One cue does not fit all: A systematic review with meta-analysis of the effectiveness of cueing on freezing of gait in Parkinson’s disease

Cosentino, Carola; Putzolu, Martina; Mezzarobba, Susanna; Cecchella, Margherita; Innocenti, Tiziano; Bonassi, Gaia; Botta, Alessandro; Lagravinese, Giovanna; Avanzino, Laura; Pelosin, Elisa

doi:10.1016/j.neubiorev.2023.105189

Cited by 12 publications

(9 citation statements)

References 79 publications

(535 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Also, the coupling strength between steps and cues varies with cueing modalities: the stronger gait is tied to the cue, the greater the gait-modifying effects of the cues, yielding superior effects for visual cues ( 14 , 15 ), followed by auditory and somatosensory cues. As the response of people with PD to cueing is highly variable [e.g., a person with PD showing responsiveness to 3D cues, but not to 2D cues ( 16 )], flexibility is required for tailoring cues to this heterogeneity, as well as to individual-specific gait characteristics ( 1 , 17 ), which may be challenging for some existing one-size-fits-all types or forms of cueing.…”

Section: Introductionmentioning

confidence: 99%

“…Even though early AR cueing research in people with PD with the first-generation AR headsets did not find any significant improvements on FoG, the results were still encouraging as subjective benefits of AR cueing are often reported ( 23 – 25 ). The lack of positive findings may be related to the limited AR field of view (AR-FOV) of the AR headsets ( 18 , 23 , 26 , 27 ), an insufficient familiarization period to AR headsets ( 23 ), the fact that only one specific visual cue was implemented ( 1 , 17 ), or the emphasis on FoG as an outcome measure instead of other valuable gait characteristics like gait speed and step length, susceptible to improvement with AR cueing ( 20 , 25 , 28 , 29 ). In the present study we address these issues.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Gait-modifying effects of augmented-reality cueing in people with Parkinson’s disease

Hoogendoorn,

Geerse,

van Dam

et al. 2024

Front. Neurol.

View full text Add to dashboard Cite

IntroductionExternal cueing can improve gait in people with Parkinson’s disease (PD), but there is a need for wearable, personalized and flexible cueing techniques that can exploit the power of action-relevant visual cues. Augmented Reality (AR) involving headsets or glasses represents a promising technology in those regards. This study examines the gait-modifying effects of real-world and AR cueing in people with PD.Methods21 people with PD performed walking tasks augmented with either real-world or AR cues, imposing changes in gait speed, step length, crossing step length, and step height. Two different AR headsets, differing in AR field of view (AR-FOV) size, were used to evaluate potential AR-FOV-size effects on the gait-modifying effects of AR cues as well as on the head orientation required for interacting with them.ResultsParticipants modified their gait speed, step length, and crossing step length significantly to changes in both real-world and AR cues, with step lengths also being statistically equivalent to those imposed. Due to technical issues, step-height modulation could not be analyzed. AR-FOV size had no significant effect on gait modifications, although small differences in head orientation were observed when interacting with nearby objects between AR headsets.ConclusionPeople with PD can modify their gait to AR cues as effectively as to real-world cues with state-of-the-art AR headsets, for which AR-FOV size is no longer a limiting factor. Future studies are warranted to explore the merit of a library of cue modalities and individually-tailored AR cueing for facilitating gait in real-world environments.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gait-modifying effects of augmented-reality cueing in people with Parkinson’s disease

Hoogendoorn,

Geerse,

van Dam

et al. 2024

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…Patients with FOG describe a feeling that their feet are "glued" or "magnetically stuck" to the floor. FOG has traditionally been associated with Parkinson's disease (PD), yet it is more common in atypical forms of parkinsonism, such as progressive supranuclear palsy and multiple system atrophy (MSA) (Factor, 2008;Rezvanian et al, 2020;Cosentino et al, 2023). 10.3389/fnins.2023.1194904 However, limited studies have reported the prevalence of FOG in patients with MSA.…”

Section: Introductionmentioning

confidence: 99%

Freezing of gait in Chinese patients with multiple system atrophy: prevalence and risk factors

Chen¹,

Wang²,

Huang³

et al. 2023

Front. Neurosci.

