Sijobert Benoît, Azevedo Christine, Andreu David, Verna Claudia, Geny Christian
Inria - Université de Montpellier, Montpellier, France.
Service de Neurologie, CHU Montpellier Hospital, Montpellier, France.
Artif Organs. 2017 Nov;41(11):E222-E232. doi: 10.1111/aor.13059.
This study aims to investigate the effect of a somatosensory cueing on gait disorders in subjects with Parkinson's disease (PD). After having performed stepping in place and timed up and go assessing tasks, 13 participants with PD were equipped with an electrical stimulator and an inertial measurement unit (IMU) located under the lateral malleolus on the sagittal plane. Electrodes were positioned under the arch of the foot and electrical stimulation (ES) parameters (five 500 µs/phase charge-balanced biphasic pulses delivered at 200 Hz, repeated four times at 10 Hz) adjusted to deliver a sensitive signal. Online IMU signal was processed in order to trigger ES at heel off detection. Starting from a quiet standing posture, subjects were asked to walk at their preferred speed on a path including 5 m straight line, u-turn, and walk around tasks. Three situations were considered: no stimulation baseline precondition (C0), ES condition (C1), and no stimulation baseline post-condition (C0bis), for eliminating a learning effect possibility. In ES condition (C1) the time to execute the different tasks was globally decreased in all the subjects (n = 13). Participants' results were then grouped regarding whether they experienced freezing of gait (FOG) or not during C0 no stimulation baseline precondition. In "freezer" subjects (n = 9), the time to complete the entire path was reduced by 19%. FOG episodes occurrence was decreased by 12% compared to baseline conditions. This preliminary work showed a positive global effect on gait and FOG in PD by a somatosensory cueing based on sensitive electrical stimulation.
本研究旨在调查体感提示对帕金森病（PD）患者步态障碍的影响。在进行原地踏步和计时起立行走评估任务后，13名PD患者配备了一个电刺激器和一个位于矢状面外踝下方的惯性测量单元（IMU）。电极置于足弓下方，并调整电刺激（ES）参数（以200Hz发送五个500µs/相位电荷平衡双相脉冲，以10Hz重复四次）以传递敏感信号。对在线IMU信号进行处理，以便在足跟离地检测时触发ES。从安静站立姿势开始，要求受试者以其偏好的速度在一条包括5米直线、掉头和绕行任务的路径上行走。考虑了三种情况：无刺激基线预处理（C0）、ES条件（C1）和无刺激基线后处理（C0bis），以消除学习效应的可能性。在ES条件（C1）下，所有受试者（n = 13）执行不同任务的时间总体上有所减少。然后根据参与者在C0无刺激基线预处理期间是否经历步态冻结（FOG）对结果进行分组。在“冻结者”受试者（n = 9）中，完成整个路径的时间减少了19%。与基线条件相比，FOG发作次数减少了12%。这项初步工作表明，基于敏感电刺激的体感提示对PD患者的步态和FOG有积极的总体影响。
