Objective: To report a case of Parkinson’s disease gait impairment which responded favourably to intervention with an assistance dog.

Background: Gait abnormalities including freezing of gait are common in Parkinson’s disease (PD) and can result in significant patient distress (1). Non pharmacological interventions such as exercise can improve motor symptoms of PD (2). Assistance dogs are used to support activities of daily living and mobility in individuals with disabilities (3). We describe a person with PD with gait deficits secondary to PD who responded favourably to daily use of an assistance dog. Accelerometer, neuropsychological and clinical data was used to provide an objective measurement of the effects of the intervention.

Method: We performed accelerometery analysis on the patient during normal ambulation and during  ambulation with an assistance dog. Neuropsychological data (the Parkinson’s Disease Quality of Life questionnaire and the Parkinson’s Disease Questionnaire) was recorded by a neuropsychologist prior to intervention. A clinical and video assessment of gait were obtained by a neurologist. The patients subjective experience after one month of use of the assistance dog  was recorded by the neurology team. We will repeat all analysis after a period of six months.

Results: The patient reported that a previous pet dog had provided somatosensory cues which greatly alleviated his freezing of gait (FOG) episodes. During daily use of this assistance dog, improvements in a number of gait deficits were reported. The patient described a marked improvement in stooped posture while mobilising and reductions in the frequency and duration of FOG episodes. Accelerometer, neuropsychological and clinical data collection is ongoing.

Conclusion: The use of an assistance dog in this individual with  PD resulted in subjective improvements in posture and mobility and collection of objective data is ongoing. The use of an assistance dog may result in improvement in gait abnormalities and balance in PD. Future analysis will aim to objectively quantify the subjective improvements described by this patient and others who use assistance dogs. We plan to further evaluate this therapeutic intervention in more patients.

References: 1. Gilat M, Ligia Silva de Lima A, Bloem BR, Shine JM, Nonnekes J, Lewis SJG. Freezing of gait: Promising avenues for future treatment. Parkinsonism Relat Disord. 2018; 52: 7-16. 2. Kolk NM van der, Vries NM de, Kessels RPC, Joosten H, Bloem B. Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson’s disease: a double-blind, randomised controlled trial. Lancet Neurol. 2019; 18: 998-1008. 3. Assistance Dogs International. Types of assistance dogs. Assistance Dogs International 2017. Available online at http://www.assistancedogsinternation.org/about-us/types-of-assistance-dogs

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