Investigating the Effects of a Kinematic Gait Parameter-Based Haptic Cue on Toe Clearance in Parkinson's Patients.

Abstract

Recurrent falls pose a significant challenge for Parkinson's disease (PD) patients and are a leading cause of disability in this population. One contributing factor to these recurring falls is the reduced minimum toe clearance (mTC). Preventing such falls by enhancing mTC has become an important goal in gait training among PD patients. In this paper, we propose a wearable cueing-based novel gait training device in anticipation of improved mTC. The cueing device records the foot strike angle (FSA) and cues the participants if the FSA is observed above a threshold. The patients with PD (n = 8) were recruited and asked to walk under two conditions: (a) with cue and (b) without cue at a self-selected speed during the ON medication state. Kinetic and kinematic gait parameters such as vertical ground reaction force, center of pressure, toe clearance, and FSA were recorded. A Mann-Whitney U test showed a significant increase (p < 0.001) in the toe clearance (within 34% to 64% of the swing phase from the toe-off instance) and FSA, from 87.60mm and - 5.43degrees respectively during without cue to 94.29mm and 2.93degrees respectively during with cue walking condition except in one subject. These findings support the potential incorporation of an FSA-based cueing device for toe clearance improvement among PD patients. In addition, the wearable setup supports the cueing device applicability outside laboratory and home settings.