Residual effects of combined vibratory and plantar stimulation while seated influences plantar pressure and spatiotemporal gait measures in individuals with Parkinson's disease exhibiting freezing of gait

Warongporn Phuenpathom; Pattamon Panyakaew; Peerapon Vateekul; Decho Surangsrirat; Roongroj Bhidayasiri

doi:10.3389/fnagi.2023.1280324

Residual effects of combined vibratory and plantar stimulation while seated influences plantar pressure and spatiotemporal gait measures in individuals with Parkinson's disease exhibiting freezing of gait

Front Aging Neurosci. 2024 Jan 9:15:1280324. doi: 10.3389/fnagi.2023.1280324. eCollection 2023.

Authors

Warongporn Phuenpathom^#¹, Pattamon Panyakaew^#¹, Peerapon Vateekul^#², Decho Surangsrirat^#³, Roongroj Bhidayasiri^#^{1

4}

Affiliations

¹ Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
² Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
³ Assistive Technology and Medical Devices Research Center, National Science and Technology Development Agency, Pathum Thani, Thailand.
⁴ The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand.

^# Contributed equally.

Abstract

Introduction: Combined plantar pressure and vibratory stimulation has been shown to decrease freezing of gait (FOG) episodes and improve spatiotemporal gait parameters compared to single stimulation in Parkinson's disease (PD) patients with FOG. However, the effect of combined plantar stimulations on plantar pressure analysis has never been explored.

Methods: Forty PD patients with frequent FOG were allocated to either FOG shoes embedded with a 100 Hz vibratory stimulation at the Achilles tendons and a soft thickened silicone pad at the hallux and sole, or sham shoes with a non-working vibratory motor and a flat non-pressure silicone pad (20 patients per arm) while seated for 96 s. The objective gait and plantar pressure analysis were measured immediately after the stimulation. Outcomes included the normalized percentage of changes in percent FOG (%FOG) and plantar pressure in the heel-strike and push-off phase that were compared between pre- and post-stimulations.

Results: The FOG shoes group showed significantly decreased %FOG (81.5 ± 28.9% vs. 6.8 ± 22.1%, p < 0.001), plantar pressure in the heel-strike (47.8 ± 43.7% vs. 4.3 ± 9.8%, p < 0.001), plantar pressure in the push-off (57.7 ± 59.6% vs. 6.2 ± 11.6%, p < 0.001), force time integral (FTI) (40.9 ± 32.5% vs. 6.6 ± 17.3%, p < 0.001), and decreased heel contact time (19.3 ± 12.3% vs. 22.7 ± 32.5%, p < 0.001) when compared to the sham group. There was a strong negative correlation between %FOG and peak plantar pressure (r = -0.440, p = 0.005), plantar pressure in the heel-strike (r = -0.847, p < 0.001).

Conclusion: Our study demonstrated that the FOG shoe could decrease FOG episodes by improving the heel-strike pressure, toe push-off and normalized heel-to-toe plantar pressure, suggesting that modification inputs from the peripheral sensory systems might significant improvement in FOG in PD.

Keywords: Parkinson shoe; Parkinson’s disease; freezing of gait; plantar pressure; vibration.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research project was registered in the Thai Clinical Trial Registry, No. TCTR20210419001. The Second Century Fund, Chulalongkorn University, Senior Research Scholar Grant (RTA6280016) of the Thailand Science Research and Innovation (TSRI), and Centre of Excellence grant of Chulalongkorn University (GCE 6100930004-1), Bangkok, Thailand.