Feasibility and effects of home-based smartphone-delivered automated feedback training for gait in people with Parkinson's disease: A pilot randomized controlled trial |
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| Affiliation: | 1. KU Leuven, Department of Rehabiliation Sciences, Neuromotor Rehabilitation Research Group, Leuven, Belgium;2. Tel Aviv Sourasky Medical Center, Department of Neurology, Center for the Study of Movement, Cognition, and Mobility, Tel Aviv, Israel;3. University of Bologna, Department of Electrical, Electronic and Information Engineering – Guglielmo Marconi, Bologna, Italy;4. University of Sydney, Faculty of Health Sciences, Clinical and Rehabilitation Sciences Research Group, Sydney, Australia;5. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;6. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel;1. Department of Physical Therapy, Temple University, 3307 North Broad Street, Philadelphia, PA 19140, United States;2. Department of Kinesiology, Temple University, 1800 North Broad Street, Philadelphia, PA 19122, United States;3. Department of Bioengineering, Temple University, 1947 North 12th Street, Philadelphia, PA 19122, United States;4. Shriners Hospital for Children − Philadelphia, 3351 North Broad Street, Philadelphia, PA 19140, United States;1. Parkinson’s Disease Research Clinic, Brain and Mind Centre, University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia;2. Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA 94305, USA;1. The University of Sydney, Faculty of Health Sciences, Sydney, Australia;2. University of Technology Sydney, Graduate School of Health, Sydney, Australia;3. The University of Sydney, Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, Sydney, Australia;4. Southern Cross University, Coffs Harbour, Australia;5. University of Tasmania, School of Health Sciences, Hobart, Australia;6. Temper Tantrum, Hobart, Australia;1. Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands;2. CAPES Foundation, Ministry of Education of Brazil, Brasília/DF, Brazil;3. Institute for Computing and Information Sciences, Nijmegen, The Netherlands;4. The Michael J Fox Foundation for Parkinson’s Research, New York, USA;5. UCB Biopharma, Monheim, Germany;6. UCB Biopharma Slough, United Kingdom;7. Aston University, Birmingham, UK;8. Media Lab, Massachusetts Institute of Technology, Cambridge, USA;9. Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The Netherlands;1. University of São Paulo; School of Medicine; Department of Physical Therapy, Speech and Occupational Therapy, São Paulo, Brazil;2. School of Physical Education and Sports, Motor Behavior Laboratory, University of Sao Paulo, Brazil;3. Department of Rehabilitation and Movement Science of Rutgers University, United States of America;1. Department of Physical Therapy, Universidade Federal Do Paraná (UFPR), Curitiba, Paraná, Brazil;2. Department of Neurology, Universidade Federal Do Paraná (UFPR), Curitiba, PR, Brazil |
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| Abstract: | BackgroundInertial measurement units combined with a smartphone application (CuPiD-system) were developed to provide people with Parkinson's disease (PD) real-time feedback on gait performance. This study investigated the CuPiD-system's feasibility and effectiveness compared with conventional gait training when applied in the home environment.MethodsForty persons with PD undertook gait training for 30 min, three times per week for six weeks. Participants were randomly assigned to i) CuPiD, in which a smartphone application offered positive and corrective feedback on gait, or ii) an active control, in which personalized gait advice was provided. Gait, balance, endurance and quality of life were assessed before and after training and at four weeks follow-up using standardized tests.ResultsBoth groups improved significantly on the primary outcomes (single and dual task gait speed) at post-test and follow-up. The CuPiD group improved significantly more on balance (MiniBESTest) at post-test (from 24.8 to 26.1, SD∼5) and maintained quality of life (SF-36 physical health) at follow-up whereas the control group deteriorated (from 50.4 to 48.3, SD∼16). No other statistically significant differences were found between the two groups. The CuPiD system was well-tolerated and participants found the tool user-friendly.ConclusionCuPiD was feasible, well-accepted and seemed to be an effective approach to promote gait training, as participants improved equally to controls. This benefit may be ascribed to the real-time feedback, stimulating corrective actions and promoting self-efficacy to achieve optimal performance. Further optimization of the system and adequately-powered studies are warranted to corroborate these findings and determine cost-effectiveness. |
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| Keywords: | Parkinson's disease Physical therapy Gait training Auditory feedback Wearable sensor Smartphone |
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