 publications

References 40 publications

Assessment of a Robotic Walker in Older Adults With Parkinson's Disease in Daily Living Activities

Assessment of a Robotic Walker in Older Adults With Parkinson's Disease in Daily Living Activities

A Walker Designed for Parkinson’s Disease Patients Based on a Survey in Dhaka, Bangladesh

Human-in-the-loop Auditory Cueing Strategy for Gait Modification

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