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Erschienen in: Neurological Sciences 12/2020

01.06.2020 | Original Article

Wearable haptic anklets for gait and freezing improvement in Parkinson’s disease: a proof-of-concept study

verfasst von: Simone Rossi, Tommaso Lisini Baldi, Marco Aggravi, Monica Ulivelli, David Cioncoloni, Viola Niccolini, Lorenzo Donati, Domenico Prattichizzo

Erschienen in: Neurological Sciences | Ausgabe 12/2020

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Abstract

Background and objective

In a proof-of-concept study, we aimed to verify whether the wearable haptic anklets, a device that delivers personalized suprathreshold alternating exteroceptive stimulation at the anklets on demand, may improve the quality of walking, including the freezing of gate (FOG), in idiopathic Parkinson’s disease (PD) patients. The clinical relevance of the presented device as a walking pacemaker to compensate the disturbed locomotion through the generation of a more physiological internal walking rhythm should be verified in a dedicated clinical trial.

Methods

We tested 15 patients diagnosed as idiopathic PD, during their regular treatment regimen. Patients were evaluated during walking with the device switched on and off, personalized at their most comfortable cadence. Stride velocity, variance, and length, as well as FOG episode duration during walking or turning of 180°, were quantified by an optical high-performance motion capture VICON system.

Results

The alternating, rhythmic, sensory stimulation significantly improved either walking velocity or reduced inter-stride variance. Effects were more variable on stride length. The significant reduction of FOG episodes’ duration correlated with clinical severity of scales rating gate and balance. No safety problems occurred.

