P10 Using Smart Socks and Rhythmic Haptic Cues to Stimulate the Foot Arch May Reduce Gait Variability During a Freezing of Gait Elicitation Task
Brodie M, Iberzanov A, Lord S, Canning C, Fung V, Henderson E, Close J, Lovell N, Lung T, Schreier G, Vigano D, and Delbaere K
- NeuRA, Randwick, Australia
- Faculty of Health Sciences, University of Sydney, Australia
- Movement Disorders Unit, Westmead Hospital, Westmead, Australia
- Department of Population Health Sciences, University of Bristol, Bristol. UK
- Graduate School of Biomedical Engineering, University of NSW, Randwick, Australia
- The George Institute for Global Health, Sydney, Australia
- Digital Health Information Systems, AIT Austrian Institute of Technology, Graz, Austria
- Sensoria Health Inc, Redmond, USA
Falls are a serious complication for people with Parkinson’s disease (PD) and are often precipitated by excessive step-time-variability and freezing-of-gait (FOG). [1-2] Our previous work showed an acetylcholinesterase inhibitor can reduce step-time-variability; contributing to a 45% reduction in falls.  Rhythmic auditory cues may also reduce step-time-variability, but this could intrude on activities of daily living (ADLs).  This study tests the hypothesis that rhythmic haptic cues can reduce gait variability in healthy people during tasks known to evoke FOG in people with PD. 
Eleven healthy people (6-male, 5-female, aged 24-61) participated in two pilot studies including: (i) a FOG elicitation task comprising walking and turning in tight spaces; (ii) three-laps of a flight of stairs; (iii) five-laps of a six-meter walkway. Step-time-variability for baseline walks (no cues), training walks (cued) and retention walks (no cues) was assessed. During training, haptic cues were applied to alternate foot arches using vibrotactile buzzers for 250ms at the participants’ preferred cadences. Step-time-variability was assessed with an accelerometer attached to the sacrum and pressure sensor within a Sensoria smart-sock.
Study one (n=6): Step-time-variability remained unchanged during three repeated baseline FOG elicitation walks. After three training walks with haptic cues, step-time-variability was significantly reduced by 35% (p=0.04). Study two (n=5): Non-significant 45% and 8% reductions in step-time-variability were observed for laps of the walkway and stairs respectively (both p>0.05).
Rhythmic haptic cues may reduce step-time-variability during tasks known to elicit FOG. Further research is now required in people with PD.
- Henderson, E. J., et al. Rivastigmine for gait stability in patients with Parkinson’s disease (ReSPonD): a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Neurol 15, 249-258, doi:10.1016/S1474-4422(15)00389-0 (2016)
- Allen, N. E., Schwarzel, A. K. & Canning, C. G. Recurrent falls in Parkinson’s disease: a systematic review. Parkinson’s disease 2013, 906274, doi:10.1155/2013/906274 (2013).
- Brodie, M. A., et al. Symmetry matched auditory cues improve gait steadiness in most people with Parkinson’s disease but not in healthy older people. Journal of Parkinson’s disease 5, 105-116, doi:10.3233/JPD-140430 (2015).
- Lord, S., et al. Freezing of gait in people with Parkinson’s disease during simple and complex walks: nature, occurrence and risk factors. Lancet Neurology (Submitted 2018).