Optimizing Augmented Reality Cueing Strategies for Freezing of Gait in Parkinson Disease: Interim Results of the ELIMINATE FoG Study (P2-11.008)

Abstract

<h3>Objective:</h3> To improve augmented reality (AR) cueing strategies in combatting freezing of gait (FoG) in Parkinson Disease (PD), and to create the first clinically effective non-rhythmic spatial AR cue using a novel, versatile cueing strategy. <h3>Background:</h3> FoG is a common symptom of PD that can interrupt daily living and cause devastating falls. Previous research demonstrated benefits of AR cueing on FoG, but those cues were not feasible for real-world applications, required attentional demands that cause social disruption, or relied on adherence to a rhythm. Non-rhythmic spatial AR cues are promising in terms of versatility and user-friendliness but have not proven effective in reducing FoG, possibly due to limited AR field-of-view of prior headsets. The Magic Leap 2 (ML2) is a new AR headset with the largest AR field-of-view to date. This hardware presents a fresh opportunity to test spatial AR cueing strategies. PD cueing products have begun to hit market; clinical guidance is needed on their use. <h3>Design/Methods:</h3> 36 PD patients will complete walking tasks in AR hallways wearing accelerometers and the ML2. The first intervention will utilize a proven physical cue to test cue-responsiveness. AR cue conditions will be randomized in order: no cue (control), constant, user hand-triggered as-needed, user eye-triggered as-needed, examiner-triggered as-needed. Our cue consists of two concentric circles with radii based on stride length; this shape allows use on turns and straight paths. This is a single-center, within-subjects, unblinded study. FoG and gait parameters will be collected via the ML2, accelerometers, and video, and compared between the test arms. <h3>Results:</h3> Sessions begin November 2022. Data from the first 50% of participants will be presented. <h3>Conclusions:</h3> Initial comparisons of cueing strategies and lessons on ML2 usability (this is the first clinical trial to use this headset) will be used to adapt the study, including a re-analysis of sample size. <b>Disclosure:</b> Mr. Baugher has nothing to disclose. Mr. Kaya has nothing to disclose. Mrs. Scelina has nothing to disclose. Miss Ghosh has nothing to disclose. Miss Amato has nothing to disclose. Dr. Baker has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Enspire DBS. The institution of Dr. Baker has received research support from St Jude/Abbott. The institution of Dr. Baker has received research support from NIH. Dr. Baker has received intellectual property interests from a discovery or technology relating to health care. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerevel. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Fernandez has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Fernandez has received research support from Biogen. The institution of Dr. Fernandez has received research support from Michael J Fox Founda. The institution of Dr. Fernandez has received research support from Roche. The institution of Dr. Fernandez has received research support from Parkinson Foundation. The institution of Dr. Fernandez has received research support from UCB. Dr. Fernandez has received publishing royalties from a publication relating to health care. Dr. Fernandez has received personal compensation in the range of $10,000-$49,999 for serving as a Steering Committee/Advisory Committee Member with Parkinson Study Group. The institution of Dr. Alberts has received research support from NIH. Dr. Alberts has received intellectual property interests from a discovery or technology relating to health care. Dr. Alberts has received personal compensation in the range of $500-$4,999 for serving as a Member, Health and Wellness Council with Peloton Interactive. The institution of Prof. Szewczyk has received research support from NASA. The institution of Prof. Szewczyk has received research support from NASA. The institution of Dr. Liao has received research support from American Parkinson Disease Association.