Pallavi Priya, Raghuvanshi Ankita, Kumar Suhagiya Dharmik, Patel Niravkumar, Kanetkar Manasi, Chhatlani Rahul, Rana Manish, Betai Sagar, Rajan Roopa, Lahiri Uttama
Department of Electrical EngineeringIndian Institute of Technology Gandhinagar Gandhinagar 382355 India.
Aksharkrupa Hospital Ahmedabad 380004 India.
IEEE J Transl Eng Health Med. 2025 Apr 24;13:183-192. doi: 10.1109/JTEHM.2025.3563381. eCollection 2025.
Parkinson's disease (PD) is characterized by gait disturbances with freezing of gait (FoG) being one of the most disabling symptoms. The FoG episode is often preceded by an increase in variability in Step Time. As the disease progresses, such gait impairment may become resistant to pharmacotherapy. Use of external cues is an alternative. Existing solutions deliver external cues in a continuous manner that might cause habituation effects, thereby emphasizing the need for on-demand cueing. Manual on-demand cueing upon freezing has been shown to be powerful in bringing an individual out of a freezing state. This can be achieved if one's proneness to freeze before entering into freezing state can be sensed, and in-turn triggering an external cue on-demand. Motivated by this, we have developed a wearable device ([Formula: see text]) that can sense such proneness based on variability in Step Time to offer a visual cue on-demand. We conducted a study involving 20 age-matched healthy individuals and those with PD who walked overground while wearing SmartWalkVC operated in three modes with regard to offering visual cue, namely (a) On-demand cueing, (b) Continuous cueing and (c) No cueing. The results of our study showed that with on-demand cueing, those with PD had minimum variability of Step Time among all the three modes unlike healthy individuals whose gait remained majorly unaffected by different cueing modes. Also, walking speed increased along with a reduction in FoG episodes for those with PD in the on-demand cueing mode compared with the other two modes.Clinical and Translational Impact Statement: Wearable SmartWalkVC quantifies one's Step Time variability to offer visual cue on-demand, reducing one's Freezing of Gait that can have clinical significance and be translated to impact one's social presence.
帕金森病（PD）的特征是步态障碍，其中步态冻结（FoG）是最致残的症状之一。FoG发作之前通常是步幅时间变异性增加。随着疾病进展，这种步态损害可能对药物治疗产生抗性。使用外部提示是一种替代方法。现有解决方案以连续方式提供外部提示，这可能会导致习惯化效应，从而强调按需提示的必要性。已经证明，在冻结时手动按需提示在使个体摆脱冻结状态方面非常有效。如果能够感知到一个人在进入冻结状态之前的冻结倾向，并相应地触发按需外部提示，就可以实现这一点。受此启发，我们开发了一种可穿戴设备（[公式：见正文]），它可以根据步幅时间的变异性来感知这种倾向，以提供按需视觉提示。我们进行了一项研究，涉及20名年龄匹配的健康个体和帕金森病患者，他们在佩戴SmartWalkVC的情况下在地面行走，SmartWalkVC在提供视觉提示方面有三种模式，即（a）按需提示，（b）连续提示和（c）无提示。我们的研究结果表明，与健康个体不同，健康个体的步态在很大程度上不受不同提示模式的影响，而对于帕金森病患者，在按需提示模式下，步幅时间的变异性在所有三种模式中最小。此外，与其他两种模式相比，在按需提示模式下，帕金森病患者的步行速度增加，FoG发作次数减少。临床和转化影响声明：可穿戴式SmartWalkVC量化一个人的步幅时间变异性，以提供按需视觉提示，减少步态冻结，这可能具有临床意义，并转化为对一个人社交状态的影响。
