A Technological Review of Wearable Cueing Devices Addressing Freezing of Gait in Parkinson’s Disease
Abstract
:1. Introduction
- Cueing may compensate for the defective internal rhythm generator of the basal ganglia, consequently affecting the coordination and execution of movement [31,32]. In this way, the PwP may use auditory, visual or somatosensory cueing to provide temporal information (external rhythm) to which movement can be coupled [33].
- Another theory is that the PwP may use visual cueing to provide spatial information to scale and guide movements, which may allow the PwP to bypass their defective basal ganglia during gait [34].
- Previous studies also have suggested that cognitive/attentional mechanisms might explain the positive effects of cueing on FoG. Namely, auditory, visual or somatosensory cueing may shift the PwP’s attention to the task of walking, helping them to consciously think of what to do next [35].
- Studies indicate that enhanced proprioceptive information processing could be the mechanism underlying the positive effects of cueing on FoG. In this way, the PwP may use visual or somatosensory cueing as an artificial means to stimulate the proprioceptive inputs, providing enhanced information on limb position and movement during gait [36].
- Immediate cueing: the majority of studies have investigated the immediate effect of cueing on FoG [36,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59]. These studies predominantly evaluated the effect of cueing over a single session of use, with the objective of the cueing being to provide an immediate benefit in terms a reduction in the number/duration of FoG episodes.
- Therapeutic cueing: a number of studies have investigated the therapeutic effect of cueing [60,61,62,63,64,65,66,67,68,69,70]. During these studies, the PwP engaged in a number of therapy sessions per week (treatment period). The cueing in this case was only delivered during the therapy sessions. These therapy sessions aimed to provide a therapeutic benefit, which ameliorated FoG when the person was walking at home or in the community without any cueing being provided.
2. Methods
2.1. Review Questions
2.2. Article Search Strategy
2.3. Article Screening
2.4. Quality Assessment
- Each outcome variable was systematically measured and an inter-observer agreement (IOA) was reported for a minimum of 20% of data for each experimental condition. The IOA score must meet or exceeded 80%.
- The study included at least three replication attempts of intervention effects at different points in time or in three different phase repetitions.
- An intervention phase met the minimal data point threshold for the design type as specified by WWC guidelines [74].
3. Results
3.1. Auditory Cueing Devices
3.2. Visual Cueing Devices
3.3. Somatosensory Stimuli Devices
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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FoG Subtype | Off-Medication State | On-Medication State |
---|---|---|
Dopaminergic-Responsive FoG | FoG Occurs | No FoG |
Dopaminergic-Induced FoG | No FoG | FoG Occurs |
Dopaminergic-Resistant FoG | FoG Occurs | FoG Occurs |
Ref. | Cueing Technology | Cueing Mode | Cueing Trigger | Cueing Stimuli Type, Sound (Frequency, Duration) | Cueing Tempo Configuration | Effectiveness |
---|---|---|---|---|---|---|
[75] | Custom-built: Small Bluetooth enabled Linux based wearable computer and Bluetooth enabled movement sensor. Commercial: Wired headphones. | O. | FoG detection algorithm (73.1%, 81.6%, <2 s) 1. | Rhythmic, ticking (NR, NR). | Fixed (60 bpm). | ↓ Frequency and duration of Off-FoG 5. ↓ Frequency of On-FoG 4. ↓ Duration of On-FoG 3. ↑ Duration of On-FoG 3. |
[44] | Custom-built: Metronome. Commercial: Headphones. | C. | NA. | Rhythmic, tone (4625 Hz, 50 ms). | Adjustable (NR). | ↓ Frequency of EoD-FoG. ↓ Duration of EoD-FoG. |
[50] | Commercial: Metronome (SDM300 SAMICK). | C. | NA. | Rhythmic, tone (45–440 Hz, NR). | Adjustable (40–216 bpm). | ↑ Frequency of Off-FoG. |
[45] | Commercial: Metronome (Peterson BodyBeat). | C. | NA. | Rhythmic, rimshot, clave, wood Block or beep (NR, NR). | Adjustable (10–280 bpm). | ↓ Percentage of Off-FoG per walking task. |
