Continuous wearable monitor for the detection and release of Freezing of Gait

Project Summary Abstract We propose to develop a practical system designed for daily in community use that detects the occurrence of freezing of gate FOG and triggers external cueing stimuli to unfreeze the user Significance Parkinsonandapos s disease PD affects more than one million Americans and its prevalence is expected to double by Many symptoms of PD become resistant to pharmacological or neurosurgical treatments and therefore become dominant factors affecting quality of life Among the most treatment resistant motor symptoms is freezing of gait FOG This symptom affects more than of all patients with PD and is characterized by episodic impairments in the ability to initiate gait and the spontaneous arrest of movement during stepping Incidence of FOG increases with severity and duration of PD with of severely affected patients reporting freezing Clinicians have long recognized that one of the best methods to facilitate movement initiation in patients with FOG symptoms is to provide them with a sensory cue e g visual acoustic or somatosensory Recently studies have shown that self triggered cues e g via button press as is done in most commercially available cueing systems ineffective in improving gait initiation but that exogenously presented cues reduce the incidence of an inappropriate gait initiation sequences from to less than and increase the magnitude of force generation during stepping increases by an average of Hypothesis It is hypothesized that through the novel combination of commercially available sensors and custom software the proposed system will be able to identify FOG episodes in users and provide a sensory cue to facilitate movement thereby minimize the impact of FOG symptoms on quality of life Specific Aims The following aims are proposed Develop a prototype electronics and mechanical packaging in a comfortable easy to use form factor appropriate for use by individuals with PD Perform in lab testing of system performance and safety Design andamp implement FOG Detection Algorithms Evaluate the prototype system in lab and in community Project Narrative Parkinsonandapos s disease PD affects more than one million Americans and its prevalence is expected to double by More than of all patients with PD are effected by freezing of gait FOG a symptom characterized by episodic impairments in the ability to initiate gait and the spontaneous arrest of movement during stepping Like many PD symptoms FOG becomes progressively resistant to pharmacological or neurosurgical treatments and therefore becomes a dominant factor affecting quality of life Studies show that exogenously presented sensory cues e g buzzer bell or laser line mitigate FOG symptoms however current commercially available products only provide users with ineffective self triggered queues It is hypothesis that an easy to use system capable of exogenously presenting sensor queues in response to FOG episodes will improve mobility and quality of life for users