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 deve...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Parkinson's Disease |
| Online Access: | http://dx.doi.org/10.1155/2019/2478980 |
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| author | Rodney Marsh Michael H. Cole Nadeeka N. W. Dissanayaka Tiffany R. Au Sandra Clewett John D. O’Sullivan Peter A. Silburn |
| author_facet | Rodney Marsh Michael H. Cole Nadeeka N. W. Dissanayaka Tiffany R. Au Sandra Clewett John D. O’Sullivan Peter A. Silburn |
| author_sort | Rodney Marsh |
| collection | DOAJ |
| 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 | Article |
| id | doaj-art-b785b76680fc4c4b9f22a3907ebf65c1 |
| institution | Kabale University |
| issn | 2090-8083 2042-0080 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Parkinson's Disease |
| spelling | doaj-art-b785b76680fc4c4b9f22a3907ebf65c12025-02-03T01:09:35ZengWileyParkinson's Disease2090-80832042-00802019-01-01201910.1155/2019/24789802478980The 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 GaitRodney Marsh0Michael H. Cole1Nadeeka N. W. Dissanayaka2Tiffany R. Au3Sandra Clewett4John D. O’Sullivan5Peter A. Silburn6School of Medicine, University of Queensland, Royal Brisbane & Women’s Hospital, Herston, QLD 4029, Brisbane, AustraliaSchool of Behavioural and Health Sciences, Australian Catholic University, Brisbane Campus, 1100 Nudgee Road, Banyo, QLD 4014, Brisbane, AustraliaUniversity of Queensland, UQ Centre for Clinical Research, Building 71/918 Royal Brisbane & Women’s Hospital, Herston, QLD 4029, Brisbane, AustraliaUniversity of Queensland, UQ Centre for Clinical Research, Building 71/918 Royal Brisbane & Women’s Hospital, Herston, QLD 4029, Brisbane, AustraliaSchool of Health & Rehabilitation Sciences, University of Queensland, St Lucia, QLD 4067, Brisbane, AustraliaSchool of Medicine, University of Queensland, Royal Brisbane & Women’s Hospital, Herston, QLD 4029, Brisbane, AustraliaSchool of Medicine, University of Queensland, Royal Brisbane & Women’s Hospital, Herston, QLD 4029, Brisbane, AustraliaBackground. 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.http://dx.doi.org/10.1155/2019/2478980 |
| spellingShingle | Rodney Marsh Michael H. Cole Nadeeka N. W. Dissanayaka Tiffany R. Au Sandra Clewett John D. O’Sullivan Peter A. Silburn 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 Parkinson's Disease |
| 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 |
| url | http://dx.doi.org/10.1155/2019/2478980 |
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