Efficacy of Wearable Device Gait Training on Parkinson's Disease: A Randomized Controlled Open-label Pilot Study

Kawashima, Nozomu; Hasegawa, Kazuko; Iijima, M.; Nagami, Kayo; Makimura, Tomomi; Kumon, Aya; Ohtsuki, Shigeaki

doi:10.2169/internalmedicine.8949-21

Cited by 14 publications

(31 citation statements)

References 40 publications

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“…For these reasons, somatosensory and motor cues (i.e., whole-body movements with force synchronized with the patient’s intention) rather than visual, auditory, and superficial stimulation are preferable for improving gait disturbances by shifting the COG. Previous joint assist devices have provided cues to induce forward steps in patients 16 , 17 , although these devices have used sagittal and noncyclic force rather than the recommended lateral cyclic force. Therefore, a wearable system that provides lateral cyclic force to the user may effectively improve gait and movement similar to the somatosensory and motor cues provided by physical therapists.…”

Section: Introductionmentioning

confidence: 99%

Gait improvement with wearable cyborg HAL trunk unit for parkinsonian patients: five case reports

Uehara¹,

Kawamoto²,

Imai³

et al. 2023

Sci Rep

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Cybernic treatment involves the generation of an interactive bio-feedback loop between an individual’s nervous system and the worn cyborg Hybrid Assistive Limb (HAL); this treatment has been applied for several intractable neuromuscular disorders. Thus, it is of interest to determine its potential for parkinsonian patients. This study confirmed the feasibility of using a HAL trunk unit to improve parkinsonian gait disturbance. HAL establishes functional and physical synchronization with the wearer by providing lateral cyclic forces to the chest in the form of somatosensory and motor cues. To confirm the feasibility of its use for improving parkinsonian gait disturbances, we conducted experiments with three Parkinson’s disease patients and two patients with progressive supranuclear palsy. During the experiments, the immediate effect of the intervention was assessed; all participants exhibited improvements in gait disturbance while wearing the HAL unit, and this improvement effect persisted without the HAL unit in two participants. Afterward, based on the assessment, we conducted a continuous intervention for one participant. In this intervention, the number of steps in the final experiment was significantly decreased compared with the initial state. These findings suggest that the proposed method is an option for treating parkinsonian patients to generate somatosensory and motor cues.

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Section: Introductionmentioning

confidence: 99%

Gait improvement with wearable cyborg HAL trunk unit for parkinsonian patients: five case reports

Uehara¹,

Kawamoto²,

Imai³

et al. 2023

Sci Rep

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“…4,25,[43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] We also found studies using Robotic-assisted gait training for PD. 24,29,[59][60][61][62] We analyzed several types of AP and categorized them into commercial and non-commercial devices available for research, rehabilitation, or home-based care. The majority of them are available on the market and depicted in ►Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…59 An automated wearable exoskeleton robot may detect the hip joint angle and provide torque to assist in hip flexion and extension facilitating gait training. 60 Some studies have shown the beneficial effects of RAGT for FOG in PD. One study compared treadmill gait training with RAGT.…”

Section: Roboticsmentioning

confidence: 99%

Assisted technology in Parkinson's disease gait: what's up?

Capato,

Chen,

Miranda

et al. 2024

Arq Neuropsiquiatr

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Background Gait disturbances are prevalent and debilitating symptoms, diminishing mobility and quality of life for Parkinson's disease (PD) individuals. While traditional treatments offer partial relief, there is a growing interest in alternative interventions to address this challenge. Recently, a remarkable surge in assisted technology (AT) development was witnessed to aid individuals with PD. Objective To explore the burgeoning landscape of AT interventions tailored to alleviate PD-related gait impairments and describe current research related to such aim. Methods In this review, we searched on PubMed for papers published in English (2018-2023). Additionally, the abstract of each study was read to ensure inclusion. Four researchers searched independently, including studies according to our inclusion and exclusion criteria. Results We included studies that met all inclusion criteria. We identified key trends in assistive technology of gait parameters analysis in PD. These encompass wearable sensors, gait analysis, real-time feedback and cueing techniques, virtual reality, and robotics. Conclusion This review provides a resource for guiding future research, informing clinical decisions, and fostering collaboration among researchers, clinicians, and policymakers. By delineating this rapidly evolving field's contours, it aims to inspire further innovation, ultimately improving the lives of PD patients through more effective and personalized interventions.

