Highlights
- •A target gait speed is conveyed by touching a moving handrail during gait.
- •We compared the gaits of patients with Parkinson disease under 3 conditions: (1) unassisted; (2) using a banister; and (3) using a moving handrail.
- •We found the moving handrail increased gait speed; the banister reduced gait speed.
- •Parkinsonian gait is ameliorated with moving haptic speed cues.
Abstract
Objective
To determine whether haptic (touch and proprioception) cues from touching a moving
handrail while walking can ameliorate the gait symptoms of Parkinson disease (PD),
such as slowness and small stride length.
Design
Nonrandomized, controlled before-after trial.
Setting
Physical therapy clinic.
Participants
People with PD (n=16) and healthy age-matched control subjects (n=16) with no neurologic
disorders volunteered. No participants withdrew.
Interventions
We compared gait using a moving handrail as a novel assistive aid (speed self-selected)
versus a banister and unassisted walking. Participants with PD were tested on and
off dopaminergic medication.
Main Outcome Measures
Mean gait speed, stride length, stride duration, double-support duration, and medial-lateral
excursion.
Results
With the moving handrail, participants with PD increased gait speed relative to unassisted
gait by 16% (.166m/s, P=.009, d=.76; 95% confidence interval [CI], .054–.278m/s) and increased stride length by 10%
(.053m, P=.022, d=.37; 95% CI, .009–.097m) without significantly changing stride or double-support
duration. The banister reduced speed versus unassisted gait by 11% (−.097m/s, P=.040, d=.40; 95% CI, .002–.193m/s) and reduced stride length by 8% (.32m, P=.004, d=.26; 95% CI, .010–.054m), whereas it increased stride duration by 3% (.023s, P=.022, d=.21; 95% CI, .004–.041s) and double-support duration by 35% (.044s, P=.031, d=.58; 95% CI, .005–.083s). All medication × condition interactions were P>.05.
Conclusions
Using haptic speed cues from the moving handrail, people with PD walked faster by
spontaneously (ie, without specific instruction) increasing stride length without
altering cadence; banisters slowed gait. Haptic cues from the moving handrail can
be used by people with PD to engage biomechanical and neural mechanisms for interpreting
tactile and proprioception changes related to gait speed to control gait better than
static cues afforded by banisters.
Keywords
List of abbreviations:
H&Y (Hoehn and Yahr), PD (Parkinson disease)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 03, 2014
Footnotes
Supported by the National Institutes of Health (grant no. R03 HD058150-01A2).
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
