The effect of tactile feedback on gait initiation in people with Parkinson's disease: A pilot study.
BACKGROUND
Gait initiation and turning are common triggers for Freezing of Gait (FOG) in people with Parkinson's disease (PD). Recently, it has been shown that closed-loop tactile feedback (CLTF) can be effective to improve turning performance in people with FOG.


RESEARCH QUESTION
Does CLTF change the preparation and execution of the first step during gait initiation?


METHODS
People (n = 36) with PD with FOG (PD + FOG) (n = 18) and without FOG (PD-FOG) (n = 18) were included in the study and performed self-initiated gait with or without CLTF under single and dual task conditions. Anticipatory postural adjustments (APAs) and step kinematics were quantified with inertial measurement units (IMUs). Muscle activity of the right and left tensor fasciae latae (TFL) was measured via EMG recordings.


RESULTS
PD + FOG and PD-FOG did not differ in age, gender and disease duration and severity (p > 0.05). PD + FOG performed smaller APAs (F = 4.559, p = 0.04) with a higher amount of TFL co-contraction (F = 6.034, p = 0.02) compared to PD-FOG. CLTF had no effect on APAs but led to an increase in first step duration (F = 7.921, p = 0.008).


CONCLUSIONS
PD + FOG had smaller APAs and higher left and right TFL co-contraction during gait initiation. CLTF did not impact preparation of the first step but led to a slower execution of the first step. We speculate that, similarly to findings from turning, CLTF might result in the participant attending more closely to the first step compared to without CLTF. Whether increased attention on gait initiation is beneficial in diminishing FOG should be investigated in more detail.
['Schlenstedt|Christian|C|', 'Peterson|Daniel S|DS|', 'Mancini|Martina|M|']
D000368:Aged D059031:Anticipation, Psychological D001696:Biomechanical Phenomena D056228:Feedback, Sensory D005260:Female D005684:Gait D020233:Gait Disorders, Neurologic D006801:Humans D008297:Male D008875:Middle Aged D018482:Muscle, Skeletal D010300:Parkinson Disease D010865:Pilot Projects D011434:Proprioception D014110:Touch
Freezing of gait Anticipatory postural adjustment Posture Cue Electromyography Parkinson’s disease Postural balance Postural control Vibration