A preliminary investigation of a novel design of visual cue glasses that aid gait in Parkinson's disease

Abstract

Objective: Parkinson's disease is a relatively common progressive neurodegenerative disorder, one of whose main features is difficulty with walking. This can be partially corrected by providing cues for the placement of each step. We piloted the potential benefit of simple custom-designed `walking glasses' worn by the patient that provide visual and auditory cues to aid in step placement. Design: We used a repeated measures design to compare gait performance when unaided and when using the walking glasses with different patterns of visual and auditory stimulation by timing patients' walking over a `real-life' predefined 30-m course. Setting: Hospital outpatient clinic. Subjects: Fifteen patients with idiopathic Parkinson's disease who had significant gait problems and no other condition affecting gait performance. Main measures: Timed walk. Results: Using the glasses, 8 of 15 patients achieved a significant and meaningful average improvement in walking time of at least 10% (mean (95% confidence interval) improvement in these patients was 21.5% (3.9%)), while a further 2 had subjective and modest objective benefit. Different patterns of visual and auditory cues suited different patients. Visual cueing alone with a fixed horizontal cue line present all the time statistically resulted in the greatest improvement in walking time. Conclusions: This pilot study shows promising improvement in the gait of a significant proportion of Parkinson's disease patients through the use of a simple, inexpensive and robust design of walking glasses, suggesting practical applicability in a therapy setting to large numbers of such patients.