Immediate Effects of Lower Limb Sensory Simulation Using Smart Socks to Stabilize Gait in People with Parkinson's Disease

Matthew A. Brodie, Paulo H. Pelicioni, Yoshiro Okubo, Daniel Y. Chan, Vincent Carroll, Barbara Toson, Davide Vigano, Maurizio MacAgno, Sharlene Sternberg, Guenter Schreier, Nigel H. Lovell

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Abstract

People with Parkinson's disease (PD) experience gait impairment that can lead to falls and poor quality of life. Here we investigate the feasibility of using smart socks to stimulate the lower limbs of people with PD to reduce excessive step time variability during walking. We hypothesised that rythmic excitation of lower limb afferents, matched to a participant's comfortable pace, would entrain deficient neuro-muscular signals resulting in improved gait. Five people with mild to moderate PD symptoms (70 ± 9 years) were tested on medication before and after a 30-minute familierization session. Paired t-tests and Cohen's d were used to assess gait changes and report effect sizes. Participant experiences were recorded through structured interviews. Lower limb stimulation resulted in an acute 15% increase in gait speed (p=0.006, d=0.62), an 11% increase in step length (p=0.04, d=0.35), a 44% reduction in step time variability (p=0.03, d=0.91), a 22% increase in perceived gait quality (p=0.04, d=1.17), a 24% reduction in mental effort to walk (p=0.02, d=0.79) and no statistical difference for cadence (p=0.16). Participants commented positively on the benefit of stimulation during training but found that stimulation could be distracting when not walking and the socks hard to put on. While the large effects for step time variability and percieved gait quality (Cohen's d > 0.8) are promising, limitations regarding sample size, potential placebo effects and translation to the home environment should be addressed by future studies.Clinical Relevance-This study demonstrates the feasibility of using smart stimulating socks to reduce excessive step time variability in people with PD.

Original languageEnglish
Title of host publication2023 45th Annual International Conference of the IEEE Engineering in Medicine and Biology Conference, EMBC 2023 - Proceedings
PublisherInstitute of Electrical and Electronics Engineers
Number of pages4
ISBN (Electronic)9798350324471
DOIs
Publication statusPublished - 11 Dec 2023
Event45th Annual International Conference of the IEEE Engineering in Medicine and Biology Conference, EMBC 2023 - Sydney, Australia
Duration: 24 Jul 202327 Jul 2023

Publication series

NameProceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS
ISSN (Print)1557-170X

Conference

Conference45th Annual International Conference of the IEEE Engineering in Medicine and Biology Conference, EMBC 2023
Country/TerritoryAustralia
CitySydney
Period24/07/2327/07/23

Bibliographical note

Funding Information:
*Research supported by Shake It Up Australia Foundation and The Michael J. Fox Foundation.

Publisher Copyright:
© 2023 IEEE.

Keywords

  • Legged locomotion
  • Smart textiles
  • Biology
  • Interviews
  • Diseases

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