Objective: To investigate the effect of tactile biofeedback during every stance phase on freezing of gait (FoG) in Parkinson’s disease (PD).

Background: Accumulating evidence suggests that inadequate integration of sensory inputs and defective proprioceptive internal maps may underlie abnormal motor control in PD. Interestingly, FoG most frequently occurs during tasks that require asymmetric motor control, such as turning or when patients start walking, that depend heavily on task-specific changes in proprioceptive feedback. For these reasons, augmenting somatosensory information by using a biofeedback approach during appropriate phases of the gait cycle may improve gait disturbances.

Methods: Eight subjects with idiopathic PD with FoG (MDS-UPDRS III: 41±14 and newFoG questionnaire: 20±5) performed a turning task, consisting of turning in place for one minute (changing turning direction after each full turn) while off their levodopa medication. Three inertial sensors were mounted on the posterior trunk and on each shank. Turning was compared across 3 randomized conditions: i) baseline, ii) turning to the beat of a metronome (control), and iii) turning with phase-dependent tactile biofeedback via light vibration to the wrists every time the ipsilateral foot was in stance phase. For each condition, a FoG ratio, power spectral density ratio between high and low frequencies of shank accelerations, and the percentage of time spent freezing during the task were measured. This study is in progress and will collect 20 subjects with FoG and 20 subjects with without FoG.

Results: All subjects showed mild-to-moderate FoG during the assessment. The FoG ratio in the baseline turning condition was 2.5±0.7 and it significantly reduced with both the metronome (1.4±0.6, p=0.03) and tactile-biofeedback conditions (1±0.3; p=0.008). Similarly, the % time spent freezing in the one minute turning task significantly decreased from 48%±10 at baseline to 25%±10 in the metronome condition (p=0.01) and to 19%±7 in the tactile biofeedback condition (p=0.005).

Conclusions: We observed a significant decrease in freezing of gait while turning in both an externally-cued condition (metronome) and biofeedback condition. These preliminary observations suggest that augmenting somatosensory information with a phase-dependent biofeedback system, relying on a very unobtrusive modality may be very helpful in reducing FoG in everyday life.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/fighting-freezing-of-gait-in-parkinsons-disease-effect-of-a-phase-dependent-tactile-biofeedback/