Good vibrations: tactile cueing for freezing of gait in Parkinson’s disease

Abstract

Background Cueing strategies can alleviate freezing of gait (FOG) in people with Parkinson’s disease (PD). We evaluated tactile cueing delivered via vibrating socks, which has the benefit of not being noticeable to bystanders. Objective To evaluate the effect of tactile cueing compared to auditory cueing on FOG. Methods Thirty-one persons with PD with FOG performed gait tasks during both ON and OFF state. The effect of open loop and closed loop tactile cueing, as delivered by vibrating socks, was compared to an active control group (auditory cueing) and to a baseline condition (uncued gait). These four conditions were balanced between subjects. Gait tasks were videotaped and annotated for FOG by two experienced raters. Motion data were collected to analyze spatiotemporal gait parameters. Responders were defined as manifesting a relative reduction of > 10% in the percent time frozen compared to uncued gait. Results The average percent time frozen during uncued gait was 11.2% in ON and 21.5% in OFF state. None of the three tested cueing modalities affected the percentage of time frozen in either the ON (p = 0.20) or OFF state (p = 0.12). The number of FOG episodes and spatiotemporal gait parameters were also not affected. We found that 22 out of 31 subjects responded to cueing, the response to the three types of cueing was highly individual. Conclusions Cueing did not improve FOG at the group level; however, tactile as well as auditory cueing improved FOG in many individuals. This highlights the need for a personalized approach when using cueing to treat FOG.

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

“…3 6 We also found some studies using devices as compensation strategies to improve gait in PD such as visual laser cues, 40 rhythmical auditory cues provided by a metronome, 41 and tactile cues. 42…”

“…3,6 We also found some studies using devices as compensation strategies to improve gait in PD such as visual laser cues, 40 rhythmical auditory cues provided by a metronome, 41 and tactile cues. 42 Some studies used VR to interact three-dimensional virtual environment. 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.…”

“…40 Additionally, proprioceptive devices, such as tactile cues or vibratory ones, are being explored to provide external support during walking. 42 Finally, visual, and auditory cues can be combined with treadmill training, and it has shown to be better than standard treadmill training alone. 46 This association may focus on gait and cognitive deficits to optimally address several critical aspects of fall risk and improve mobility, physical activity, cognitive function, and FOG in PD.…”

Neuron Foundry Mach 8: A Concept of Multi-modal Neuro-supportive Energy Therapy Device for Treating Neurodegenerative Disorders

“…Tuning fork wave therapy has modest effects on motor performance (7.43%) and cognition (4.38%) [127]. However, it shows a significant 50.00% improvement in freezing of gait [128]. Freezing of gait is a common and challenging symptom in PD, leading to falls and reduced mobility.…”

On‐Demand Cueing for Freezing of Gait in Parkinson's Disease: A Randomized Controlled Trial

“…Furthermore, it is largely unknown whether cueing is equally effective off and on medication. 14 Recent work has shown the potential of technological devices to deliver cues in daily life 12,13 including lasershoes, 17 laser-canes, 18 augmented reality glasses, 19 vibrating socks or other tactile cues, 20,21 and smartphones for auditory cueing. [22][23][24] Many of these tools present cues continuously or require patients to trigger the cues themselves.…”