Handling Gait Impairments of Persons with Parkinson’s Disease by Means of Real-Time Biofeedback in a Daily Life Environment
A smartphone app with telemedicine capability integrating data from foot-mounted inertial measurement units (CuPiD-system) was developed to realize a portable gait analysis system and, on top of it, to provide people with Parkinson’s disease (PD) remote supervision and real-time feedback on gait performance. Eleven persons with PD were recommended to perform gait training for 30 min, three times per week for six weeks. The app offered praising/corrective verbal feedback, encouraging participants to keep the spatio-temporal gait parameters within a clinically determined ‘therapeutic window’. On average, persons performed 20 training sessions of 1.8 km in 24 min and received 28 corrective and 68 praising messages. The mean walking rhythm was 58 strides/min with a stride length of 1.28 m. System’s usability was determined as positive by the users. In conclusion, CuPiD resulted to be effective in promoting gait training in semi-supervised conditions, stimulating corrective actions and promoting self-efficacy to achieve optimal performance.
KeywordsParkinson’s disease Wearable sensors Android APP Tele-rehabilitation Biofeedback Gait
The research leading to these results has received funding from the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement No. 288516 (CuPiD project).
- 10.Ginis, P., Nieuwboer, A., Dorfman, M., Ferrari, A., Gazit, E., Canning, C.G., Rocchi, L., Chiari, L., Hausdorff, J.M., Mirelman, A.: Feasibility and effects of home-based smartphone-delivered automated feedback training for gait in people with Parkinson’s disease: a pilot randomized controlled trial. Parkinsonism Relat. Disord. 22, 28–34 (2015)CrossRefGoogle Scholar
- 12.Rochester, L., Baker, K., Hetherington, V., Jones, D., Willems, A.-M., Kwakkel, G., Van Wegen, E., Lim, I., Nieuwboer, A.: Evidence for motor learning in Parkinson’s disease: acquisition, automaticity and retention of cued gait performance after training with external rhythmical cues. Brain Res. 1319, 103–111 (2010)CrossRefGoogle Scholar
- 13.Nieuwboer, A., Kwakkel, G., Rochester, L., Jones, D., van Wegen, E., Willems, A.M., Chavret, F., Hetherington, V., Baker, K., Lim, I.: Cueing training in the home improves gait-related mobility in Parkinson’s disease: the RESCUE trial. J. Neurol. Neurosurg. Psychiatry 78, 134–140 (2007)CrossRefGoogle Scholar
- 19.Tomlinson, C.L., Patel, S., Meek, C., Herd, C.P., Clarke, C.E., Stowe, R., Shah, L., Sackley, C.M., Deane, K.H.O., Wheatley, K., Ives, N.: Physiotherapy versus placebo or no intervention in Parkinson’s disease. Cochrane Database Syst. Rev. 9, CD002817 (2013)Google Scholar
- 20.Lamotte, G., Rafferty, M.R., Prodoehl, J., Kohrt, W.M., Comella, C.L., Simuni, T., Corcos, D.M.: Effects of endurance exercise training on the motor and non-motor features of Parkinson’s disease: a review. J. Parkinsons Dis. 5, 21–41 (2015)Google Scholar
- 25.CuPiD.: Closed-loop system for personalized and at-home rehabilitation of people with Parkinson’s disease.: FP7-ICT-288516, 2011–2014Google Scholar