Objective: To assess the effectiveness of laser-shoes in the home situation of PD patients with FOG.

Background: Freezing of gait (FOG) in Parkinson’s disease (PD) is common and debilitating. In recent laboratory studies, laser-shoes were promising in reducing FOG severity (Ferraye et al., 2016; Barthel et al., 2018).

Methods: 21 PD patients with severe FOG participated. Patients completed three consecutive conditions: week 1=wearing laser-shoes, but without cueing (‘Without Cueing’); week 2=wearing laser-shoes, with cueing (‘With Cueing’); week 3=without laser-shoes (‘Follow-Up’). Outcomes were assessed at the end of each week. The primary outcome was FOG severity FOG (New FOG Questionnaire, NFOGQ). Secondary outcomes included quality of life (Parkinson’s Disease Questionnaire-39, PDQ-39), self-reported falls and near-falls, number of self-reported FOG episodes, and perceived efficacy of the shoes. An activity monitor objectively measured relative locomotion duration.

Results: FOG severity improved significantly (NFOGQ: 20.35±5.00 Without Cueing versus 18.12±5.44 With Cueing, p=0.036). There was no significant difference between With Cueing and Follow-Up (p=0.235), suggesting potential carry-over. We also observed a reduction of self-reported falls (41%), near-falls (58%), and FOG episodes (31%) With Cueing. These clinical results were paralleled by positive subjective experiences. The PDQ-39 and relative locomotion duration did not differ across conditions.

Conclusions: These findings suggest that laser-shoes have potential as a mobile visual cueing device to reduce FOG and risk of falls in PD patients within their home situation. A placebo contribution cannot be excluded because outcomes were self-completed by participants who were not blinded to the intervention. Further work is now needed to further establish the merits of laser-shoes.

References: Ferraye MU, Fraix V, Pollak P, Bloem BR, Debu B. The laser-shoe: A new form of continuous ambulatory cueing for patients with Parkinson’s disease. Parkinsonism & related disorders. 2016. Barthel C, Nonnekes J, van Helvert M, et al. The laser shoes: A new ambulatory device to alleviate freezing of gait in Parkinson disease. Neurology. 2018;90(2):e164-e171.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/visual-cueing-using-laser-shoes-reduces-freezing-of-gait-in-parkinson-patients-at-home/