Assistive Devices for Personal Mobility in Parkinson's Disease: A Systematic Review of the Literature

BACKGROUND: Gait abnormalities are a hallmark of Parkinson's disease and contribute to falling risk. As disease symptoms progress, assistive devices are often prescribed. However, there are no guidelines for choosing appropriate ambulatory devices for gait impairment. OBJECTIVE: To review the scientific evidence on assistive devices for gait impairment in Parkinson's disease. METHODS: We performed a systematic literature review for articles relating to parkinsonian gait impairment and assistive devices. We assessed the studies’ methodological quality and risk of bias using the PEDro scale. RESULTS: Seventeen articles were reviewed. Four articles (23.53%) showed that canes and standard and two‐wheeled walkers without visual cues decreased gait speed and stride length, with no significant effects on freezing of gait or falls. Instead, improvements were observed with the use of visual [seven articles (41.18%)] and auditory cues [three articles (17.65%)], including decreased number of freezing episodes and increased stride length. CONCLUSIONS: Although assistive devices seem to improve confidence, there is still limited information about the efficacy of assistive devices on gait parameters and functional disability in Parkinson's disease. Further, longitudinal, multicenter, randomized, blinded, and controlled studies using assistive devices in a free‐living context are required to provide the best scientific evidence