Conclusions

The WEARHAP-PD device, whose Technology Readiness Level (TRL) is 6, significantly improved some walking abilities (walking velocity and stride variance) and reduced the duration of FOG episodes in idiopathic PD patients. Unlike the traditional auditory and visual explicit cues that require the user’s allocation of attention for correct functioning, the interaction of the patients with the surrounding environment was preserved, due to the likely implicit processing of haptic stimuli.
Literatur
1.
Zurück zum Zitat Nieuwboer A, Dom R, De Weerdt W, Desloovere K, Fieuws S, Broens-Kaucsik E (2001) Abnormalities of the spatiotemporal characteristics of gait at the onset of freezing in Parkinson’s disease. Mov Disord 16:1066–1075CrossRef Nieuwboer A, Dom R, De Weerdt W, Desloovere K, Fieuws S, Broens-Kaucsik E (2001) Abnormalities of the spatiotemporal characteristics of gait at the onset of freezing in Parkinson’s disease. Mov Disord 16:1066–1075CrossRef
2.
Zurück zum Zitat Nonnekes J, Snijders AH, Nutt JG, Deuscl G, Giladi N, Bloem BR (2015) Freezing of gait: a practical approach to management. Lancet Neurol 14:768–778CrossRef Nonnekes J, Snijders AH, Nutt JG, Deuscl G, Giladi N, Bloem BR (2015) Freezing of gait: a practical approach to management. Lancet Neurol 14:768–778CrossRef
3.
Zurück zum Zitat Abboud H, Genc G, Thompson NR, Oravivattanakul S, Alsallom F, Reyes D, Wilson K, Cerejo R, Yu XX, Floden D, Ahmed A, Gostkowski M, Ezzeldin A, Marouf H, Mansour OY, Machado A, Fernandez HH (2017) Predictors of functional and quality of life outcomes following deep brain stimulation surgery in parkinson's disease patients: disease, patient, and surgical factors. Parkinsons Dis 5609163 Abboud H, Genc G, Thompson NR, Oravivattanakul S, Alsallom F, Reyes D, Wilson K, Cerejo R, Yu XX, Floden D, Ahmed A, Gostkowski M, Ezzeldin A, Marouf H, Mansour OY, Machado A, Fernandez HH (2017) Predictors of functional and quality of life outcomes following deep brain stimulation surgery in parkinson's disease patients: disease, patient, and surgical factors. Parkinsons Dis 5609163
4.
Zurück zum Zitat Muslimovic D, Post B, Speelman JD, Schmand B, de Haan RJ (2008) Determinants of disability and quality of life in mild to moderate Parkinson disease. Neurology 70:2241–2247 Muslimovic D, Post B, Speelman JD, Schmand B, de Haan RJ (2008) Determinants of disability and quality of life in mild to moderate Parkinson disease. Neurology 70:2241–2247
5.
Zurück zum Zitat Spaulding SJ, Barber B, Colby M, Cormack B, Mick T, Jenkins ME (2013) Cueing and gait improvement among people with Parkinson’s disease: a meta-analysis. Arch Phys Med Rehabil 94:562–570CrossRef Spaulding SJ, Barber B, Colby M, Cormack B, Mick T, Jenkins ME (2013) Cueing and gait improvement among people with Parkinson’s disease: a meta-analysis. Arch Phys Med Rehabil 94:562–570CrossRef
6.
Zurück zum Zitat Ginis P, Nackaerts E, Nieuwboer A, Heremans E (2018) Cueing for people with Parkinson’s disease with freezing of gait: a narrative review of the state-of-the-art and novel perspectives. Ann Phys Rehabil Med 61:407–413CrossRef Ginis P, Nackaerts E, Nieuwboer A, Heremans E (2018) Cueing for people with Parkinson’s disease with freezing of gait: a narrative review of the state-of-the-art and novel perspectives. Ann Phys Rehabil Med 61:407–413CrossRef
7.
Zurück zum Zitat Thaut MH, McIntosh GC, Rice RR, Miller RA, Rathbun J, Brault JM (1996) Rhythmic auditory stimulation in gait training for Parkinson’s disease patients. Mov Disord 11:193–200CrossRef Thaut MH, McIntosh GC, Rice RR, Miller RA, Rathbun J, Brault JM (1996) Rhythmic auditory stimulation in gait training for Parkinson’s disease patients. Mov Disord 11:193–200CrossRef
8.
Zurück zum Zitat Cochen Decock V, Dotov D, Damm L, Picot MC, Ihalainen P, Driss V, Geny C, Bardy B, Dalla Bella S. (2019) BeatPark: a new wearable device for gait auto-rehabilitation in Parkinson’s disease delivering adapted musical stimulation. Mov Disord 34: (suppl 2) [abstract] Cochen Decock V, Dotov D, Damm L, Picot MC, Ihalainen P, Driss V, Geny C, Bardy B, Dalla Bella S. (2019) BeatPark: a new wearable device for gait auto-rehabilitation in Parkinson’s disease delivering adapted musical stimulation. Mov Disord 34: (suppl 2) [abstract]
9.
Zurück zum Zitat Novak P, Novak V (2006) Effect of step-synchronized vibration stimulation of soles on gait in Parkinson’s disease: a pilot study. J Neuroeng Rehabil 3:9CrossRef Novak P, Novak V (2006) Effect of step-synchronized vibration stimulation of soles on gait in Parkinson’s disease: a pilot study. J Neuroeng Rehabil 3:9CrossRef
