Effects of visual and auditory cues on gait initiation in people with Parkinson's disease

Jiang, Ying; Norman, Kathleen E.

doi:10.1191/0269215506cr925oa

Cited by 128 publications

(117 citation statements)

References 22 publications

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“…He suggested that the placement of visual cues perpendicular to the direction of gait spaced one step length apart were most effective in improving gait in patients with PD. Many single-session studies have confirmed the benefit of visual cues (high-contrast transverse floor lines) [21][22][23][24]. However these open-loop feedback systems may not have long-term effects [25] unless a dedicated physical training program is established, as demonstrated in a patient trained to walk on floor cues reaching 120 percent of the uncued stride length over a 1-month period [26].…”

Section: Discussionmentioning

confidence: 99%

At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease

Espay¹,

Baram²,

Dwivedi³

et al. 2010

JRRD

132

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Abstract-Shuffling and freezing while walking can impair function in patients with Parkinson disease (PD). Open-loop devices that provide fixed-velocity visual or auditory cues can improve gait but may be unreliable or exacerbate freezing of gait in some patients. We examined the efficacy of a closedloop, accelerometer-driven, wearable, visual-auditory cueing device in 13 patients with PD with off-state gait impairment at baseline and after 2 weeks of twice daily (30 minute duration) at-home use. We measured gait velocity, stride length, and cadence using a validated electronic gait-analysis system. Subjects underwent standard motor assessment and completed a self-administered Freezing of Gait Questionnaire (FOGQ) (range 0-24; lower is better). After training, device use enhanced walking velocity (61.6 ± 20.1 cm/s to 72.6 ± 26.5 cm/s, p = 0.006) and stride length (74.3 ± 16.4 cm to 84.0 ± 18.5 cm, p = 0.004). Upon device removal, walking velocity (64.5 ± 21.4 cm/s to 75.4 ± 21.5 cm/s, p < 0.001) and stride length (79.0 ± 20.3 cm to 88.8 ± 17.7 cm, p = 0.003) exhibited a greater magnitude of change, suggesting immediate residual benefits. Also upon device removal, nearly 70 percent of subjects improved by at least 20 percent in either walking velocity, stride length, or both. An overall improvement in gait was measured by the FOGQ (14.2 ±1.9 to 12.4 ± 2.5, p = 0.02). Although issues related to compliance and response variability render a definitive interpretation of study outcome difficult, devices using closed-loop sensory feedback appear to be effective and desirable nonpharmacologic interventions to improve walking in selected individuals with PD.

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Section: Discussionmentioning

confidence: 99%

At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease

Espay¹,

Baram²,

Dwivedi³

et al. 2010

JRRD

132

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“…10,12,15 Wagenaar and Beek 17 report the successful application of the perception-action coupling by means of using external information (for example, visual, auditive or tactile) in patients with gait disorders. Researchers suggest that disorders of the physiological system are the consequences of not only the structural abnormality but also the abnormality of spatiotemporal organization.…”

Section: Discussionmentioning

confidence: 99%

“…Details of each tested condition are as follows: K The visual cue condition Subjects walked at their fastest speed and stepped each pace in accordance with colored tapes that were attached on the floor at an interval equal to 40% of the subject's height (Figure 1a). 10,11 Distance between the tapes provided an External cues on gait performance in iSCI subjects S Amatachaya et al appropriate spatial adjustment (step length) for subjects to perceive by visual perception as the so-called 'visual cue.' K The auditory cue condition Subjects walked at their fastest speed and stepped each foot according to the rhythm of the metronome that was set 25% faster than the baseline cadence of the subject (Figure 1b).…”

Section: Experimental Protocolmentioning

confidence: 99%

“…External information applied to improved movement control during walking commonly include visual and auditory cues. 9,10 However, these cues facilitated patients to modify their movements according to the information provided. Visual cues are mostly applied to provide spatial adjustment (step length) whereas auditory cues are likely used for temporal adjustment (cadence).…”

