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Session: Sensors and pain
Session starts: Friday 25 January, 10:30
Presentation starts: 11:45
Room: Lecture room 558

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Jaap de Ruyter van Steveninck (Donders Institute, dept. of Biophysics)
Hizirwan Salim (University of Twente, dept of Biomedical Signals and Systems)
Sabine Janssen (University of Twente, dept of Biomedical Signals and Systems)
Tjitske Heida (University of Twente, dept of Biomedical Signals and Systems)
Richard van Wezel (Donders Institute, dept. of Biophysics)

Abstract:
Freezing of gait (FOG) is a debilitating motor symptom that occurs in up to 60% of PD patients.[1] The symptom can be defined as a short-lasting arrest of gait, accompanied with the subjective feeling of the feet being glued to the ground. FOG impairs mobility, is frequently associated with falls and injuries, and reduces quality of life. Several factors have shown to evoke FOG in people with Parkinson’s disease (PD-FOG), with ‘turning around’ being the most frequent trigger.[2] Pharmacological management and deep brain stimulation can partly reduce the symptom, but are difficult to optimally implement. Consequently, alternative therapeutic options remain necessary. External cueing has shown to be a valuable strategy to prevent or overcome freezing.[3] With external visual cues discrete targets or references in the external environment are attended by the patient and used as ‘suggestions’ for enforcing an appropriate amplitude of gait and presume to elicit a shift from habitual control towards a more goal-directed mode of action control. So far, visual cueing for PD-FOG has mostly been limited to a laboratory setting, because of the nature of the stimuli. In the current study, we use smart glasses and motion sensors for interactive visual cueing in augmented reality, aiding in turning around. The stimuli consist of targets surrounding the user, and a Pac-Man figure, whose movement is linked to body rotation. The targets can be interactively reached by turning around. This design promotes goal-directed gait control and maximizes the subject’s attention to gait and posture. This mobile visual cueing application could be an important step towards on-demand symptomatic treatment of PD-FOG in the home setting. [1] N. Giladi et al., "Freezing of gait in PD: prospective assessment in the DATATOP cohort," Neurology, vol. 56, no. 12, pp. 1712-21, Jun 26 2001. [2] S. G. Rahman, H.J. ; Quinn N.P. ; Jahanshahi, M. , "The factors that induce or overcome freezing of gait in Parkinson’s disease.," Behavioural Neurology vol. 19, pp. 127–136, 2008. [3] P. Ginis, E. Nackaerts, A. Nieuwboer, and E. Heremans, "Cueing for people with Parkinson's disease with freezing of gait: A narrative review of the state-of-the-art and novel perspectives," Ann Phys Rehabil Med, Sep 7 2017.