10.
Zurück zum Zitat King LK, Almeida QJ, Ahonen H (2009) Short-term effects of vibration therapy on motor impairments in Parkinson’s disease. NeuroRehabilitation 25:297–306CrossRef King LK, Almeida QJ, Ahonen H (2009) Short-term effects of vibration therapy on motor impairments in Parkinson’s disease. NeuroRehabilitation 25:297–306CrossRef
11.
Zurück zum Zitat De Nunzio AM, Grasso M, Nardone A, Godi M, Schieppati M (2010) Alternate rhythmic vibratory stimulation of trunk muscles affects walking cadence and velocity in Parkinson’s disease. Clin Neurophysiol 121:240–247CrossRef De Nunzio AM, Grasso M, Nardone A, Godi M, Schieppati M (2010) Alternate rhythmic vibratory stimulation of trunk muscles affects walking cadence and velocity in Parkinson’s disease. Clin Neurophysiol 121:240–247CrossRef
12.
Zurück zum Zitat Winfree KN, Pretzer-Aboff I, Hilgart D, Aggarwal R, Behari M, Agrawal SK (2013) The effect of step-synchronized vibration on patients with Parkinson’s disease: case studies on subjects with freezing of gait or an implanted deep brain stimulator. IEEE Trans Neural Syst Rehabil Eng 5:806–811CrossRef Winfree KN, Pretzer-Aboff I, Hilgart D, Aggarwal R, Behari M, Agrawal SK (2013) The effect of step-synchronized vibration on patients with Parkinson’s disease: case studies on subjects with freezing of gait or an implanted deep brain stimulator. IEEE Trans Neural Syst Rehabil Eng 5:806–811CrossRef
13.
Zurück zum Zitat Kuo AD (2002) The relative role of feedforward and feedback in the control of rhythmic movements. Mot Control 6:129–145CrossRef Kuo AD (2002) The relative role of feedforward and feedback in the control of rhythmic movements. Mot Control 6:129–145CrossRef
14.
Zurück zum Zitat Dimitrijevic MR, Gerasimenko Y, Pinter MM (1998) Evidence for a spinal central pattern generator in humans. Ann N Y Acad Sci 860:360–376CrossRef Dimitrijevic MR, Gerasimenko Y, Pinter MM (1998) Evidence for a spinal central pattern generator in humans. Ann N Y Acad Sci 860:360–376CrossRef
15.
Zurück zum Zitat Lisini Baldi T, Paolocci G, Prattichizzo D (2018) Human guidance: suggesting walking pace under manual and cognitive load. In EuroHaptics 2018: Haptics: science, technology, and applications, volume 10894, Pages 416–427, Pisa, Italy Lisini Baldi T, Paolocci G, Prattichizzo D (2018) Human guidance: suggesting walking pace under manual and cognitive load. In EuroHaptics 2018: Haptics: science, technology, and applications, volume 10894, Pages 416–427, Pisa, Italy
16.
Zurück zum Zitat Lisini Bladi T, Paolocci G, Barcelli D, Prattichizzo D (2020) Wearable haptics for remote social walking. IEEE Trans Haptics, 2020 (in press) Lisini Bladi T, Paolocci G, Barcelli D, Prattichizzo D (2020) Wearable haptics for remote social walking. IEEE Trans Haptics, 2020 (in press)
17.
Zurück zum Zitat Scheggi S, Talarico A, Prattichizzo D (2014) A remote guidance system for blind and visually impaired people via vibrotactile haptic feedback. In 22nd Mediterranean conference on control and automation (pp. 20–23). IEEE Scheggi S, Talarico A, Prattichizzo D (2014) A remote guidance system for blind and visually impaired people via vibrotactile haptic feedback. In 22nd Mediterranean conference on control and automation (pp. 20–23). IEEE
18.
Zurück zum Zitat Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease. a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184CrossRef Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease. a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184CrossRef
19.
Zurück zum Zitat Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stern MB, Dodel R, Dubois B, Holloway R, Jankovic J, Kulisevsky J, Lang AE, Lees A, Leurgans S, LeWitt PA, Nyenhuis D, Olanow CW, Rascol O, Schrag A, Teresi JA, van Hilten JJ, LaPelle N, Movement Disorder Society UPDRS Revision Task Force (2008) Movement Disorder Society-sponsored revision of the unified Parkinson’s disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord 23:2129–2170CrossRef Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stern MB, Dodel R, Dubois B, Holloway R, Jankovic J, Kulisevsky J, Lang AE, Lees A, Leurgans S, LeWitt PA, Nyenhuis D, Olanow CW, Rascol O, Schrag A, Teresi JA, van Hilten JJ, LaPelle N, Movement Disorder Society UPDRS Revision Task Force (2008) Movement Disorder Society-sponsored revision of the unified Parkinson’s disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord 23:2129–2170CrossRef
20.