[82] | Custom-built: FoG detection device and Android application. Commercial: Smartphone and wireless ear-set. | O. | FoG detection algorithm (82.2%, 92.8%, 3.2 s) 1. | Rhythmic, ticking, musical beats, clapping or verbal (NR, NR). | Adjustable (NR). | NR. |
[85] | Custom-built: Two movement sensors devices and Android application. Commercial: Smartphone and wired headphones. (GaitAssist) | O. | FoG detection algorithm (97.1%, 26.5%, 0.5 s) 2. | Rhythmic, ticking (NR, NR). | Adjustable (NR). | ↓ Frequency of FoG. ↓ Duration of FoG. |
[48] | Custom-built: Android application. Commercial: Google Glass. | O. | NA. | Rhythmic, NR (NR, NR). | Adjustable (NR). | ↓ Frequency of EoD-FoG 6. |
Ref | Cueing Technology | Cueing Mode | Cueing Trigger | Cueing Stimuli Type, Visual (Color) | Cueing Tempo Configuration | Effectiveness |
---|---|---|---|---|---|---|
[61] | Custom-built: Binocular Smartglasses. (Visual-auditory walker) | C. | NA. | Optical Flow, moving virtual checkerboard-tiled (NR). | Dynamic (Automatically adjusts to gait speed). | ↓ FOGQ score. |
[43] | Custom-built: Walking cane with attached laser. | C. | NA. | Static, horizontal laser line (green or red). | NA. | ↓ Frequency of On-FoG and Off-FoG (green laser). ↓ Frequency of On-FoG (red laser). ↑↓ Frequency of Off-FoG (red laser). 1 |
[45,57] | Commercial: U-Step walking cane. | C. | Weight-activated switch. | Static, horizontal laser line (red). | NA. | ↓ Percentage of Off-FoG per walking task. |
[49,57] | Commercial: U-Step walking stabilizer. | O. | Push button switch. | Static, horizontal laser line (red). | NA. | ↑↓ Frequency of On-FoG. 2 |
[42] | Custom-built: Walking cane with attached laser. (LaserCane) | C. | Weight-activated switch. | Static, horizontal laser line (green). | NA. | ↓ Frequency of On-FoG and Off-FoG steps |
[48] | Custom-built: Android app. Commercial: Google Glass monocular smartglasses. | C. | NA. | Optical Flow or Rhythmic, moving virtual vertically oriented lines or flashing virtual screen (red). | Adjustable. | |
[55] | Custom-built: Chest worn laser. | C. | NA. | Static or Rhythmic, horizontal laser line or flashing horizontal laser line (NR). | Adjustable. | ↓ Frequency of On-FoG. |
[56] | Custom-built: Android app. Commercial: Epson’s Moverio BT-200 binocular smartglasses. (Smart Gait-Aid) | O. | FoG detection algorithm (97%, 88%, 1.1 s). | Optical Flow, moving virtual horizontal lines (blue). | Dynamic (Automatically adjusts to gait speed). | NR. |
[51] | Custom-built: Shoe attachment with laser (Laser Shoes). | C. | Heel strike switch. | Static, horizontal laser line (red). | NA. | ↓ Frequency of On-FoG and Off-FoG. ↓ Percentage of time in On-FoG and Off-FoG. |
Ref. | Cueing Technology | Cueing Mode | Cueing Trigger | Cueing Stimuli Type, Somatosensory (Frequency, Duration) | Cueing Tempo Configuration | Effectiveness |
---|---|---|---|---|---|---|
[45] | Commercial: Metronome (Peterson BodyBeat). | C. | NA. | Rhythmic, vibrations (NR, NR). | Adjustable (10–280 bpm). | ↓ Percentage of walking task with Off-FoG. |
[54] | Custom-built: Two channel electrical stimulator (cueStim). | C. | NA. | Rhythmic, Biphasic electrical pulses (NR, 500 ms). | Fixed (86 bpm) | ↓ Frequency of On-FoG. |
[92] | Custom-built: Vibrating waistband. | C. | NA. | Rhythmic, vibrations (NR, 100–1000 ms). | Adjustable (80–250 Hz). | NA |
[94] | Custom-built: Vibrating system (VibroGait). | C. | NA. | Rhythmic, vibrations (200–300 Hz, NR) | Dynamic (Automatically adjusts to gait speed). | ↓ Frequency of and time spent in Off-FoG. |
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Sweeney, D.; Quinlan, L.R.; Browne, P.; Richardson, M.; Meskell, P.; ÓLaighin, G. A Technological Review of Wearable Cueing Devices Addressing Freezing of Gait in Parkinson’s Disease. Sensors 2019, 19, 1277. https://doi.org/10.3390/s19061277
Sweeney D, Quinlan LR, Browne P, Richardson M, Meskell P, ÓLaighin G. A Technological Review of Wearable Cueing Devices Addressing Freezing of Gait in Parkinson’s Disease. Sensors. 2019; 19(6):1277. https://doi.org/10.3390/s19061277
Chicago/Turabian StyleSweeney, Dean, Leo R. Quinlan, Patrick Browne, Margaret Richardson, Pauline Meskell, and Gearóid ÓLaighin. 2019. "A Technological Review of Wearable Cueing Devices Addressing Freezing of Gait in Parkinson’s Disease" Sensors 19, no. 6: 1277. https://doi.org/10.3390/s19061277