Training stepping automaticity in Parkinson’s disease
Wearable devices can be used for music contingent stepping-in-place (SIP) training to increase motor automaticity in people with Parkinson’s disease. This training can significantly improve stepping automaticity and aid patients in self-management of their symptoms.
Deficits in dual-tasking are an early and consistent hallmark of declines in cognitive function in Parkinson’s disease (PD). Exercise programs that include SIP are effective to prevent falls and maintain functional independence, but there is a need for symptom self-maintenance tools in patients with PD. This pilot study aimed to test the feasibility and efficacy of a wearable, sensor-enabled technology to support an in-home SIP program.
Eleven patients (n=5 intervention) participated in this study. The intervention group received the wearable platform, which can be used on an iPod strapped to the knee, the control group listened to a podcast instead. With the platform, patients receive auditory reward stimuli during SIP. When their step height is normal and regular, music will play continuously. When they stop, take small amplitude steps or shuffle, the music will stop, thus providing feedback. Both groups performed SIP training, with or without the device, for 4 weeks with a minimum of 3 times per week and 10 minutes per training.
There was a significant group by training interaction, showing an improvement of dual-task step automaticity following music but not podcast training. This pilot study shows that using a wearable device to support self-management of symptoms in PD may be feasible and effective.
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> From: Chomiak et al., Medicine 96 (2017) e5934. All rights reserved to The Author(s). Click here for the online summary.