Use of Harmonic Ratios To Examine the Effect of Cueing Strategies on Gait Stability in Persons With Parkinson's Disease

This paper explores the use of biofeedback to improve gait in Parkinson's disease (PD) and, in particular, reports on the design and testing of a new vibratory orthosis. The orthosis causes a rhythmic vibratory stimulus to be applied to one or other side of the lumbar region. The stimulus is synchronized with stepping through the use of heel-located switches; each switch controls the stimulus to the corresponding side of the body. In the experimental evaluation it was hypothesized that step-synchronized, vibratory stimulation applied to the lumbar region will lead to an increase in walking velocity in patients with idiopathic Parkinson's disease. Subjects were asked to carry out walking trials under two conditions. In one condition, the vibratory orthosis was active; in the other condition the vibratory orthosis was inactive. Walking velocity was measured over a straight, 10 m walkway. A comparison between the two conditions using a paired t-test showed a significant increase in walking velocity when the vibratory orthosis was active, compared with the inactive condition. It was speculated that use of the vibratory orthosis, which stimulates proprioceptive receptors, may lead to an improvement in gait, stability and may support gait re-education in PD patients. It was also suggested that the results may inform future ideas for rehabilitation of similar neurological diseases.

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Gait Characteristics under Imposed Challenge Speed Conditions in Patients with Parkinson’s Disease During Overground Walking

Sensors ◽

10.3390/s20072132 ◽

2020 ◽

Vol 20 (7) ◽

pp. 2132 ◽

Cited By ~ 2

Author(s):

Myeounggon Lee ◽

Changhong Youm ◽

Byungjoo Noh ◽

Hwayoung Park ◽

Sang-Myung Cheon

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Stride Length ◽

Motor Symptoms ◽

Overground Walking ◽

Gait Stability ◽

Double Support ◽

Gait Characteristics ◽

Measurement Units ◽

Walking Tests

Evaluating gait stability at slower or faster speeds and self-preferred speeds based on continuous steps may assist in determining the severity of motor symptoms in Parkinson’s disease (PD) patients. This study aimed to investigate the gait ability at imposed speed conditions in PD patients during overground walking. Overall, 74 PD patients and 52 age-matched healthy controls were recruited. Levodopa was administered to patients in the PD group, and all participants completed imposed slower, preferred, and faster speed walking tests along a straight 15-m walkway wearing shoe-type inertial measurement units. Reliability of the slower and faster conditions between the estimated and measured speeds indicated excellent agreement for PD patients and controls. PD patients demonstrated higher gait asymmetry (GA) and coefficient of variance (CV) for stride length and stance phase than the controls at slower speeds and higher CVs for phases for single support, double support, and stance. CV of the double support phase could distinguish between PD patients and controls at faster speeds. The GA and CVs of stride length and phase-related variables were associated with motor symptoms in PD patients. Speed conditions should be considered during gait analysis. Gait variability could evaluate the severity of motor symptoms in PD patients.

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