Feasibility of external rhythmic cueing with the Google Glass for improving gait in people with Parkinson's disease.
New mobile technologies like smartglasses can deliver external cues that may improve gait in people with Parkinson's disease in their natural environment. However, the potential of these devices must first be assessed in controlled experiments. Therefore, we evaluated rhythmic visual and auditory cueing in a laboratory setting with a custom-made application for the Google Glass. Twelve participants (mean age = 66.8; mean disease duration = 13.6 years) were tested at end of dose. We compared several key gait parameters (walking speed, cadence, stride length, and stride length variability) and freezing of gait for three types of external cues (metronome, flashing light, and optic flow) and a control condition (no-cue). For all cueing conditions, the subjects completed several walking tasks of varying complexity. Seven inertial sensors attached to the feet, legs and pelvis captured motion data for gait analysis. Two experienced raters scored the presence and severity of freezing of gait using video recordings. User experience was evaluated through a semi-open interview. During cueing, a more stable gait pattern emerged, particularly on complicated walking courses; however, freezing of gait did not significantly decrease. The metronome was more effective than rhythmic visual cues and most preferred by the participants. Participants were overall positive about the usability of the Google Glass and willing to use it at home. Thus, smartglasses like the Google Glass could be used to provide personalized mobile cueing to support gait; however, in its current form, auditory cues seemed more effective than rhythmic visual cues.
Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. 217, 7500, AE, Enschede, The Netherlands. yan.zhao@utwente.nl.
Yan
http://orcid.org/0000-0002-5866-5932
Y
Zhao
Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. 217, 7500, AE, Enschede, The Netherlands.|Department of Rehabilitation, Radboud University Medical Center, P.O. Box 9101, HB, Nijmegen, The Netherlands.
Jorik
J
Nonnekes
Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. 217, 7500, AE, Enschede, The Netherlands.
Erik J M
EJ
Storcken
Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. 217, 7500, AE, Enschede, The Netherlands.|Department of Neurology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
Sabine
S
Janssen
Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands.
Erwin E H
EE
van Wegen
Department of Neurology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
Bastiaan R
BR
Bloem
Department of Neurology, Medisch Spectrum Twente, P.O. Box 50 000, 7500, KA, Enschede, The Netherlands.
Lucille D A
LD
Dorresteijn
Department of Neurology, Medisch Spectrum Twente, P.O. Box 50 000, 7500, KA, Enschede, The Netherlands.
Jeroen P P
JP
van Vugt
Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. 217, 7500, AE, Enschede, The Netherlands.
Tjitske
T
Heida
Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. 217, 7500, AE, Enschede, The Netherlands.|Department of Biophysics, Donders Institute of Brain, Cognition and Behaviour, Radboud University, P.O. Box 9010, 6500, GL, Nijmegen, The Netherlands.
Richard J A
RJ
van Wezel
D000161:Acoustic Stimulation / Q000379:methods; D000368:Aged; D001696:Biomechanical Phenomena; D003463:Cues; D005139:Eyeglasses; D005240:Feasibility Studies; D005260:Female; D005684:Gait; D020235:Gait Apraxia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D010507:Periodicity; D010775:Photic Stimulation / Q000379:methods; D012656:Self-Help Devices; D016896:Treatment Outcome
Assistive devices; External cueing; Freezing of gait; Gait; Smartglasses