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Study points the way for improved Parkinson’s disease therapy

In a new study published in the October 2017 issue of Gait & Posture, College of Public Health researchers, along with faculty at the University of Delaware, showed how a new device called ArmSense can enhance arm swing—and, as a result, improve walking ability—in people with Parkinson’s disease.

The methods behind ArmSense represent a new area of study when it comes to physical therapy for people with Parkinson’s disease. Therapeutic interventions usually focus on people widening their steps. They’ll employ visual cues, such as marks on a floor that people aim for when stepping, or have patients walk to the sound of a metronome that provides a steady rhythm for their movements.

ArmSense takes a different approach by enhancing arm swing to result in wider steps and improved balance. They’re small, wireless devices users wear on their wrists. They emit a small vibration when the person swings their arms at a predetermined length. This lets the person begin their movement independently, instead of relying on cues.

The devices are also potentially discreet and portable, making them easier for people to use at home or in public.

“We want this to be a ground-level, community resource that people can use for themselves,” explained Elizabeth Thompson, assistant professor of instruction in the Department of Physical Therapy and the study’s lead investigator.

This trial represented one of the few times researchers have linked arm swing to longer steps. They assessed 12 people with Parkinson’s disease walking at two speeds. Each person used no cues at first, then walked following visual markers on the floor and while listening to a metronome. Half the group used the visual cues first, the other half the audial. Then, all the participants walked with the ArmSense prototypes delivering vibrations when they met their goals.

The participants swung their arms more and took wider steps when using the devices. While visual cues also led to an increase in step length, participants swayed more, making it more likely that they lose their balance. ArmSense increased the step length without causing this extra movement.

People also improved their gait in just 15 minutes when using ArmSense—quicker than researchers expected. Now, the question is how long they’ll retain those advances. With other interventions, people with Parkinson’s often revert back to their inhibited gait without using cues. In a follow-up study, researchers are assessing the participants a month after using ArmSense.

If the improvements stick, it will give Thompson and others a better idea of how the devices can fit into a person’s physical therapy regiment.

“We’re looking for the best way to get this out and available, but that’s contingent on these studies,” she explained. “We’re being careful to do that first, and to make the user experience as good as possible.”

Read more research from the Department of Physical Therapy.

Posted:  February 1, 2018