Department of Neurology and Clinical Neurophysiology, Medical Spectrum Twente, Enschede, The Netherlands.
Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Heyendaalseweg 135, P.O. Box 9102, 6525 AJ, Nijmegen, The Netherlands.
J Neurol. 2023 Jul;270(7):3424-3432. doi: 10.1007/s00415-023-11663-9. Epub 2023 Mar 21.
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.
To evaluate the effect of tactile cueing compared to auditory cueing on FOG.
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.
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.
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.
提示策略可以减轻帕金森病（PD）患者的冻结步态（FOG）。我们评估了通过振动袜子提供的触觉提示，这种提示的好处是不会引起旁观者的注意。
评估与听觉提示相比，触觉提示对 FOG 的影响。
31 名患有 FOG 的 PD 患者在 ON 和 OFF 状态下进行步态任务。比较了振动袜子提供的开环和闭环触觉提示与主动对照组（听觉提示）和基线条件（无提示步态）的效果。这四种条件在受试者之间平衡。步态任务被录像并由两名经验丰富的评分者对 FOG 进行注释。运动数据被收集来分析时空步态参数。响应者被定义为与无提示步态相比，冻结时间的相对减少>10%。
在 ON 状态下，无提示步态时的平均冻结时间百分比为 11.2%，在 OFF 状态下为 21.5%。在 ON（p=0.20）或 OFF 状态（p=0.12）下，三种测试提示方式均未影响冻结时间的百分比。FOG 发作次数和时空步态参数也没有受到影响。我们发现，31 名受试者中有 22 名对提示有反应，对三种类型的提示的反应是高度个体化的。
提示并不能改善群体水平的 FOG；然而，触觉和听觉提示在许多个体中改善了 FOG。这凸显了在使用提示治疗 FOG 时需要个性化方法的必要性。
