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.

中文翻译：

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穿戴式触觉脚链可改善帕金森氏症的步态和改善结冰：概念验证研究。

背景和目标

在一项概念验证研究中，我们旨在验证可穿戴式触觉脚踝（一种可按需在脚踝上提供个性化的阈上交替上位感受性刺激的设备）是否可以改善步行质量，包括门的冻结（FOG），在特发性帕金森氏病（PD）患者中。所提出的设备作为步行起搏器通过产生更生理的内部步行节律来补偿运动障碍的临床意义应在专门的临床试验中进行验证。

方法

在他们的常规治疗方案中，我们测试了15名被诊断为特发性PD的患者。在步行过程中对患者进行评估，以其最舒适的节奏个性化地打开和关闭设备。通过光学高性能运动捕捉VICON系统对步速，方差和长度以及180°步行或转弯期间的FOG发作持续时间进行了量化。

结果

交替的，有节奏的，感觉上的刺激显着改善了步行速度或步幅间差异。对步幅的影响变化更大。FOG发作持续时间的显着减少与量表门和平衡的临床严重程度相关。没有发生安全问题。

结论

WEARHAP-PD设备的技术准备水平（TRL）为6，可显着提高特发性PD患者的某些步行能力（步行速度和步幅变化）并减少FOG发作的持续时间。与传统的听觉和视觉显式提示需要用户分配注意力以实现正常功能不同，由于可能会对触觉刺激进行隐式处理，因此保留了患者与周围环境的互动。