Zurück zum Zitat Barthel C, Nonnekes J, van Helvert M, Haan R, Janssen A, Delval A, Weerdesteyn V, Debû B, van Wezel R, Bloem BR, Ferraye MU (2018) The laser shoes. A new ambulatory device to alleviate freezing of gait in Parkinson disease. Neurology 90:e164–e171 Barthel C, Nonnekes J, van Helvert M, Haan R, Janssen A, Delval A, Weerdesteyn V, Debû B, van Wezel R, Bloem BR, Ferraye MU (2018) The laser shoes. A new ambulatory device to alleviate freezing of gait in Parkinson disease. Neurology 90:e164–e171
21.
Zurück zum Zitat Nieuwboer A, Rochester L, Herman T, Vandenberghe W, Emil GE, Thomaes T, Giladi N (2009) Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson’s disease and their carers. Gait Posture 30:459–463CrossRef Nieuwboer A, Rochester L, Herman T, Vandenberghe W, Emil GE, Thomaes T, Giladi N (2009) Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson’s disease and their carers. Gait Posture 30:459–463CrossRef
22.
Zurück zum Zitat Tinetti ME, Williams TF, Mayewski R (1986) Tinetti balance assessment tool. Fall risk index for elderly patients based on number of chronic dis- abilities. Am J Med 80:429–434CrossRef Tinetti ME, Williams TF, Mayewski R (1986) Tinetti balance assessment tool. Fall risk index for elderly patients based on number of chronic dis- abilities. Am J Med 80:429–434CrossRef
23.
Zurück zum Zitat Gemperle F, Hirsch T, Goode A, Pearce J, Siewiorek D, Smailigic A (2003) “Wearable vibro-tactile display,” Corneige Mellon University Gemperle F, Hirsch T, Goode A, Pearce J, Siewiorek D, Smailigic A (2003) “Wearable vibro-tactile display,” Corneige Mellon University
24.
Zurück zum Zitat Riener A (2011) Sensor-actuator supported implicit interaction in driver assistance systems, S. H. Et al., Ed. Springer, vol. 10 Riener A (2011) Sensor-actuator supported implicit interaction in driver assistance systems, S. H. Et al., Ed. Springer, vol. 10
25.
Zurück zum Zitat Roerdink M, Bank PJ, Peper CL, Beek PJ (2011) Walking to the beat of different drums: practical implications for the use of acoustic rhythms in gait rehabilitation. Gait Posture 33:690–694CrossRef Roerdink M, Bank PJ, Peper CL, Beek PJ (2011) Walking to the beat of different drums: practical implications for the use of acoustic rhythms in gait rehabilitation. Gait Posture 33:690–694CrossRef
26.
Zurück zum Zitat Ahn J, Hogan N (2012) Walking is not like reaching: evidence from periodic mechanical perturbations. PLoS One 7:e31767CrossRef Ahn J, Hogan N (2012) Walking is not like reaching: evidence from periodic mechanical perturbations. PLoS One 7:e31767CrossRef
27.
Zurück zum Zitat Leman M, Moelants D, Varewyck M, Styns F, van Noorden L, Martens JP (2013) Activating and relaxing music entrains the speed of beat synchronized walking. PLoS One 8:e67932CrossRef Leman M, Moelants D, Varewyck M, Styns F, van Noorden L, Martens JP (2013) Activating and relaxing music entrains the speed of beat synchronized walking. PLoS One 8:e67932CrossRef
29.
Zurück zum Zitat Abbruzzese G, Berardelli A (2003) Sensorimotor integration in movement disorders. Mov Disord 18:231–240CrossRef Abbruzzese G, Berardelli A (2003) Sensorimotor integration in movement disorders. Mov Disord 18:231–240CrossRef
30.
Zurück zum Zitat Zis P, Grünewald RA, Chaudhuri RK, Hadjivassiliou M (2017) Peripheral neuropathy in idiopathic Parkinson’s disease: a systematic review. J Neurol Sci 378:204–209CrossRef Zis P, Grünewald RA, Chaudhuri RK, Hadjivassiliou M (2017) Peripheral neuropathy in idiopathic Parkinson’s disease: a systematic review. J Neurol Sci 378:204–209CrossRef
31.
Zurück zum Zitat Zehr EP, Duysens J (2004) Regulation of arm and leg movement during human locomotion. Neuroscientist 10:347–361CrossRef Zehr EP, Duysens J (2004) Regulation of arm and leg movement during human locomotion. Neuroscientist 10:347–361CrossRef
32.
Zurück zum Zitat Nielsen JB (2003) How we walk: central control of muscle activity during human walking. Neuroscientist 9:195–204CrossRef Nielsen JB (2003) How we walk: central control of muscle activity during human walking. Neuroscientist 9:195–204CrossRef
33.
Zurück zum Zitat Kotz SA, Schwartze M (2010) Cortical speech processing unplugged: a timely subcortico-cortical framework. Trends Cogn Sci 14:392–399CrossRef Kotz SA, Schwartze M (2010) Cortical speech processing unplugged: a timely subcortico-cortical framework. Trends Cogn Sci 14:392–399CrossRef
34.
