Can google glass™ technology improve freezing of gait in parkinsonism? A pilot study

Abstract

Purpose

Freezing of gait (FOG) is a disabling phenomenon defined by the periodic absence or reduction of forward progression of the feet despite the intention to walk. We sought to understand whether Google Glass (GG), a lightweight wearable device that provides simultaneous visual-auditory cues, might improve FOG in parkinsonism.

Methods

Patients with parkinsonism and FOG utilized GG custom-made auditory-visual cue applications: “Walk With Me” and “Unfreeze Me” in a single session intervention. We recorded ambulation time with and without GG under multiple conditions including 25 feet straight walk, dual task of performing serial 7’s while straight walking, 180 degree turn after walking 25 feet, and walking through a doorway. FOG and patient experience questionnaires were administered.

Results

Using the GG “Walk With Me” program, improvements were noted in the following: average 25 feet straight walk by 0.32 s (SD 2.12); average dual task of serial 7’s and 25 feet straight walk by 1.79 s (SD 2.91); and average walk through doorway by 0.59 s (SD 0.81). Average 180 degree turn after 25 feet walk worsened by 1.89 s (SD 10.66). Using the “Unfreeze Me” program, only the average dual task of serial 7’s and 25 feet straight walk improved (better by 0.82 s (SD 3.08 sec). All other tasks had worse performance in terms of speed of completion.

Conclusion

This feasibility study provides preliminary data suggesting that some walking tasks may improve with GG, which uses various musical dance programs to provide visual and auditory cueing for patients with FOG.

IMPLICATIONS FOR REHABILITATION

• Freezing of gait in parkinsonian syndromes is a disabling motor block described by patients as having their feet stuck to the floor leading to difficulty in initiation of gait and increased risk for falls.

• Wearable assistive devices such as Google Glass™ use visual and auditory cueing that may improve gait pattern in patients with freezing of gait.

• Augmented reality programs using wearable assistive devices are a home-based therapy, with the potential for reinforcing physical therapy techniques; this is especially meaningful during the COVID-19 pandemic when access to both medical and rehabilitative care has been curtailed.

Keywords:

• Freezing of gait
• parkinsonism
• Parkinson’s Disease
• augmented reality
• Google Glass
• visual-auditory cueing

Acknowledgements

We would like to acknowledge Mr. David Leventhal for providing us with the Google Glass technology and programs utilized in this study. He acts as a representative of Discalced, Inc (dba Mark Morris Dance Group), which owns the copyright on the content embedded in “Moving Through Glass,” and grants permission to use the photo attached in the article.

Author contributions

AL: Writing- Original Draft, Validation: NH: Investigation, Writing- Review & Editing: MV: Validation, Writing- Review & Editing: FW: Formal Analysis: PP: Conceptualization, Investigation: SB: Data Curation, Visualization: DP: Data Curation, Visualization: CC: Investigation, Data Curation: CH: Conceptualization, Writing- Review & Editing, Supervision: HS: Conceptualization, Methodology, Investigation, Writing- Original Draft, Project Administration.

Disclosure statement

No potential conflict of interest was reported by the author(s).