Influence of Cueing and an Attentional Strategy on Freezing of Gait in Parkinson Disease During Turning

Spildooren, Joke; Vercruysse, Sarah; Heremans, Elke; Galna, Brook; Verheyden, Geert; Vervoort, Griet; Nieuwboer, Alice

doi:10.1097/npt.0000000000000178

Cited by 22 publications

(34 citation statements)

References 44 publications

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“…The purpose of this study was to explore the use of discrete external visual cues to promote eye movements during a walking turn in a group with PD, thus reinforcing a head first strategy (Ambati et al, 2016;Spildooren et al, 2017). Neurotypical young adults were examined as a basis for understanding how visual cues may influence robust turning control.…”

Section: Discussionmentioning

confidence: 99%

“…Neurotypical young adults naturally produce a head first strategy (Patla et al, 1999;Hollands et al, 2002;Ambati et al, 2016;Spildooren et al, 2017). Given this, we wanted to see how NYA would react to discrete external visual cues during walking turns.…”

Section: Neurotypical Young Adultsmentioning

confidence: 99%

“…Turning while walking is defined as having a robust cranio-caudal segment sequence resulting in a head first turning strategy (Spildooren et al, 2017) or steering synergy (Patla et al, 1999;Ambati et al, 2016). This strategy requires independent control of the segments, increasing the complexity of control by the CNS, but also allows individuals to respond to perturbations (Assaiante and Amblard, 1995).…”

Section: Introductionmentioning

confidence: 99%

“…It is therefore no surprise that turning while walking becomes difficult through the natural aging of the CNS as well as for individuals with CNS deficits and/or diseases. For example, individuals with Parkinson's disease present an "en-bloc" turning strategy defined as the ascending organization of segment reorientation where the head and body reorient at the same time (or as one) in a blocked or single unit fashion (Assaiante and Amblard, 1995;Spildooren et al, 2017). The use of this strategy serves to minimize the degrees of freedom the CNS must control and aids in postural control.…”

Section: Introductionmentioning

confidence: 99%

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Visual Cues Promote Head First Strategies During Walking Turns in Individuals With Parkinson's Disease

Baker

Pitman

MacLellan

et al. 2020

Front. Sports Act. Living

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Anticipatory eye movement promotes cranio-caudal sequencing during walking turns. Clinical groups, such as Parkinson's disease (PD), do not produce anticipatory eye movements, leading to increased risk of falls. Visual cues may promote anticipatory eye movement by guiding the eyes into the turn. This study examined if visual cues could train anticipatory eye movement. Ten neurotypical young adults and 6 adults with PD completed three blocks of walking trials. Trials were blocked by visual condition: non-cued baseline turns (5 trials), visually cued turns (10 trials), and non-cued post turns (5 trials). A Delsys Trigno (Delsys, Boston, MA) recorded horizontal saccades at 1024 Hz via electrooculography (EOG). Two Optotrak cameras (Northern Digital Inc., ON, Canada) captured body segment kinematics at 120 Hz. Initiation of segment rotation with respect to ipsilateral foot contact (IFC1) prior to the turn was calculated. Neurotypical young adults (NYA) produced typical cranio-caudal rotation sequences during walking turns. Eyes led (407 ms prior to IFC1), followed by the head (50 ms prior to IFC1), then trunk and pelvis. In contrast, PD produced no anticipatory eye or segment movement at baseline. During pre-trials the eyes moved 96 ms after IFC1 and segment movement was initiated by the pelvis followed by trunk and head segments. After visual cue training however, PD produced anticipatory eye movements 161 ms prior to IFC1, followed by the head 88 ms following IFC1 but ahead of trunk and pelvis onset. These results suggest visual cues assist in producing cranio-caudal control during walking turns in PD.

