WO2005020866A1

WO2005020866A1 - An apparatus and method for improving the walk of a person suffering from a movement disorder

Info

Publication number: WO2005020866A1
Application number: PCT/GB2004/003462
Authority: WO
Inventors: Alice Marjan Nieuwboer; Rowena Dilys Plant; Gerrit Kwakkel; Erwin Van Wegen
Original assignee: University Of Northumbria At Newcastle
Priority date: 2003-08-29
Filing date: 2004-08-12
Publication date: 2005-03-10
Also published as: GB0320246D0

Abstract

A device and method for improving the walk of people suffering from movement disorders are described. These disorders include freezing gait, start hesitation, festination and some difficulties with getting up from a chair or out of bed and are typically seen in Parkinson's disease suffers. The device includes a pulsed signal producing means (12) for producing pulsed signals and a frequency controlling means (16) for altering the frequency of the signals produced. The device also includes more than one output means (18) for transferring the signal to at least one sensory device (20). The method includes providing a series of regular pulsed sensory signals which act as a series of cues, to a person suffering from a movement disorder, to move in response to the cues.

Description

An apparatus and method for improving the walk of a person suffering from a movement disorder

The present invention relates to an apparatus and method for improving the walk of a person suffering from a movement disorder, and particularly, but not exclusively, to people suffering from freezing gait, start hesitation, festination and some difficulties with getting up from a chair or out of bed.

A common disorder encountered by people suffering from Parkinson's Disease is that termed "freezing gait". A person suffering from this disorder will find it difficult to walk, in particular having taken a step they "freeze" and are unable to take a further step. Other movement disorders associated with diseases of the basal ganglia include start hesitation, where there is difficulty in starting to walk and festination where the correct length and timing of step are not maintained. Other motor blocks which result in freezing may also be experienced causing difficulties in getting up from a chair or bed. Hesitation, festination and freezing can occur in relation other sequences of movement such as talking.

A number of devices and methods of assisting sufferers in at least partially overcoming such disorders, including freezing gait have been devised. For example, U.S. Patent No. 5575294 describes a device which provides a visual cue in the form of a line indicated on the floor by use of a laser or similar device. According to U.S. 5575294, the presence of the line encourages the person suffering with freezing gait to step forward over the line. As the person moves forward the line also moves forward and they are again encouraged to step over the line. This device has the disadvantage that it provides a single cue, in the form of the line of light, and if this is not acted upon by the person using the device there is no further input or reminder to act on the cue. Furthermore, the device is generally held by the person using it, perhaps as part of a walking stick, and therefore the line of light emitted may not constantly be at the correct angle for the user to step over, or may not remain still since uncontrollable shaking of the hands is not uncommon in sufferers of Parkinson's Disease.

An alternative device is that suggested in U.S. Patent No. 5597309 which describes the use of a visor placed over the eyes of the person suffering with freezing and other gait difficulties. It is possible to see through the visor whilst images can also be projected onto the inside of the visor as though they were part of the view seen through the visor. This device is used to display into the field of view ahead of the person using the device, indicators showing where steps should be taken. Thus, the device indicates to the person where they should next place their foot in order to take the next pace. This device requires very complex electronics in particular to maintain the position relative to the ground of the indicator as the user moves their head. As a result this device is likely to be expensive. Furthermore, the device may also prove to be inconveniently large and obtrusive for most users.

Further devices which have been used in an attempt to assist persons overcoming a freezing gait include the use of electric stimulating pulses applied to the leg muscles thereby stimulating the person to take a step forward. This device can cause discomfort to the person using it, requires sufficient dexterity from the person using the device to operate the control means and is not suitable for all patients.

Preferred embodiments of the present invention seek to overcome the above described disadvantages of the prior art. According to the present invention there is provided a device for improving the walk of a person suffering from a movement disorder, the device comprising: -

pulsed signal producing means for producing at least one pulsed signal;

frequency controlling means for altering the frequency of the or each signal; and

a plurality of output means for transferring said signal to at least one sensory device.

By providing a device from which may be selected more than one pulsed signal, the advantage is provided that since different users respond better to one sensory stimulation, i.e. auditory, visual or tactile signals, a single unit can be provided which allows the user to experiment and find which stimulation works most effectively for them. Alternatively, it may be the case that a user finds that under certain conditions one form of stimulation is more effective than another, or that one form of stimulation may be unsuitable. For example, it is clear that in a noisy environment an audible signal may be inappropriate. Furthermore, some users may find the use of two simultaneous forms of stimulation provides the most effective assistance in overcoming movement disorders.

The device of the present invention is very simple to operate when compared to the devices of the prior art. In particular, this device does not require considerable manual dexterity and once turned on, does not rely on the user holding the device in a certain orientation and is safe. Since many Parkinson's Disease sufferers also experience considerable difficulty completing manual tasks it is important that any device designed to assist them overcoming any related disorders be simple to operate. Thus since the device of the present invention will continue work once switched on the user is able to concentrate on taking steps alone without having to simultaneously operate the device .