Section: Introductionmentioning

confidence: 99%

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Effects of external cues on gait performance in independent ambulatory incomplete spinal cord injury patients

et al. 2009

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Study design: An experimental, cross-sectional study. Objective: To investigate effects of external information or external cues on gait performance in independent ambulatory incomplete spinal cord injury (iSCI) patients (American Spinal Injury Association C or D, and functional independence measure walking scores ¼ 5-7). Setting: A university hospital, Thailand. Method: Gait performance was assessed in 29 patients with iSCI under four conditions including self-determined fastest walking speed, and fastest walking with the use of visual, auditory and visuotemporal cues. Average gait speed, stride length, cadence and percent step symmetry of these conditions were compared. Results: The use of external cues facilitated subjects to walk faster with a greater stride length, cadence and percent step symmetry than their own determination. The visuotemporal cue assisted subjects to increase their walking speed by 0.17 m s À1 . The visual cue helped subjects to walk with a significantly greater stride length than the self-determined fastest pace condition (Po0.05). However, the visual cue made subjects walk with the lowest cadence and significantly lower than the visuotemporal cue condition (Po0.05). Conclusion: External information helped subjects to reorganize movement characteristics and perform a more efficient spatiotemporal gait pattern. The findings imply a significant role of external information on gait performance in patients with iSCI.

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“…Some studies have characterized gait kinetics and kinematics in patients with PD (Morris, Iansek, Matyas, and Summers, 1998) demonstrating a degree of normal ization with the addition of transverse lines (Morris et al, 1999). Similarly, in a study of gait initiation in PD, gait velocity, push-off force and magnitude of first and second step length were significantly greater when transverse line visual cues were implemented (Jiang and Norman, 2006).…”

Section: Introductionmentioning

confidence: 99%

Laserlight visual cueing device for freezing of gait in Parkinson’s disease: a case study of the biomechanics involved

Egerton

McCandless

Evans

et al. 2015

Physiotherapy Theory and Practice

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Keywords Background: Freezing of gait (FOG) is a serious gait disorder affecting up to two-thirds of people EMG, gait, kinematics, kinetics, Parkinson's with Parkinson's disease (PO). Cueing has been explored as a method of generating motor disease execution using visual transverse lines on the floor. However, the impact of a laser light visual cue remains unclear. Objective: To determine the biomechanical effect of a laser cane on FOG in History a participant with PO compared to a healthy age-and gender-matched control. Methods: The Received 25 March 2014 participant with PO and healthy control were given a task of initiating gait from standing.Revised 24 January 2015 Electromyography (EMG) data were collected from the tibialis anterior (TA) and the medial Accepted 14 February 2015 gastrocnemius (GS) muscles using an 8-channel system. A 10-camera system (Qualisys)Published online 8 September 2015 recorded movement in 6 degrees of freedom and a calibrated anatomical system technique was used to construct a full body model. Center of mass (COM) and center of pressure (COP) were the main outcome measures. Results: The uncued condition showed that separation of COM and COP took longer and was of smaller magnitude than the cued condition. EMG activity revealed prolonged activation of GS, with little to no TA actiVity. The cued condition showed earlier COM and COP separation. There was reduced fluctuation in GS, with abnormal, early bursts of TA activity.Step length improved in the cued condition compared to the uncued condition. Conclusion: Laserlight visual cueing improved step length beyond a non-cued condition for this patient indicating improved posture and muscle control.

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Effects of visual and auditory cues on gait initiation in people with Parkinson's disease

Cited by 128 publications

References 22 publications

At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease

At-home training with closed-loop augmented-reality cueing device for improving gait in patients with Parkinson disease

Effects of external cues on gait performance in independent ambulatory incomplete spinal cord injury patients

Laserlight visual cueing device for freezing of gait in Parkinson’s disease: a case study of the biomechanics involved

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