Abstract:

Introduction: Parkinson’s Disease (PD) is a progressive neurodegenerative disorder which presents with a myriad of motor, non-motor and psychiatric symptoms. Symptoms which are typically more difficult to treat, such as gait abnormality, postural instability and freezing of gait, increase the risk of falls in this vulnerable population, which has a negative impact on health outcomes and a considerable economic impact. Novel technologies utilising non-invasive neuromodulation may help ameliorate some of these symptoms and reduce the risk and burden of falls. This paper reports a case of a PD patient utilising a wearable device delivering vibrotactile stimulation and cueing to aid mobility and reduce risk and number of falls.

Case Presentation: The 75-year-old male, with a 15-year history of PD, presented with postural instability, frequent falls, freeze of gait and deteriorating coordination. The patient required assistance from his primary caregiver to ambulate and apomorphine injections were utilised by the patient upon severe freezing for symptom relief. Utilising a wearable device delivering vibrotactile stimulation and cueing over a 14-week period reduced falls by 83%, the FES-1 score by 15.5% and his MDS-UPDRS Part III motor score by 20 points.

Discussion: Long-term use of the novel vibrotactile stimulation device, which delivers rhythmic kinesthetic stimuli on the sternum, significantly reduced the frequency of falls in this patient with PD. This finding may be due to improvements in postural stability and freeze of gait, as reflected in MDS-UPDRS assessment scores, and patient self reporting. Further larger-scale studies are needed to confirm and validate these findings.

Keywords:

CUEING; FREEZING OF GAIT; PARKINSON’S DISEASE; POSTURAL INSTABILITY; VIBROTACTILE STIMULATION