Smart ankle bracelet-laser device to improve gait and detect freezing of gait in Parkinsonism patients: a case series

Freezing of gait (FOG) is one of the most disabling symptoms of Parkinsonism. Moreover, it does not respond well to medication. Visual cues have been shown to alleviate FOG in Parkinsonism; however, their efficacy is inconsistent. Currently, most mobile cueing devices are used as an open-loop cueing system, which requires manual control to enable constant visual cues. Thus, such devices may not be suitable for some people, especially those who have attention deficits. In addition, objective measurements of FOG in real-life situations remain challenging. Therefore, we developed a smart-ankle laser as a closed-loop cueing system that can detect the patient’s walking pattern and automatically project a laser line that follows each walking step, thus requires less attention. Real-time motion was also recorded within the device for FOG measurement. We studied the efficacy of the device in three Parkinsonism patients with FOG (one man and two women, aged 58–76 years) immediately after use and two patients at 1-week follow-up. Gait speed, Timed Up and Go test performance, stride length, and % FOG improved with the use of the laser, without adverse effects.

步态冻结（Freezing of gait, FOG）是帕金森综合征（Parkinsonism）最具致残性的症状之一，且对药物治疗响应不佳。已有研究表明，视觉提示（Visual cues）可缓解帕金森综合征患者的步态冻结症状，但其疗效并不稳定。当前多数移动式提示设备采用开环提示系统（open-loop cueing system），需通过手动控制以持续输出视觉提示，因此这类设备并不适用于部分人群，尤其是存在注意力缺陷的患者。此外，在真实生活场景中对步态冻结进行客观测量仍颇具挑战。为此，本研究开发了一款智能踝部激光闭环提示系统（closed-loop cueing system），该系统可检测患者的行走模式，并自动投射与每一步行走同步的激光线，从而降低对患者的注意力需求。设备内置实时运动记录模块，用于步态冻结的量化测量。本研究针对3名伴发步态冻结的帕金森综合征患者（1男2女，年龄58~76岁），在设备使用后即刻评估其疗效，并对其中2名患者开展了为期1周的随访评估。结果显示，使用该激光提示系统后，受试者的步行速度、计时起立行走测试（Timed Up and Go test）表现、步幅及步态冻结占比（% FOG）均得到改善，且未出现不良反应。