Effects of Sensitive Electrical Stimulation‐Based Somatosensory Cueing in Parkinson's Disease Gait and Freezing of Gait Assessment

Abstract

This study aims to investigate the effect of a somatosensory cueing on gait disorders in subjects with Parkinson's disease (PD). After having performed stepping in place and timed up and go assessing tasks, 13 participants with PD were equipped with an electrical stimulator and an inertial measurement unit (IMU) located under the lateral malleolus on the sagittal plane. Electrodes were positioned under the arch of the foot and electrical stimulation (ES) parameters (five 500 µs/phase charge-balanced biphasic pulses delivered at 200 Hz, repeated four times at 10 Hz) adjusted to deliver a sensitive signal. Online IMU signal was processed in order to trigger ES at heel off detection. Starting from a quiet standing posture, subjects were asked to walk at their preferred speed on a path including 5 m straight line, u-turn, and walk around tasks. Three situations were considered: no stimulation baseline precondition (C0), ES condition (C1), and no stimulation baseline post-condition (C0bis), for eliminating a learning effect possibility. In ES condition (C1) the time to execute the different tasks was globally decreased in all the subjects (n = 13). Participants' results were then grouped regarding whether they experienced freezing of gait (FOG) or not during C0 no stimulation baseline precondition. In "freezer" subjects (n = 9), the time to complete the entire path was reduced by 19%. FOG episodes occurrence was decreased by 12% compared to baseline conditions. This preliminary work showed a positive global effect on gait and FOG in PD by a somatosensory cueing based on sensitive electrical stimulation.

Nonpharmacological, Nonsurgical Treatments for Freezing of Gait in Parkinson's Disease: A Systematic Review

“…Only the stimulation of the less affected limb showed a significant reduction in duration of FOG episodes. Conversely, Sijobert and colleagues assessed the use of electrical stimulation delivered by foot electrodes and showed a 12% reduction in FOG episodes.…”

A sensor fusion approach for inertial sensors based 3D kinematics and pathological gait assessments: toward an adaptive control of stimulation in post-stroke subjects

“…These existing methods were not applicable to assess the gait of post-stroke subjects with a complex forward swing. Therefore, we had to adapt an algorithm we developed in an earlier work for Parkinson's disease [21], to segment impaired gait cycle and we took advantage of Martin et al [17] quaternion computation to accurately remove gravity. Only a few studies have been conducted in hemiplegic participants in the literature [23], thus we mainly compared our results with publications on healthy individuals [24].…”

“…where The method described in [21] has been used to detect gait events, not only based on sagittal angular rate but also taking into account acceleration measurements. Stride length was then defined as the distance between two consecutive initial contacts, computed in the transverse plane (Equ.…”

Wireless Electrical Stimulators and Sensors Network for Closed Loop Control in Rehabilitation

“…Through this open wearable FES architecture, a scalable hardware solution has been achieved, adaptable to the needs of different FES applications, environments, and pathologies. It is now used by our research team for other applications (Sijobert et al, 2017;Zhan et al, 2018), enabling clinicians to explore novel directions and study new hypotheses.…”