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Wearable haptic anklets for gait and freezing improvement in Parkinson’s disease: a proof-of-concept study

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Abstract

Background and objective

In a proof-of-concept study, we aimed to verify whether the wearable haptic anklets, a device that delivers personalized suprathreshold alternating exteroceptive stimulation at the anklets on demand, may improve the quality of walking, including the freezing of gate (FOG), in idiopathic Parkinson’s disease (PD) patients. The clinical relevance of the presented device as a walking pacemaker to compensate the disturbed locomotion through the generation of a more physiological internal walking rhythm should be verified in a dedicated clinical trial.

Methods

We tested 15 patients diagnosed as idiopathic PD, during their regular treatment regimen. Patients were evaluated during walking with the device switched on and off, personalized at their most comfortable cadence. Stride velocity, variance, and length, as well as FOG episode duration during walking or turning of 180°, were quantified by an optical high-performance motion capture VICON system.

Results

The alternating, rhythmic, sensory stimulation significantly improved either walking velocity or reduced inter-stride variance. Effects were more variable on stride length. The significant reduction of FOG episodes’ duration correlated with clinical severity of scales rating gate and balance. No safety problems occurred.

Conclusions

The WEARHAP-PD device, whose Technology Readiness Level (TRL) is 6, significantly improved some walking abilities (walking velocity and stride variance) and reduced the duration of FOG episodes in idiopathic PD patients. Unlike the traditional auditory and visual explicit cues that require the user’s allocation of attention for correct functioning, the interaction of the patients with the surrounding environment was preserved, due to the likely implicit processing of haptic stimuli.

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Funding

The research leading to these results has received funding from the European Union’s Horizon 2020 research and innovation program—Societal Challenge 1 (DG CONNECT/H) under grant agreement n. 643644 of the project “ACANTO: A CyberphysicAl social NeTwOrk using robot friends” and under grant agreement n° 601165 of the project ``WEARHAP–WEARable HAPtics for humans and robots”.

Author information

Author notes

  1. Simone Rossi and Tommaso Lisini Baldi contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), University of Siena, Policlinico Le Scotte, Viale Bracci, I-53100, Siena, Italy

    Simone Rossi, Monica Ulivelli, Viola Niccolini & Lorenzo Donati

  2. Department of Information Engineering and Mathematics Human Centered Robotics Group, SIRSLab, University of Siena, Siena, Italy

    Tommaso Lisini Baldi, Marco Aggravi & Domenico Prattichizzo

  3. U.O.P. Professioni della Riabilitazione, Azienda Ospedaliera Universitaria Senese, Siena, Italy

    David Cioncoloni

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  1. Simone Rossi
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Contributions

Simone Rossi: Study conception, patients’ recruitment, supervision of data acquisition, and manuscript preparation.

Tommaso Lisini Baldi: Device conception and manufacturing, data acquisition and analysis, and manuscript preparation.

Marco Aggravi: Device conception and manufacturing and data acquisition and analysis.

Monica Ulivelli: Patients’ recruitment, clinical coordination, and critical revision of the manuscript.

David Cioncoloni: Data acquisition and organization.

Viola Niccolini: Data acquisition and analysis.

Lorenzo Donati: Data acquisition and analysis.

Domenico Prattichizzo: Device and study conception and critical review of the manuscript.

Corresponding author

Correspondence to Simone Rossi.

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Rossi, S., Lisini Baldi, T., Aggravi, M. et al. Wearable haptic anklets for gait and freezing improvement in Parkinson’s disease: a proof-of-concept study. Neurol Sci 41, 3643–3651 (2020). https://doi.org/10.1007/s10072-020-04485-4

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