Study Rationale:
Cues, such as stripes on the ground, may help alleviate and sometimes even prevent freezing of gait in people with Parkinson's disease. However, different people prefer different types of cues: some need 3-D cues to step over, while others need 2-D cues to step on. Recent technological breakthroughs have led to a prototype of a smart wearable assistive cueing device, called Holocue, which offers cueing options. With Holocue, users can activate visual cues of their preference using voice commands. Holocue, which works indoors and outdoors, also captures data of users' movement and environment. With these data, Holocue may predict when and where freezing of gait is likely to occur, followed by preventive automatic cue activation.
Hypothesis:
We hypothesize that Holocue will reduce gait-freezing episodes in daily life. Using Holocue data, we also expect to be able to make accurate, fast predictions of when and where freezing of gait will occur.
Study Design:
This proof-of-concept study consists of three parts. In part 1, we will explore the potential of Holocue with on-demand cueing for reducing freezing. This will be examined in both standardized laboratory and home settings. In part 2, we will test prediction models of freezing using Holocue movement and environment data. In part 3, we will improve the Holocue application based on the experience and feedback of the users in part 1 and the findings of part 2, before studying its potential for reducing freezing in free-living environments.
Impact on Diagnosis/Treatment of Parkinson's Disease:
If we can demonstrate a positive effect of Holocue for reducing freezing in free-living environments, Holocue may become an aid for people with freezing of gait. This would improve quality of life, as no medication is currently available to alleviate this disabling motor symptom.
Next Steps for Development:
We are using developer versions of state-of-the-art mixed-reality headsets (Microsoft's HoloLens) for this study. If proven feasible and effective, Holocue could be implemented into emerging mixed-reality consumer headsets. This would require subsequent controlled trials to study its feasibility of use and efficacy in daily life.