Focused Vibrotactile Stimulation with Cueing Effect on Freezing of Gait in Parkinson’s Disease: Two Case Reports

Tan, Xiu Sheng; Pierres, Floyd; Dallman-Porter, Alex; Hardie-Brown, William; Kwon, Kyum‐Yil

doi:10.14802/jmd.21076

Cited by 5 publications

(6 citation statements)

References 10 publications

(20 reference statements)

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“…Auditory cues appear to make use of almost instantaneous motor entrainment to an external beat, activating the frontoparietal control and motor-cerebellar networks to bypass internal rhythm deficits of the basal ganglia ( Braunlich et al, 2019 ). Somatosensory stimulation has historically been limited by the sophistication of the delivery technology, however, smaller wearable vibrotactile devices are emerging with early positive benefits on FOG ( Tan et al, 2021 ), though their effects require validation. Long-term effects and the out-of-laboratory benefits of cueing training are to be confirmed ( Chang et al, 2019 ).…”

Section: Non-pharmacological Approachesmentioning

confidence: 99%

Future Therapeutic Strategies for Freezing of Gait in Parkinson’s Disease

Cui

Lewis

2021

Front. Hum. Neurosci.

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Freezing of gait (FOG) is a common and challenging clinical symptom in Parkinson’s disease. In this review, we summarise the recent insights into freezing of gait and highlight the strategies that should be considered to improve future treatment. There is a need to develop individualised and on-demand therapies, through improved detection and wearable technologies. Whilst there already exist a number of pharmacological (e.g., dopaminergic and beyond dopamine), non-pharmacological (physiotherapy and cueing, cognitive training, and non-invasive brain stimulation) and surgical approaches to freezing (i.e., dual-site deep brain stimulation, closed-loop programming), an integrated collaborative approach to future research in this complex area will be necessary to systematically investigate new therapeutic avenues. A review of the literature suggests standardising how gait freezing is measured, enriching patient cohorts for preventative studies, and harnessing the power of existing data, could help lead to more effective treatments for freezing of gait and offer relief to many patients.

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Section: Non-pharmacological Approachesmentioning

confidence: 99%

Future Therapeutic Strategies for Freezing of Gait in Parkinson’s Disease

Cui

Lewis

2021

Front. Hum. Neurosci.

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“…Vibration stimuli to the muscles act as a powerful proprioceptive input and strongly affect the motion perception during extremity movements of healthy people and patients with various neurological disorders ( Cohen and Starr, 1985 ; Han et al, 2014 ). Peripheral vibrotactile stimulation has been shown to improve bradykinesia, FOG, gait impairment, and postural instability in patients with PD, possibly by affecting the central pattern generator in a desynchronized state ( Zehr and Haridas, 2003 ; Volpe et al, 2014 ; Pereira et al, 2016 ; Syrkin-Nikolau et al, 2018 ; Peppe et al, 2019 ; Serio et al, 2019 ; Spolaor et al, 2021 ; Tan et al, 2021 ). Three possible mechanisms for how vibration stimuli work against FOG in patients with PD have been laid forth: (i) a cueing effect, (ii) modulation effect against impairment in dealing with conflicting cognitive/attentional resources, and (iii) enhanced proprioceptive processing ( Pereira et al, 2016 ).…”

Section: Resultsmentioning

confidence: 99%

“…Admittedly, these changes were significant but small. Another study placed the CUE1 (Charco Neurotech Ltd., London, United Kingdom) on the patient’s sternum to produce focused vibrotactile pulsatile stimuli ( Tan et al, 2021 ). Since this device was effective for FOG when it was turned on before the FOG episodes, the authors hypothesized that CUE1 has a cueing effect in addition to enhanced proprioceptive stimuli.…”

Section: Resultsmentioning

confidence: 99%

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Fujikawa

Morigaki

Yamamoto

et al. 2022

Front. Aging Neurosci.

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BackgroundPharmacotherapy is the first-line treatment option for Parkinson’s disease, and levodopa is considered the most effective drug for managing motor symptoms. However, side effects such as motor fluctuation and dyskinesia have been associated with levodopa treatment. For these conditions, alternative therapies, including invasive and non-invasive medical devices, may be helpful. This review sheds light on current progress in the development of devices to alleviate motor symptoms in Parkinson’s disease.MethodsWe first conducted a narrative literature review to obtain an overview of current invasive and non-invasive medical devices and thereafter performed a systematic review of recent randomized controlled trials (RCTs) of these devices.ResultsOur review revealed different characteristics of each device and their effectiveness for motor symptoms. Although invasive medical devices are usually highly effective, surgical procedures can be burdensome for patients and have serious side effects. In contrast, non-pharmacological/non-surgical devices have fewer complications. RCTs of non-invasive devices, especially non-invasive brain stimulation and mechanical peripheral stimulation devices, have proven effectiveness on motor symptoms. Nearly no non-invasive devices have yet received Food and Drug Administration certification or a CE mark.ConclusionInvasive and non-invasive medical devices have unique characteristics, and several RCTs have been conducted for each device. Invasive devices are more effective, while non-invasive devices are less effective and have lower hurdles and risks. It is important to understand the characteristics of each device and capitalize on these.

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“…It was certified as a class 1 medical product. The device measured 40 mm in diameter, 11 mm in height, and 17 g in weight, and was attached to the sternum with medical adhesive patches [ 12 ] ( Figure 1 ). The SVSD was used with the default settings for example same vibration frequency for all participants, and no customisation of the stimulation settings was employed in this study.…”

Section: Methodsmentioning

confidence: 99%

Exploring a New Cueing Device in People Who Experience Freezing of Gait: Acceptance of a Study Design

Wilhelm

Riedl

Paumann

et al. 2022

Parkinson's Disease

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Background. Freezing of Gait (FoG) is a disabling symptom of Parkinson’s Disease (PD) and is defined as a “brief episodic absence or marked reduction of forward progression of the feet despite the intention to walk.” Compensatory strategies such as cueing and high frequency vibrotactile stimulation can reduce FoG severity and improve gait parameters. A new Sternal high frequency Vibrotactile Stimulation Device (SVSD) with cueing function has been developed, however the clinical effects of this device are yet to be fully investigated. Objective. The aim of this study was to investigate, if the proposed study design using a SVSD and gait analysis sensor insoles was acceptable for people with PD. Methods. This feasibility study was designed as a randomized cross-over study. Thirteen participants took part in a one off 60-minute data collection session. The acceptability of the study design was assessed with a mixed methods questionnaire considering each step of the study process. Secondary outcome measures were the feasibility of using the 10 Metre Walk Test (10MWT), the Freezing of Gait Score (FoG-Score), and Patient Global Impression of Change (PGI-C) with and without the SVSD. Results. The participants scored all aspects of the study design as very satisfactory. In addition, all participants could perform the secondary outcome measures and were deemed feasible. Feedback from open ended questions provided ideas and considerations for adaptations of future clinical studies. Conclusion. The proposed study design was acceptable for people with PD. Implications. This study design, with small adaptations, can be used for larger studies to evaluate the effect of an SVSD on FoG in people with PD.

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Focused Vibrotactile Stimulation with Cueing Effect on Freezing of Gait in Parkinson’s Disease: Two Case Reports

Cited by 5 publications

References 10 publications

Future Therapeutic Strategies for Freezing of Gait in Parkinson’s Disease

Future Therapeutic Strategies for Freezing of Gait in Parkinson’s Disease

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Exploring a New Cueing Device in People Who Experience Freezing of Gait: Acceptance of a Study Design

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