SCH: Context-aware Freezing of Gait mitigation in real-world setting

该项目旨在减轻步态冻结（FoG）的负担，超过50%的帕金森病患者（PD）患有这种疾病。FoG是PD的一种常见的、破坏性的表现，目前还没有治愈或充分的药物或手术治疗。FoG被定义为“尽管有行走的意图，但脚部向前移动的短暂、间歇性缺失或明显减少”。众所周知，FoG发作经常是由各种环境和心理因素引发的。最常见的触发因素包括开始犹豫（步态开始时冻结），穿过狭窄的空间，转弯犹豫（改变方向时冻结），接近视觉目标，双重任务，压力大，时间敏感的情况，如

This project seeks to reduce the burden of freezing of gait (FoG), which is suffered by over 50% of people living with Parkinson’s disease (PD). FoG is a common, devastating manifestation of PD for which there is no cure or adequate medical or surgical treatment. FoG has been defined as a “brief, episodic absence or marked reduction of forward progression of the feet, despite the intention to walk”. It is widely known that FoG episodes are frequently triggered by various environmental and psychological factors. The most commonly recognized triggers include start hesitation (freezing upon gait initiation), walking through tight quarters, turn hesitation (freezing when changing directions), approaching a visual target, dual tasking, and stressful, time sensitive situations such as entering an elevator before the doors close. Each individual with PD is unique with regard to how sensitive they are to these various triggers, underscoring the need for customized therapeutic approaches. A promising option for treating FoG is the use of tactile stimulation, however, no technology to date can provide customized therapy that adapts to the individual’s needs with regard to the specific triggering scenarios. In this proposed project, the Virginia Commonwealth University and William & Mary teams will work together to develop novel technology that deploys context-specific vibration stimuli tailored to the individual’s needs, with the goal of preventing or mitigating FoG. In Task 1, we will design and develop a wearable system for automatic FoG detection and vibration delivery using existing technology (Ultigesture UG motion sensors, PDVibe3, and a smartphone). The device will be able to detect FoG immediately upon occurrence. In Task 2, we will determine the optimum dose of vibration frequency and amplitude for the five most common environmental and psychological triggers for FoG in a controlled environment (in the clinical lab). In Task 3, we will integrate a global positioning mechanism into the wearable system so that the device can recognize environmental triggers of FoG. We will program the optimal parameters of vibration determined in Task 2 (for each of the five triggers) to deploy in response to corresponding environmental and psychological triggers and will test it in a real-world setting (a public place). Upon completion of this project we will have created and tested a closed-loop system that will deliver customized vibration therapy to people with PD at the precise moment it is needed to prevent or mitigate FoG episodes. This project aligns directly with the NINDS mission to reduce the burden of neurological diseases such as PD.