Zurück zum Zitat Kotz SA, Schwartze M (2011) Differential input of the supplementary motor area to a dedicated temporal processing network: functional and clinical implications. Front Integr Neurosci 5:86CrossRef Kotz SA, Schwartze M (2011) Differential input of the supplementary motor area to a dedicated temporal processing network: functional and clinical implications. Front Integr Neurosci 5:86CrossRef
35.
Zurück zum Zitat Nutt JG, Bloem BR, Giladi N, Hallett M, Horak FB, Nieuwboer A (2011) Freezing of gait: moving forward on a mysterious clinical phenomenon. Lancet Neurol 10:734–744CrossRef Nutt JG, Bloem BR, Giladi N, Hallett M, Horak FB, Nieuwboer A (2011) Freezing of gait: moving forward on a mysterious clinical phenomenon. Lancet Neurol 10:734–744CrossRef
36.
Zurück zum Zitat Boecker H, Ceballos-Baumann A, Bartenstein P, Weindl A, Siebner HR, Fassbender T, Munz F, Schwaiger M, Conrad B (1999) Sensory processing in Parkinson’s and Huntington’s disease: investigations with 3D H(2)(15)O-PET. Brain 122:1651–1665CrossRef Boecker H, Ceballos-Baumann A, Bartenstein P, Weindl A, Siebner HR, Fassbender T, Munz F, Schwaiger M, Conrad B (1999) Sensory processing in Parkinson’s and Huntington’s disease: investigations with 3D H(2)(15)O-PET. Brain 122:1651–1665CrossRef
37.
Zurück zum Zitat Ulivelli M, Rossi S, Pasqualetti P, Rossini PM, Ghiglieri O, Passero S, Battistini N (1999) Time course of frontal somatosensory evoked potentials relation to L-dopa plasma levels and motor performance in PD. Neurology 53:1451–1457CrossRef Ulivelli M, Rossi S, Pasqualetti P, Rossini PM, Ghiglieri O, Passero S, Battistini N (1999) Time course of frontal somatosensory evoked potentials relation to L-dopa plasma levels and motor performance in PD. Neurology 53:1451–1457CrossRef
38.
Zurück zum Zitat Lewis GN, Byblow WD (2002) Altered sensorimotor integration in Parkinson’s disease. Brain 125:2089–2099CrossRef Lewis GN, Byblow WD (2002) Altered sensorimotor integration in Parkinson’s disease. Brain 125:2089–2099CrossRef
39.
Zurück zum Zitat Fasano A, Herman T, Tessitore A, Strafella AP, Bohnen NI (2015) Neuroimaging of freezing of gait. J Park Dis 5:241–254 Fasano A, Herman T, Tessitore A, Strafella AP, Bohnen NI (2015) Neuroimaging of freezing of gait. J Park Dis 5:241–254
40.
Zurück zum Zitat Shik ML, Severin FV, Orlovsky GN (1996) Control of walking and running by means of electrical stimulation of the mid-brain. Biophysics 11:756–765 Shik ML, Severin FV, Orlovsky GN (1996) Control of walking and running by means of electrical stimulation of the mid-brain. Biophysics 11:756–765
41.
Zurück zum Zitat Chung SJ, Lee YH, Yoo HS, Oh JS, Kim JS, Ye BS, Sohn YH, Lee PH (2019) White matter hyperintensities as a predictor of freezing of gate in Parkinon’s disease. Parkinsonism Relat Disord 66:105–109CrossRef Chung SJ, Lee YH, Yoo HS, Oh JS, Kim JS, Ye BS, Sohn YH, Lee PH (2019) White matter hyperintensities as a predictor of freezing of gate in Parkinon’s disease. Parkinsonism Relat Disord 66:105–109CrossRef
42.
Zurück zum Zitat Nonnekes J, Ružicka E, Nieuwboer A, Hallett M, Fasano A, Bloem BR (2019) Comopensation strategies for gait impairment in Parkinson diseae. JAMA Neurol 76:718–725CrossRef Nonnekes J, Ružicka E, Nieuwboer A, Hallett M, Fasano A, Bloem BR (2019) Comopensation strategies for gait impairment in Parkinson diseae. JAMA Neurol 76:718–725CrossRef
43.
Zurück zum Zitat Conte A, Khan N, Defazio G, Rothwell JC, Berardelli A (2013) Pathophysiology of somatosensory abnormalities in Parkinson disease. Nat Rev Neurol 9:687–697CrossRef Conte A, Khan N, Defazio G, Rothwell JC, Berardelli A (2013) Pathophysiology of somatosensory abnormalities in Parkinson disease. Nat Rev Neurol 9:687–697CrossRef
44.
Zurück zum Zitat Konczak J, Sciutti A, Avanzino L, Squeri V, Gori M, Masia L, Abbruzzese G, Sandini G (2012) Parkinson’s disease accelerates age-related decline in haptic perception by altering somatosensory integration. Brain 135:3371–3379CrossRef Konczak J, Sciutti A, Avanzino L, Squeri V, Gori M, Masia L, Abbruzzese G, Sandini G (2012) Parkinson’s disease accelerates age-related decline in haptic perception by altering somatosensory integration. Brain 135:3371–3379CrossRef
Metadaten
Titel
Wearable haptic anklets for gait and freezing improvement in Parkinson’s disease: a proof-of-concept study
verfasst von
Simone Rossi
Tommaso Lisini Baldi
Marco Aggravi
Monica Ulivelli
David Cioncoloni
Viola Niccolini
Lorenzo Donati
Domenico Prattichizzo
Publikationsdatum
01.06.2020
Verlag
Springer International Publishing
Erschienen in
Neurological Sciences / Ausgabe 12/2020
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-020-04485-4

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