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Section: Discussionmentioning

confidence: 99%

Section: Neurotypical Young Adultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Visual Cues Promote Head First Strategies During Walking Turns in Individuals With Parkinson's Disease

Baker

Pitman

MacLellan

et al. 2020

Front. Sports Act. Living

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show abstract

“…Various rhythm frequencies for “fixed” rhythmic cueing have been previously evaluated. These range from frequencies (i) equal to the person's typical step rate [13, 16], (ii) set to 10–20% below the person's typical step rate [8, 17, 18], (iii) set to 10–20% above the person's typical step rate [16, 19–21], or (iv) set to a perceived comfortable value [22]. Although the optimal frequency is unclear, it has been suggested that “fixed” rhythmic sensory stimuli help the PwP to synchronize stepping, thus helping them to regulate their gait rhythm.…”

Section: Introductionmentioning

confidence: 99%

Sensory Electrical Stimulation Cueing May Reduce Freezing of Gait Episodes in Parkinson’s Disease

Rosenthal

Sweeney

Cunnington

et al. 2018

Journal of Healthcare Engineering

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Introduction Freezing of gait (FoG) is a movement abnormality that presents with advancing Parkinson's disease (PD) and is one of the most debilitating symptoms of the disease. The mainstay of nonpharmacological management of FoG is typically through external cueing techniques designed to relieve or prevent the freezing episode. Previous work shows that electrical stimulation may prove useful as a gait guidance technique, but further evidence is required. The main objective of this study was to determine whether a “fixed” rhythmic sensory electrical stimulation (sES) cueing strategy would significantly (i) reduce the time taken to complete a walking task and (ii) reduce the number of FoG episodes occurring when performing the task. Methods 9 participants with idiopathic PD performed a self-identified walking task during both control (no cue) and cueing conditions. The self-identified walking task was a home-based daily walking activity, which was known to result in FoG for that person. A trained physiotherapist recorded the time taken to complete the walking task and the number of FoG episodes which occurred during the task. Data were analyzed by paired t-tests for both the time to complete a walking task and the number of FoG episodes occurring. Results sES cueing resulted in a reduction in the time taken to complete a walking task and in the number of FoG episodes occurring during performance of this task by 14.23 ± 11.15% (p=0.009) and 58.28 ± 33.89% (p=0.002), respectively. Conclusions This study shows a positive effect of “fixed” rhythmic sES on the time taken to complete a walking task and on the number of FoG episodes occurring during the task. Our results provide evidence that sES cueing delivered in a “fixed” rhythmic manner has the potential to be an effective cueing mechanism for FoG prevention.

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

et al. 2019

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Freezing of gait is a disabling phenomenon that appears in a substantial number of Parkinson's disease (PD) patients as the disease evolves. It is considered to be one of the most relevant contributing factors to worsening of quality of life. Current pharmacological or surgical treatment options have limited efficacy. Thus, alternative nonpharmacological/nonsurgical approaches have emerged in recent years in an attempt to improve quality of life in PD. This systematic review summarizes studies of such therapies over the past 5 years. Thirty‐five studies were evaluated by use of a qualitative evaluation, while the methodological quality was assessed using validated tools. According to our results, there appear to be two broad categories of nonpharmacological therapies: those that seek a long‐lasting benefit and those that aim to achieve a transient effect to overcome the freezing of gait episode. Among the former, it is possible to differentiate between “passive” therapies, which include transcranial magnetic stimulation or transcranial direct current stimulation, and “active” therapies, which are based on different cognitive or physical training programs. Finally, “transient effect” therapies use different types of cues, such as visual, auditory, or proprioceptive stimuli, to attempt to shift the patient's habitual motor control to a goal‐directed one. In conclusion, a broad spectrum of nonpharmacological/nonsurgical approaches for freezing of gait has emerged in recent years with promising results. © 2019 International Parkinson and Movement Disorder Society

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Influence of Cueing and an Attentional Strategy on Freezing of Gait in Parkinson Disease During Turning

Cited by 22 publications

References 44 publications

Visual Cues Promote Head First Strategies During Walking Turns in Individuals With Parkinson's Disease

Visual Cues Promote Head First Strategies During Walking Turns in Individuals With Parkinson's Disease

Sensory Electrical Stimulation Cueing May Reduce Freezing of Gait Episodes in Parkinson’s Disease

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

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