A Wearable Assistant for Gait Training for Parkinson’s Disease with Freezing of Gait in Out-of-the-Lab Environments

Abstract

People with Parkinson’s disease (PD) suffer from declining mobility capabilities, which cause a prevalent risk of falling. Commonly, short periods of motor blocks occur during walking, known as freezing of gait (FoG). To slow the progressive decline of motor abilities, people with PD usually undertake stationary motor-training exercises in the clinics or supervised by physiotherapists. We present a wearable system for the support of people with PD and FoG. The system is designed for independent use. It enables motor training and gait assistance at home and other unsupervised environments. The system consists of three components. First, FoG episodes are detected in real time using wearable inertial sensors and a smartphone as the processing unit. Second, a feedback mechanism triggers a rhythmic auditory signal to the user to alleviate freeze episodes in an assistive mode. Third, the smartphone-based application features support for training exercises. Moreover, the system allows unobtrusive and long-term monitoring of the user’s clinical condition by transmitting sensing data and statistics to a telemedicine service. We investigate the at-home acceptance of the wearable system in a study with nine PD subjects. Participants deployed and used the system on their own, without any clinical support, at their homes during three protocol sessions in 1 week. Users’ feedback suggests an overall positive attitude toward adopting and using the system in their daily life, indicating that the system supports them in improving their gait. Further, in a data-driven analysis with sensing data from five participants, we study whether there is an observable effect on the gait during use of the system. In three out of five subjects, we observed a decrease in FoG duration distributions over the protocol days during gait-training exercises. Moreover, sensing data-driven analysis shows a decrease in FoG duration and FoG number in four out of five participants when they use the system as a gait-assistive tool during normal daily life activities at home.