Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, 3498838, Haifa, Israel.
Technion, Israel Institute of Technology, Haifa, Israel.
Biomed Eng Online. 2023 Jan 19;22(1):2. doi: 10.1186/s12938-023-01066-2.
People with Parkinson's disease (PwP) may experience gait impairment and freezing of gait (FOG), a major cause of falls. External cueing, including visual (e.g., spaced lines on the floor) and auditory (e.g., rhythmic metronome beats) stimuli, are considered effective in alleviating mobility deficits and FOG. Currently, there is a need for a technology that delivers automatic, individually adjusted cues in the homes of PwP. The aims of this feasibility study were to describe the first step toward the development of a home-based technology that delivers external cues, test its effect on gait, and assess user experience.
Iterative system development was performed by our multidisciplinary team. The system was designed to deliver visual and auditory cues: light stripes projected on the floor and metronome beats, separately. Initial testing was performed using the feedback of five healthy elderly individuals on the cues' clarity (clear visibility of the light stripes and the sound of metronome beats) and discomfort experienced. A pilot study was subsequently conducted in the homes of 15 PwP with daily FOG. We measured participants' walking under three conditions: baseline (with no cues), walking with light stripes, and walking to metronome beats. Outcome measures included step length and step time. User experience was also captured in semi-structured interviews.
Repeated-measures ANOVA of gait assessment in PwP revealed that light stripes significantly improved step length (p = 0.009) and step time (p = 0.019) of PwP. No significant changes were measured in the metronome condition. PwP reported that both cueing modalities improved their gait, confidence, and stability. Most PwP did not report any discomfort in either modality and expressed a desire to have such a technology in their homes. The metronome was preferred by the majority of participants.
This feasibility study demonstrated the usability and potential effect of a novel cueing technology on gait, and represents an important first step toward the development of a technology aimed to prevent FOG by delivering individually adjusted cues automatically. A further full-scale study is needed. Trial registration This study was registered in ClinicalTrials.gov at 1/2/2022 NCT05211687.
帕金森病（PD）患者可能会出现步态障碍和冻结步态（FOG），这是跌倒的主要原因。外部提示，包括视觉（例如，地板上的间隔线）和听觉（例如，节奏节拍器）刺激，被认为可以有效缓解运动障碍和 FOG。目前，需要一种能够在家中为 PD 患者提供自动、个性化提示的技术。本研究的目的是描述开发一种在家中提供外部提示的技术的第一步，测试其对步态的影响，并评估用户体验。
我们的多学科团队进行了迭代系统开发。该系统旨在提供视觉和听觉提示：分别投射在地板上的光条纹和节拍器的节拍。最初的测试是由五名健康老年人对提示的清晰度（光条纹的清晰可见度和节拍器的声音）和所体验到的不适进行反馈。随后，在 15 名日常出现 FOG 的 PD 患者家中进行了一项试点研究。我们在三种情况下测量了参与者的行走：基线（无提示）、行走时带有光条纹和行走时带有节拍器。测量指标包括步长和步幅时间。用户体验也通过半结构化访谈进行了捕捉。
对 PD 患者步态评估的重复测量方差分析显示，光条纹显著改善了 PD 患者的步长（p=0.009）和步幅时间（p=0.019）。在节拍器条件下未测量到显著变化。PD 患者报告说，两种提示方式都改善了他们的步态、信心和稳定性。大多数 PD 患者在任何一种模式下都没有感到不适，并表示希望在家里拥有这样的技术。大多数参与者更喜欢节拍器。
这项可行性研究证明了一种新型提示技术对步态的可用性和潜在效果，这是朝着开发旨在通过自动提供个性化提示来预防 FOG 的技术迈出的重要的第一步。需要进一步进行全面研究。
本研究于 2022 年 1 月 2 日在 ClinicalTrials.gov 上注册，编号为 NCT05211687。
