title: Effect of Interpersonal Interaction on Festinating Gait Rehabilitation in Patients with Parkinson's Disease.
abstract: Although human walking gait rhythms are generated by native individual gait dynamics, these gait dynamics change during interactions between humans. A typical phenomenon is synchronization of gait rhythms during cooperative walking. Our previous research revealed that fluctuation characteristics in stride interval of subjects with Parkinson's disease changed from random to 1/f fluctuation as fractal characteristics during cooperative walking with the gait assist system Walk-Mate, which emulates a human interaction using interactive rhythmic cues. Moreover, gait dynamics were relearned through Walk-Mate gait training. However, the system's clinical efficacy was unclear because the previous studies did not focus on specific gait rhythm disorder symptoms. Therefore, this study aimed to evaluate the effect of Walk-Mate on festinating gait among subjects with Parkinson's disease. Three within-subject experimental conditions were used: (1) preinteraction condition, (2) interaction condition, and (3) postinteraction condition. The only difference between conditions was the interactive rhythmic cues generated by Walk-Mate. Because subjects with festinating gait gradually and involuntarily decreased their stride interval, the regression slope of stride interval as an index of severity of preinteraction festinating gait was elevated. The regression slope in the interaction condition was more gradual than during the preinteraction condition, indicating that the interactive rhythmic cues contributed to relieving festinating gait and stabilizing gait dynamics. Moreover, the gradual regression slope was carried over to the postinteraction condition, indicating that subjects with festinating gait have the potential to relearn stable gait dynamics. These results suggest that disordered gait dynamics are clinically restored through interactive rhythmic cues and that Walk-Mate may have the potential to assist therapists in more effective rehabilitation.
  
  
  BACKGROUND
  UMIN Clinical Trials Registry UMIN000012591.
authors.affiliation: Department of Computational Intelligence and Systems Science, Tokyo Institute of Technology, Yokohama, Kanagawa, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Uchitomi
authors.affiliation: Department of Computational Intelligence and Systems Science, Tokyo Institute of Technology, Yokohama, Kanagawa, Japan.
authors.forename: Ken-Ichiro
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Department of Neurology, Kanto Central Hospital, Setagaya, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Orimo
authors.affiliation: Department of Rehabilitation, Nissan Tamagawa Hospital, Setagaya, Tokyo, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Wada
authors.affiliation: Department of Computational Intelligence and Systems Science, Tokyo Institute of Technology, Yokohama, Kanagawa, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyake
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001479:Basal Ganglia / Q000503:physiopathology; D005260:Female; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009141:Musculoskeletal System / Q000503:physiopathology*; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D016138:Walking / Q000502:physiology