Furthermore, by providing a person suffering from movement disorders with a device producing substantially regular pulsed sensory signals, the advantage is provided that each pulse provides a cue to the user to take a step. This has proved to be very successful in assisting persons suffering with a freezing gait to overcome this disorder, and has provided a device which is flexible and adaptable to individuals' speed and preference.

The device may further comprise at least one sensory device.

In a preferred embodiment, at least one said sensory device provides a tactile signal.

In another preferred embodiment, at least one said sensory device comprises a vibrating device.

In a preferred embodiment, at least one said sensory device provides an audio signal.

In a further preferred embodiment, at least one said sensory device comprises an ear piece.

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In a preferred embodiment, at least one said sensory device provides a visual signal.

In another preferred embodiment, at least one said sensory device comprises a light emitting diode.

The device may further comprise activity monitoring means for monitoring the movement of the person using the device. The device may also further comprise recording means for recording a signal from said activity monitoring means and/or the frequency of said pulsed signal and/or the or each sensory device used.

By the use of ambulatory monitoring and by recording data such as pulse frequency and output means selected, it is possible to analyse these data and determine what frequency and output devices are most effective for each user.

In a preferred embodiment, a duration of each pulse of the or each said pulsed signal may be altered.

Allowing modulation of the frequency of the pulses provides the user with the greatest flexibility. For example, there are indications that auditory cues optimise stride length in people with Parkinson's disease when the frequency is set at 10% lower than baseline step frequency (walking 10% slower than preferred speed) .

In a preferred embodiment, said duration is dependent upon the or each sensory device used.

According to another aspect of the present invention there is provided a method for improving the walk of a person suffering from a movement disorder, the method comprising the steps of:-

providing at least one series of substantially regular pulsed sensory signals thereby providing a series of cues, to a person suffering from a movement disorder, to move in response to at least one of said cues.

By providing a series of pulsed sensory signals to provide a cue to take a step to a person suffering from a movement disorder such as freezing gait, the advantage is provided that this repeated series of cues has been shown to provide an effective stimulus to overcoming a freezing gait. Furthermore, preparatory trunk and pelvic movements (forward and backward, side to side) synchronised to a cueing rhythm enhance standing up and sitting down from a chair or bed. In connection with start hesitation the use of a cueing rhythm helps individuals to prepare to take an initial step by shifting weight from one leg to the other prior to starting to walk, and such cues improve the stability of stepping during turning in patients with Parkinson's disease.

At least one said signal may be a tactile signal.

In a preferred embodiment, said tactile signal is provided by a vibrating device.

At least one said signal may be an audio signal.

In a preferred embodiment, said audio signal is provided by an ear piece.

At least one said signal may be a visual signal.

In a preferred embodiment, said visual signal is provided by a light emitting diode.

A frequency of said pulsed sensory signals may be controlled by a frequency control device.

Said pulsed sensory signals may be of equal frequency until changed by said frequency control device.

In a preferred embodiment, a duration of each pulse of said pulsed sensory signal may be altered. In another preferred embodiment, said duration is dependent upon the form of the sensory signal being provided.

Preferably a plurality of said pulsed sensory signals may be provided simultaneously.

A preferred embodiment of the present invention will now be described by way of example only, and not in any limitative sense, with reference to the accompanying drawings in which :-

Figure 1 is a perspective view of the device of the present invention;

Figure 2 is a plan view of a fascia of the present invention;

Figure 3 is a schematic view of the device of the present invention; and

Figure 4 is a schematic view of the function of the present invention.

Referring to figures 1, 2, 3 and 4, a device 10 for improving the walk of a person suffering from movement disorders has a pulsed signal producing means 12 which produces a pulsed signal 14a, 14b and 14c. The device 10 also has a frequency controlling means which is operated using buttons 16a and 16b. A device 10 also has a number of outputs, 18a, 18b and 18c, from which it is possible to transfer the signal 14a, 14b or 14c to one or more sensory devices 20a, 20b and 20c.

The sensory device 20a, 20b or 20c which is to be used is controlled by switch 22. The frequency of signal 14a, 14b or 14c is selected by buttons 16a and 16b and is displayed by a display driver 24 on the display device 26. When the unit is switched off, using switch 28, the last selected frequency is stored in eeprom 30.

The device may also include a motion sensor (not shown) which is able to detect the movement of the person using the device. The data provided by the motion sensor, together with information on which output device was used at this time, may be transferred through data output 32 using a cable, such as that shown at 34, to a computer for analysis .

In use device 10 is turned on using switch 28. It is then necessary to decide which sensory device is to be used and set switch 22 to match the device required. For example, if a visual signal is required then light emitting diode 20a is inserted into output 18a and switch 22 set to the signal equivalent to that shown adjacent to 18a. Similarly if an audible cue is required, earphones 20b are inserted into output 18b and switch 22 set appropriately. When the jack of headphones 20b is inserted into output 18b, internal speaker 18d is automatically deactivated. If switch 22 is set to an audio output and earphones 20b are not used, internal speaker 18d provides an audible output. Finally, vibrator 20c may be inserted into output 18c.

