File
N. Mayo1, A. Abou-Sharkh1, K. Mate1
1McGill University & PhysioBiometrics Inc., Montreal, Canada
Background: People with Parkinson’s Disease (PD) develop a deteriorating a gait pattern characterised by quick, short, shuffling steps, on a narrow base of support, with stooped posture, rigid trunk, and reduced arm swing.The short stride length often causes the shoes to scuff the ground, making people with PD more likely to trip and fall. Eventually, walking for enjoyment and health promotion abates and eventually ceases.
One solution to improve gait is to emphasize a heel-to-toe gait pattern. Researchers at McGill University have developed and commercialized through PhysioBiometrics Inc. a device, Heel2ToeTM sensor, that automates this verbal curing by providing real-time auditory feedback when the heel strikes first when stepping.
One solution to improve gait is to emphasize a heel-to-toe gait pattern. Researchers at McGill University have developed and commercialized through PhysioBiometrics Inc. a device, Heel2ToeTM sensor, that automates this verbal curing by providing real-time auditory feedback when the heel strikes first when stepping.
Purpose: The purpose of this study was to estimate the extent to which training with the Heel2ToeTM over a longer period of time (3 months) was feasible and acceptable to participants and to estimate changes in walking capacity and gait pattern among people training with feedback from the sensor and among those training without feedback.
Methods:Design: A two-group, 2:1 randomized, feasibility trial was carried out with repeated measures of gait parameters and walking outcomes.
Population: People with PD manifesting gait impairments or limitations in walking capacity but able to walk without a walking aid were recruited.
Intervention: Both groups received a workbook with instructions to identify gait deficits and on simple exercises to facilitate a better walking pattern (Walk-BEST Workbook available at PhysioBiometrics website), 5 sessions with a physiotherapist (PT) over two weeks to practice walking well and practice four specific exercises, one for each major joint area involved in walking (foot and ankle, knees, hip, trunk).This personal gait training period was followed by independent home practice over 3 months. Both groups were instructed to practice walking with the sensor for a minimum period of 5 minutes, twice a day.
Measures: The primary outcome was the 6 Minute Walk Test (6MWT). Explanatory outcomes were gait quality parameters. Exploratory outcomes included the Neuro-Qol Lower Extremity Function –Short Form, Visual Analogue Health States and motivation, EuroQol EQ-5D.
Population: People with PD manifesting gait impairments or limitations in walking capacity but able to walk without a walking aid were recruited.
Intervention: Both groups received a workbook with instructions to identify gait deficits and on simple exercises to facilitate a better walking pattern (Walk-BEST Workbook available at PhysioBiometrics website), 5 sessions with a physiotherapist (PT) over two weeks to practice walking well and practice four specific exercises, one for each major joint area involved in walking (foot and ankle, knees, hip, trunk).This personal gait training period was followed by independent home practice over 3 months. Both groups were instructed to practice walking with the sensor for a minimum period of 5 minutes, twice a day.
Measures: The primary outcome was the 6 Minute Walk Test (6MWT). Explanatory outcomes were gait quality parameters. Exploratory outcomes included the Neuro-Qol Lower Extremity Function –Short Form, Visual Analogue Health States and motivation, EuroQol EQ-5D.
Results: A total of 27 people were randomized, 18 to train with the Heel2Toe sensor and gait-related exercise workbook and 9 training only with the gait-related workbook; 21 people completed the 3-month evaluation (14 and 7 in the two groups respectively. The main outcome was the distance walked in 6 minutes (6MWT); 13 of 14 people in the intervention group improved over measurement error (mean change 66.4 m.) and 0 of the 7 in the control group changed this amount (mean change -19.4 m.).Using an index of reliable change 4 of 14 made this change in the Heel2Toe group and 0 of 7 in the Workbook group.The improvements in walking distance were accompanied by improvements in gait quality metrics.Analyses on changes in other indicators of mobility and on motivation are underway.Forty % of the participants in the intervention group were strongly satisfied with their technology experience and an additional 37% were satisfied.
Conclusions: The results provide Level 2a evidence of efficacy.
Implications: TheHeel2ToeTMsensor provides therapy in every step.
Funding acknowledgements: Healthy Brain, Health Lives - McGill University
Keywords:
Innovative Technologies
Walking
Parkinsons
Innovative Technologies
Walking
Parkinsons
Topics:
Neurology: Parkinson's disease
Innovative technology: information management, big data and artificial intelligence
Disability & rehabilitation
Neurology: Parkinson's disease
Innovative technology: information management, big data and artificial intelligence
Disability & rehabilitation
Did this work require ethics approval? Yes
Institution: McGill University Health Center
Committee: MUHC Research Ethics Board
Ethics number: 2020-5842
All authors, affiliations and abstracts have been published as submitted.
