Cargando…
The CuePed Trial: How Does Environmental Complexity Impact Cue Effectiveness? A Comparison of Tonic and Phasic Visual Cueing in Simple and Complex Environments in a Parkinson's Disease Population with Freezing of Gait
BACKGROUND: The optimal prescription of cueing for the treatment of freezing of gait (FoG) in Parkinson's disease (PD) is currently a difficult problem for clinicians due to the heterogeneity of cueing modalities, devices, and the limited comparative trial evidence. There has been a rise in the...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681574/ https://www.ncbi.nlm.nih.gov/pubmed/31428302 http://dx.doi.org/10.1155/2019/2478980 |
_version_ | 1783441749808513024 |
---|---|
author | Marsh, Rodney Cole, Michael H. Dissanayaka, Nadeeka N. W. Au, Tiffany R. Clewett, Sandra O'Sullivan, John D. Silburn, Peter A. |
author_facet | Marsh, Rodney Cole, Michael H. Dissanayaka, Nadeeka N. W. Au, Tiffany R. Clewett, Sandra O'Sullivan, John D. Silburn, Peter A. |
author_sort | Marsh, Rodney |
collection | PubMed |
description | BACKGROUND: The optimal prescription of cueing for the treatment of freezing of gait (FoG) in Parkinson's disease (PD) is currently a difficult problem for clinicians due to the heterogeneity of cueing modalities, devices, and the limited comparative trial evidence. There has been a rise in the development of motion-sensitive, wearable cueing devices for the treatment of FoG in PD. These devices generally produce cues after signature gait or electroencephalographic antecedents of FoG episodes are detected (phasic cues). It is not known whether these devices offer benefit over simple (tonic) cueing devices. METHODS: We assembled 20 participants with PD and FoG and familiarized them with a belt-worn, laser-light cueing device (Agilitas™). The device was designed with 2 cueing modalities—gait-dependent or “phasic” cueing and gait-independent or “tonic” cueing. Participants used the device sequentially in the off, phasic, or tonic modes, across 2 tasks—a 2-minute walk and an obstacle course. RESULTS: A significant improvement in mean distance walked during the 2-minute walk test was observed for the tonic mode (127.3 m) compared with the off (111.4 m) and phasic (116.1 m) conditions. In contrast, there was a nonsignificant trend toward improvement in FoG frequency, duration, and course time when the device was switched from off to tonic and to phasic modes for the obstacle course. CONCLUSIONS: Parkinson's disease patients with FoG demonstrated an improvement in distance walked during the two-minute walk test when a cueing device was switched from off to phasic and to tonic modes of operation. However, this benefit was lost when patients negotiated an obstacle course. |
format | Online Article Text |
id | pubmed-6681574 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-66815742019-08-19 The CuePed Trial: How Does Environmental Complexity Impact Cue Effectiveness? A Comparison of Tonic and Phasic Visual Cueing in Simple and Complex Environments in a Parkinson's Disease Population with Freezing of Gait Marsh, Rodney Cole, Michael H. Dissanayaka, Nadeeka N. W. Au, Tiffany R. Clewett, Sandra O'Sullivan, John D. Silburn, Peter A. Parkinsons Dis Clinical Study BACKGROUND: The optimal prescription of cueing for the treatment of freezing of gait (FoG) in Parkinson's disease (PD) is currently a difficult problem for clinicians due to the heterogeneity of cueing modalities, devices, and the limited comparative trial evidence. There has been a rise in the development of motion-sensitive, wearable cueing devices for the treatment of FoG in PD. These devices generally produce cues after signature gait or electroencephalographic antecedents of FoG episodes are detected (phasic cues). It is not known whether these devices offer benefit over simple (tonic) cueing devices. METHODS: We assembled 20 participants with PD and FoG and familiarized them with a belt-worn, laser-light cueing device (Agilitas™). The device was designed with 2 cueing modalities—gait-dependent or “phasic” cueing and gait-independent or “tonic” cueing. Participants used the device sequentially in the off, phasic, or tonic modes, across 2 tasks—a 2-minute walk and an obstacle course. RESULTS: A significant improvement in mean distance walked during the 2-minute walk test was observed for the tonic mode (127.3 m) compared with the off (111.4 m) and phasic (116.1 m) conditions. In contrast, there was a nonsignificant trend toward improvement in FoG frequency, duration, and course time when the device was switched from off to tonic and to phasic modes for the obstacle course. CONCLUSIONS: Parkinson's disease patients with FoG demonstrated an improvement in distance walked during the two-minute walk test when a cueing device was switched from off to phasic and to tonic modes of operation. However, this benefit was lost when patients negotiated an obstacle course. Hindawi 2019-07-24 /pmc/articles/PMC6681574/ /pubmed/31428302 http://dx.doi.org/10.1155/2019/2478980 Text en Copyright © 2019 Rodney Marsh et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Marsh, Rodney Cole, Michael H. Dissanayaka, Nadeeka N. W. Au, Tiffany R. Clewett, Sandra O'Sullivan, John D. Silburn, Peter A. The CuePed Trial: How Does Environmental Complexity Impact Cue Effectiveness? A Comparison of Tonic and Phasic Visual Cueing in Simple and Complex Environments in a Parkinson's Disease Population with Freezing of Gait |
title | The CuePed Trial: How Does Environmental Complexity Impact Cue Effectiveness? A Comparison of Tonic and Phasic Visual Cueing in Simple and Complex Environments in a Parkinson's Disease Population with Freezing of Gait |
title_full | The CuePed Trial: How Does Environmental Complexity Impact Cue Effectiveness? A Comparison of Tonic and Phasic Visual Cueing in Simple and Complex Environments in a Parkinson's Disease Population with Freezing of Gait |
title_fullStr | The CuePed Trial: How Does Environmental Complexity Impact Cue Effectiveness? A Comparison of Tonic and Phasic Visual Cueing in Simple and Complex Environments in a Parkinson's Disease Population with Freezing of Gait |
title_full_unstemmed | The CuePed Trial: How Does Environmental Complexity Impact Cue Effectiveness? A Comparison of Tonic and Phasic Visual Cueing in Simple and Complex Environments in a Parkinson's Disease Population with Freezing of Gait |
title_short | The CuePed Trial: How Does Environmental Complexity Impact Cue Effectiveness? A Comparison of Tonic and Phasic Visual Cueing in Simple and Complex Environments in a Parkinson's Disease Population with Freezing of Gait |
title_sort | cueped trial: how does environmental complexity impact cue effectiveness? a comparison of tonic and phasic visual cueing in simple and complex environments in a parkinson's disease population with freezing of gait |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681574/ https://www.ncbi.nlm.nih.gov/pubmed/31428302 http://dx.doi.org/10.1155/2019/2478980 |
work_keys_str_mv | AT marshrodney thecuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT colemichaelh thecuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT dissanayakanadeekanw thecuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT autiffanyr thecuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT clewettsandra thecuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT osullivanjohnd thecuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT silburnpetera thecuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT marshrodney cuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT colemichaelh cuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT dissanayakanadeekanw cuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT autiffanyr cuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT clewettsandra cuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT osullivanjohnd cuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait AT silburnpetera cuepedtrialhowdoesenvironmentalcomplexityimpactcueeffectivenessacomparisonoftonicandphasicvisualcueinginsimpleandcomplexenvironmentsinaparkinsonsdiseasepopulationwithfreezingofgait |