Cues can break the freezing of gait of Parkinson’s patients

A human brain can be subdivided into three parts, each responsible for another level of functioning: archi for basic consciousness and reflexes, paleo for automatic movements and emotions, and neo for cognition and learning new behaviors. Parkinson’s disease is a neurological disease that affects the paleo-part of the brain, and thus the generation of automatic movements. This causes several motor problems, like balance control and walking.

A common symptom of Parkinson’s disease is a disruption of the walking pattern, also known as ‘freezing of gait’. With freezing of gait, the forward movement of a patient is blocked, causing sudden imbalance and an increased risk of falling. This freezing usually occurs when starting to walk, while making a turn, when walking through a door frame, or is caused by stress. The feet suddenly sticking to the ground and the upper body moving forward -freezing-, can lead to a fall and fall-related injuries. However, the neo level of the brain has not been affected. So, with conscious effort, it is possible for the patient to suppress symptoms like freezing and perform voluntary movements. It is challenging, though, to stay focused on a task that is usually performed subconsciously. External stimuli can help to direct the focus back on the movement and regain or maintain balance.

Cues

There is extensive scientific proof that the use of cues helps Parkinson’s patients to break freezing. Cues can address different senses, depending on the form. Auditory cues, for example, can be rhythmic metronome sounds or implemented in music. Visual cues are in the form of projected lines on the floor. Lastly, the haptic senses can be targeted with vibration cue. All cues form a tool through which the attention of patients stays on the movement.

Not only is freezing disrupted, but it is also shown that all three forms of cues influence the gait pattern of Parkinson’s patients. Parameters playing a crucial part in the risk of falling, such as step length and step frequency, improve when walking with cues.

Rollz Motion Rhythm

This literature provides the foundation on which the Rollz Motion Rhythm is designed. All three forms of cues are incorporated into the Rhythm module and can be customized based on user preference.

Key notes:

  • Parkinson’s disease obstructs automatic movement, like walking, causing patients to freeze.
  • With external cues, automatic movements become conscious regaining ability to move. 
  • Cues can be visually, auditory and/or tactile

Reference:

  • Koshimori Y, Thaut MH. (2018) Future perspectives on neural mechanisms underlying rhythm and music-based neurorehabilitation in Parkinson’s disease. Ageing Res Rev. 47:133-139
  • Nombela C, Hughes LE, Owen AM, Grahn JA. (2013) Into the groove: can rhythm influence Parkinson’s disease? Neurosci Biobehav Rev. 37(10 Pt 2):2564-70.  
  • Rutz DG, Benninger DH. (2020) Physical Therapy for Freezing of Gait and Gait Impairments in Parkinson Disease: A Systematic Review. PM R. 12(11):1140-1156. 
  • Literature