The selected output device is then suitably located, for example earphones 20b are inserted into the ear, or vibrator 20c placed close to the skin, and pulses are produced and sent to the device at the rate displayed at the display 26. The pulse provides a cue to the user to take a step. This is then followed by another one to take another step, and a further step and so on. The signal frequency is adjusted using buttons 16a and 16b to respectively reduce or increase the frequency so that a rate of step comfortable for the user is selected.

Referring to Figure 4, the duration of the pulse signal may vary in particular dependent upon the output device selected. As can be seen from signals 14a and 14c, when the visual and audible cues are selected a shorter signal duration is shown than when the tactile output signal 14b is selected.

Once the device has been used for some time, it is possible to analyse the success of the device by retrieving data via data output 32. The device stores the frequency and the output device selected as well as movement data. From these data it is possible to tell what frequency and output device produce the optimum movement quality for the user in question.

In an alternative embodiment of the present invention, the signal producing means 12 may be in the form of a wrist-worn control device with the operating buttons locating thereon. The number of buttons may be reduced and the device controlled via menus presented on a screen of the wrist-worn device, which may also include a clock. The output devices could be connected to the control device by wires but could alternatively be connected via wireless connection. Radio frequency connection, and in particular so-called Bluetooth protocol could provide such a wireless connection. As a further alternative, the signal producing means could be provided as part of a mobile phone or other small electronic device.

It will be appreciated by persons skilled in the art that the above embodiment has been described by way of example only, and not in any limitative sense, and that various alterations and modifications are possible without departure from the scope of the invention as defined by the appended claims.

For example, the use of a motion sensor may provide direct feedback to the device to only provide further cues once a pace has been taken. However, it would also prove necessary to provide a subsequent cue after a predetermined period of time even if no pace has been taken in case the initial cue has been missed or ignored. It is also possible that switch 22 may not be required and that the output device used would depend purely on whether an appropriate output device was connected to device 10. Thus, if earphones 20b were attached to output 18b and vibrator 20c were attached to output 18c, both of these devices will be active at the same time. Furthermore, the device may be used in connection with other sequences of movement such as speech.

Claims

1. A device for improving the walk of a person suffering from a movement disorder, the device comprising: -

pulsed signal producing means for producing at least one pulsed signal;

2. A device according to claim 1, further comprising at least one sensory device.

3. A device according to claim 1 or 2, wherein at least one said sensory device provides a tactile signal.

4. A device according to any one of the preceding claims, wherein at least one said sensory device comprises a vibrating device .

5. A device according to any one of the preceding claims, wherein at least one said sensory device provides an audio signal.

6. A device according to any one of the preceding claims, wherein at least one said sensory device comprises an ear piece.

7. A device according to any one of the preceding claims, wherein at least one said sensory device provides a visual signal. >

8. A device according to any one of the preceding claims, wherein at least one said sensory device comprises a light emitting diode.

9. A device according to any one of the preceding claims, further comprising activity monitoring means for monitoring the movement of the person using the device.

10. A device according to claim 9, further comprising recording means for recording a signal from said activity monitoring means and/or the frequency of said pulsed signal and/or the or each sensory device used.

11. A device according to any one of the preceding claims, wherein a duration of each pulse of the or each said pulsed signal may be altered.

12. A device according to claims 11, wherein said duration is dependent upon the or each sensory device used.

13. A device for improving the walk of a person suffering from freezing gait substantially as hereinbefore described with reference to the accompanying drawings.

14. A method for improving the walk of a person suffering from a movement disorder, the method comprising the steps of:-

15. A method according to claim 14, wherein at least one said signal is a tactile signal.

16. A method according to claim 15, wherein said tactile signal is provided by a vibrating device.

17. A method according to any one of claims 14 to 16, wherein at least one said signal is an audio signal.

18. A method according to claim 17, wherein said audio signal is provided by an ear piece.

19. A method according to any one of claims 14 to 18, wherein at least one said signal is a visual signal.

20. A method according to claim 19, wherein said visual signal is provided by a light emitting diode.

21. A method according to any one of claims 14 to 20, wherein a frequency of said pulsed sensory signals are controlled by a frequency control device.

22. A method according to claim 21, wherein said pulsed sensory signals are of equal frequency until changed by said frequency control device.

23. A method according to any one of claims 14 to 22, wherein a duration of each pulse of said pulsed sensory signal may be altered.

24. A method according to claims 23, wherein said duration is dependent upon the form of the sensory signal being provided.

25. A method according to any one of claims 14 to 24, wherein a plurality of said pulsed sensory signals may be provided simultaneously.

26. A method of improving the walk of a person suffering from a movement disorder substantially as hereinbefore described with reference to the accompanying drawings.