Clinical outcomes of step-synchronized vibration training in patients of Parkinson’s disease with freezing of gait
Rajeev Aggarwal1, Ingrid Pretzer-Aboff2, Kyle N Winfree3, Sunil K Agrawal4, Madhuri Behari5
1 Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
2 Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, United States, Present addresses: School of Nursing, Virginia, Commonwealth University, Richmond, Virginia
3 Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, United States, School of Informatics, Computing, and Cyber Systems, Northern, Arizona University, Flagstaff, Arizona
4 Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, United States, Department of Mechanical Engineering and Rehabilitation/Regenerative Medicine, Columbia University, New York, United States
5 Department of Neurology, All India Institute of Medical Sciences, New Delhi, India, Department of Neurology, Fortis Flt. Lt. Rajan Dhall Hospital, New Delhi, India
Department of Neurology, Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, New Delhi, India.
Source of Support: None, Conflict of Interest: None
OBJECTIVE: To elucidate the effect of step-synchronized vibration training using PDShoe on balance, gait, and quality of life in patients of Parkinson’s disease (PD) with freezing of gait (FOG).MATERIALS AND METHODS: In a pilot study, 17 patients of PD with FOG were recruited for step-synchronized vibration training. The training involved 10 sessions of gait training over 2 weeks. Each session included three 6-min bouts of walking with step-synchronized vibration applied to the second metatarsal head and medial surface of calcaneus. Participants were assessed with the Unified Parkinson’s Disease Rating Scale-III (UPDRS III), Timed Up and Go (TUG) test, Berg Balance Scale (BBS), Timed 10-Meter Walk Test, Freezing of Gait Questionnaire (FOG-Q), Falls Efficacy Scale-International (FES-I), and Parkinson’s Disease Questionnaire-39 (PDQ-39). Measurements were collected pre-intervention, post-intervention, and at a 2-week follow-up. Friedman test followed by Wilcoxon signed-rank test were used for statistical analysis.RESULTS: All participants completed the intervention without any adverse effects. Fifteen participants reported for a follow-up evaluation 2 weeks after intervention. There was statistically significant improvement in UPDRS III (P = 0.044) and significant improvement in TUG test (P = 0.005), BBS (P = 0.026), FES-I (P = 0.041), and PDQ-39 (P = 0.021) scores between pre and follow-up evaluations. No significant changes were seen in FOG-Q and Timed 10-Meter Walk Test.CONCLUSION: Step-synchronized vibration is a novel intervention to improve balance, gait, motor features, and quality of life in patients of PD with FOG. Further research is warranted to confirm the results found in this pilot study.