The Faculty of Medicine’s Dr. Bin Hu, who is also a member of the Hotchkiss Brain Institute (HBI), has created what is called the Gait Reminder−a device designed to help Parkinson’s patients walk with the help of music. Using the movement sensing technology of the 4th generation iPod touch, the device incorporates the use of a specially designed app that computes leg movement signals, triggering music to positively reinforce proper walking. In an ongoing trial, Hu is trying to determine if the Gait Reminder can help patients walk properly, long term.
Our gait is our stride (the length of steps we take). When we walk, large steps provide us with stability while smaller steps can lead to instability. Individuals with Parkinson’s have a motor disorder which makes it difficult for them to control their motor skills. Their steps, consequently, get smaller as they walk making the task very difficult.
“Difficulties in walking are disabling symptoms for Parkinson’s patients and they respond poorly to medications,” says Hu.
This walking difficulty can lead to what is called a vicious cycle. The lack of mobility can lead to additional health problems such as muscular atrophy and bone loss, making it even more of a challenge for patients to be active.
The concept of the Gait Reminder is to positively reinforce proper walking with music. The device is strapped to the knee of the patient and music can be heard through wireless headphones. As they walk, music plays when their steps are large enough. If their steps begin getting too small, the music will turn off–reminding them to increase their step size. Hu says Parkinson’s patients are able to increase their stride if they’re constantly reminded to do so, so music in this context serves as that reminder. It’s also more likely a patient will enjoy walking when the music serves as a contingent reward.
Each patient taking part in the study undergoes a base-line test on campus to determine their suitability. They undergo a walking and balance test, and their step size and other variables are measured. Hu then teaches each patient, along with their caregiver(s), how to use the device, which is very user friendly− those who wouldn’t consider themselves technologically savvy, who have never used an iPod, or who are even upwards of 75 will be able to use it.
The device contains three distinct playlists of music: a playlist of self-selected music the patient chooses, a playlist of neurology based music (music that is chosen based on human brain scans of music-elicited responses), and music that the patient has been exposed to in a group-learning environment such as choir. The patient is then able to take the Gait Reminder home to use at their convenience, with no limitations. When in use, information regarding how far the patient has walked and what music they listened to is stored, giving an objective report of patient progress.
“Some people may ask why we don’t put patients on treadmills,” says Hu. “With this kind of exercise, they can walk with another person or as part of a group, so they can really do this anywhere they want and when they want.”
While the study is still ongoing, Hu says that from the preliminary data collected they’ve seen promising results. He says some patients have entered the study struggling to walk without a walker, and are now able to walk regular distances of over one kilometre. As well, patients are reporting that they’re enjoying using the Gait Reminder.
“We’re optimistic. I think this device has lots of benefits. I don’t know how long they’ll last and how long treatment will have to be−this is something we’ll have to figure out. Just like a drug we need to find the dosage for an optimal outcome.”