Investigating gait-responsive somatosensory cueing from a wearable device to improve walking in Parkinson’s disease

Dongli Li, Andre Hallack, Sophie Gwilym, Dongcheng Li, Michele T. Hu, James Cantley (Lead / Corresponding author)

    Research output: Contribution to journalArticlepeer-review

    2 Citations (Scopus)
    84 Downloads (Pure)

    Abstract

    Freezing-of-gait (FOG) and impaired walking are common features of Parkinson’s disease (PD). Provision of external stimuli (cueing) can improve gait, however, many cueing methods are simplistic, increase task loading or have limited utility in a real-world setting. Closed-loop (automated) somatosensory cueing systems have the potential to deliver personalised, discrete cues at the appropriate time, without requiring user input. Further development of cue delivery methods and FOG-detection are required to achieve this. In this feasibility study, we aimed to test if FOG-initiated vibration cues applied to the lower-leg via wearable devices can improve gait in PD, and to develop real-time FOG-detection algorithms. 17 participants with Parkinson’s disease and daily FOG were recruited. During 1 h study sessions, participants undertook 4 complex walking circuits, each with a different intervention: continuous rhythmic vibration cueing (CC), responsive cueing (RC; cues initiated by the research team in response to FOG), device worn with no cueing (NC), or no device (ND). Study sessions were grouped into 3 stages/blocks (A-C), separated by a gap of several weeks, enabling improvements to circuit design and the cueing device to be implemented. Video and onboard inertial measurement unit (IMU) data were analyzed for FOG events and gait metrics. RC significantly improved circuit completion times demonstrating improved overall performance across a range of walking activities. Step frequency was significantly enhanced by RC during stages B and C. During stage C, > 10 FOG events were recorded in 45% of participants without cueing (NC), which was significantly reduced by RC. A machine learning framework achieved 83% sensitivity and 80% specificity for FOG detection using IMU data. Together, these data support the feasibility of closed-loop cueing approaches coupling real-time FOG detection with responsive somatosensory lower-leg cueing to improve gait in PD.
    Original languageEnglish
    Article number108
    Number of pages22
    JournalBioMedical Engineering OnLine
    Volume22
    Issue number1
    Early online date16 Nov 2023
    DOIs
    Publication statusPublished - Dec 2023

    Keywords

    • Cueing
    • Festination
    • Freezing of gait
    • Machine learning
    • Movement
    • Parkinson’s disease
    • Somatosensory
    • Vibration
    • Wearable

    ASJC Scopus subject areas

    • Radiological and Ultrasound Technology
    • Radiology Nuclear Medicine and imaging
    • Biomedical Engineering
    • Biomaterials

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