Comparing auditory, visual and vibrotactile cues in individuals with Parkinson’s disease for reducing risk of falling over different types of soil

Abstract

Introduction

Several researchers have demonstrated the positive benefits of auditory and visual cueing in the gait improvements among individuals with Parkinson’s disease (PD). However, few studies have evaluated the role of vibrotactile cueing when compared to auditory and visual cueing. This paper compares how these stimuli affect the risk of falling while walking on six types of soil (concrete, sand, parquet, broken stone, two types of carpet).

Methods

An instrumented Timed Up and Go (iTUG) test served to evaluate how audio, visual and vibrotactile cueing can affect the risk of falling of elderly. This pilot study proposes 12 participants with PD (67.7 ± 10.07 years) and nine age-matched controls (66.8 ± 8.0 years). Both groups performed the iTUG test with and without cueing. The cueing frequency was set at 10% above the cadence computed at the lower risk level of falling (walking over the concrete). A computed risk of falling (ROFA) index has been compared to the TUG time (total TUG duration).

Results

The index for evaluating the risk of falling appears to have a good reliability (ICC > 0.88) in this pilot study. In addition, the minimal detectable change (MDC) suggests that the proposed index could be more sensitive to the risk of falling variation compared to the TUG time. Moreover, while using the cueing, observed results suggest a significant decrease in the computed risk of falling compared to ‘without cueing’ for most of types of soil, especially for deformable soils, which can lead to falls.

Conclusion

When compared to other cueing, it seems that audio could be a better neurofeedback for reducing the risk of falling over different walking surfaces, which represent important risk factors for persons with gait disorder or lost functional autonomy.

Keywords:

• Falls
• iTUG test
• Parkinson’s disease
• cueing

Acknowledgements

We wish to thank Mr Jean-Guy Ménard, attached to the Parkinson Society of Saguenay, for his help in recruiting. The authors are grateful to those participants who gave so generously of their time and helped to make this research possible.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This work is supported by the financial support of the Natural Sciences and Engineering Research Council of Canada (NSERC) from two discovery grants, number 418235–2012 and 418624–2013.