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“…20 Laboratory-based studies in healthy adult and neurological populations to examine the effects of gait training using EXODs with hip assistance, including the HWA device, have demonstrated improved gait spatiotemporal parameters and endurance. [20][21][22][23][24][25] Healthy elderly and middle-aged adults showed temporary improvements in stride length, gait speed, and energy costs wearing the HWA compared with unassisted walking. 21,22 Long-term HWA usage in individuals with stroke improved gait parameters during unassisted walking.…”

Section: Introductionmentioning

confidence: 99%

“…20,23 Individuals with moderately advanced PD (n = 12) showed immediate improvements in gait speed, step length, and hip flexion and extension excursion while walking with the HWA device and improved walking endurance during unassisted walking after 10 half-hour sessions of gait training with the HWA device in the home setting. 25 The mechanical assistance given by the HWA may provide (1) temporal (rhythmic tactile stimulus on leg) and spatial (attentional stimuli to increase step amplitude) external cues and (2) force assistance to increase hip mobility and ameliorate lower extremity muscle strength and power deficits 26 that improve gait in people with mild to moderate PD. 27,28 Thus, EXOD interventions may help overcome exercise barriers due to lack of access to exercise facilities by allowing in home gait training, physical impairments by providing lower extremity step cueing and mechanical assistance, and low motivation by making walking more comfortable and less effortful, thereby improving home and community mobility for daily life activities and the quality of life in PwPD.…”

Section: Introductionmentioning

confidence: 99%

Use of a Robotic Walking Device for Home and Community Mobility in Parkinson Disease: A Randomized Controlled Trial

Kegelmeyer,

Minarsch,

Kostyk

et al. 2024

Journal of Neurologic Physical Therapy

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Background/Purpose: Gait impairments in Parkinson disease (PD) contribute to decreased quality of life. This randomized controlled trial examined immediate- and longer-term effects of a single joint robotic exoskeleton device (EXOD), the Honda Walking Assist device, on gait. Methods: Participants (n = 45) with PD (Hoehn and Yahr stages 1-3) were randomized to a robotic-assisted gait training (RAGT) group (n = 23) or control (CON) group (n = 22). The RAGT group was tested with and without the EXOD at baseline and then received supervised in-home and community training with the EXOD twice weekly for 8 weeks. The CON group received no interventions. Outcome measures included gait speed (primary), gait endurance (6-minute walk test), perceived ease of walking, and questionnaires and logs assessing performance of daily activities, freezing of gait, and daily activity levels. Results: Forty participants completed the study. No significant immediate impact of EXOD usage on participants’ gait measures was found. Differences in gait speed and secondary outcome measures postintervention were not significantly different between the RAGT and CON groups. Participants with greater disease severity (worse baseline motor scores) had greater improvements in stride length during unassisted walking after the intervention than those with lower severity (mean difference: 3.22, 95% confidence interval: 0.05-6.40; P = 0.04). Discussion and Conclusions: All RAGT participants could use the EXOD safely. The RAGT treatment used in this mostly low impairment population of people with PD may be ineffective and/or was insufficiently dosed to see a positive treatment effect. Our findings suggest that RAGT interventions in PD may be more effective in individuals with greater motor impairments. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A459).

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Efficacy of Wearable Device Gait Training on Parkinson's Disease: A Randomized Controlled Open-label Pilot Study

Cited by 14 publications

References 40 publications

Gait improvement with wearable cyborg HAL trunk unit for parkinsonian patients: five case reports

Gait improvement with wearable cyborg HAL trunk unit for parkinsonian patients: five case reports

Assisted technology in Parkinson's disease gait: what's up?

Use of a Robotic Walking Device for Home and Community Mobility in Parkinson Disease: A Randomized Controlled Trial

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