View full text Add to dashboard Cite

ObjectiveFreezing of gait (FOG) is common in neurodegenerative forms of atypical parkinsonism, but few studies have examined FOG in multiple system atrophy (MSA). In this study, we examined the prevalence of freezing of gait and its relationship to clinical features in a large cohort of Chinese MSA patients.MethodsThis exploratory study included 202 Chinese patients with probable MSA. FOG was defined as a score ≥ 1 on item 14 of the Unified Parkinson’s Disease Rating Scale. Patients with or without FOG were compared in terms of the Unified MSA Rating Scale (UMSARS) as well as cognitive and neuropsychiatric assessments.ResultsThe frequency of FOG was 48.0, 52.1, and 38.7% in MSA, MSA with predominant parkinsonism (MSA-P), and MSA with predominant cerebellar ataxia (MSA-C), respectively. FOG was associated with worse subscores on parts I, II and IV of the UMSARS as well as worse total UMSARS score; greater likelihood of speech difficulties, falls, gait impairment and balance disorder; more severe symptoms of anxiety and depression; and lower activities of daily living. The binary logistic regression model indicated that higher total UMSARS scores were associated with FOG in MSA, MSA-P, and MSA-C patients.ConclusionFreezing of gait may be common among Chinese MSA patients, FOG may correlate with severe motor symptoms, anxiety, depression and activities of daily living. Total UMSARS score may be an independent risk factor for FOG.

show abstract

“…4,10 Non-pharmacological treatment for FOG comprises teaching patients to use sensory cues, defined as providing "discrete targets for the (re-)execution of movement". 11 Still, the evidence that cueing reduces FOG in daily life is scarce [12][13][14] because of the difficulty of assessing FOG 15,16 and the practical challenges of applying cues to an episodic phenomenon. Furthermore, it is largely unknown whether cueing is equally effective off and on medication.…”

mentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

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

Zoetewei,

Herman,

Ginis

et al. 2024

Movement Disorders

View full text Add to dashboard Cite

BackgroundCueing can alleviate freezing of gait (FOG) in people with Parkinson's disease (PD), but using the same cues continuously in daily life may compromise effectiveness. Therefore, we developed the DeFOG‐system to deliver personalized auditory cues on detection of a FOG episode.ObjectivesWe aimed to evaluate the effects of DeFOG during a FOG‐provoking protocol: (1) after 4 weeks of DeFOG‐use in daily life against an active control group; (2) after immediate DeFOG‐use (within‐group) in different medication states.MethodIn this randomized controlled trial, 63 people with PD and daily FOG were allocated to the DeFOG or active control group. Both groups received feedback on their daily living step counts using the device, but the DeFOG group also received on‐demand cueing. Video‐rated FOG severity was compared pre‐ and post‐intervention through a FOG‐provoking protocol administered at home off and on‐medication, but without using DeFOG. Within‐group effects were tested by comparing FOG during the protocol with and without DeFOG.ResultsDeFOG‐use during the 4 weeks was similar between groups, but we found no between‐group differences in FOG‐severity. However, the within‐group analysis showed that FOG was alleviated by DeFOG (effect size d = 0.57), regardless of medication state. Combining DeFOG and medication yielded an effect size of d = 0.67.ConclusionsDeFOG reduced FOG considerably in a population of severe freezers both off and on medication. Nonetheless, 4 weeks of DeFOG‐use in daily life did not ameliorate FOG during the protocol unless DeFOG was worn. These findings suggest that on‐demand cueing is only effective when used, similar to other walking aids. © 2024 International Parkinson and Movement Disorder Society.

show abstract

One cue does not fit all: A systematic review with meta-analysis of the effectiveness of cueing on freezing of gait in Parkinson’s disease

Cited by 12 publications

References 79 publications

Gait-modifying effects of augmented-reality cueing in people with Parkinson’s disease

Gait-modifying effects of augmented-reality cueing in people with Parkinson’s disease

Freezing of gait in Chinese patients with multiple system atrophy: prevalence and risk factors

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

Contact Info

Product

Resources

About