Journal Article

Personalized versus fixed tactile cueing in Parkinson’s disease: Protocol for a randomized controlled trial on gait automaticity

Mancini, Martina, Carlson-Kuhta, Patricia, Silva-Batista, Carla, Liu, William, Horak, Fay B., Chung, Kathryn A., Baker-Alcalá, Francesca, Burgos, Pablo I., King, Laurie A., Lapidus, Jodi A.

2025

Overview

Gait automaticity, the ability of the brain to control locomotion with minimal use of executive-attentional resources, is altered in people with Parkinson's disease (PD). Recently, we showed that step-synchronized tactile cueing improved gait regularity and freezing of gait in PD; however, it is not known if this cueing mode also improves gait automaticity. Thus, this study investigates the effects of step-synchronized tactile cueing (versus fixed cueing) on gait automaticity in the laboratory and during daily life. This is a pilot, randomized, double-blinded study where sixty participants with PD will be randomized into one of two, cueing interventions: 1) personalized, step-synchronized tactile cueing and 2) tactile cueing at fixed intervals. Both cueing interventions use vibrotactile stimulation of wrist bands. During a laboratory study visit, we will measure cortical activity with a wireless, portable functional near-infrared spectroscopy system (fNIRS) during walking tasks. Gait will be assessed using inertial sensors placed on the limbs and trunk. In addition, in daily life, participants will use the same cueing mode at home. The primary outcomes include prefrontal & primary sensory cortex activity. Secondary outcomes are gait stride time, gait local dynamic stability, turn duration and trunk jerk during turning as metrics of gait automaticity in the laboratory. Daily life gait and turning are exploratory measures. This project will advance the understanding of brain mechanisms associated with walking automaticity during tactile cueing and provide the basis for innovative, personalized cueing to rehabilitate gait automaticity in people with PD. ClinicalTrials.gov NCT05818189.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Automation / Brain / Clinical trials / Control / Cues / Customization / Deep brain stimulation / Development and progression / Diagnosis / Double-Blind Method / Dynamic stability / Female / Gait / Gait - physiology / Health aspects / Humans / Inertial sensing devices / Influence / Infrared spectra / Infrared spectroscopy / Intervention / Laboratories / Locomotion / Male / Medical imaging / Middle Aged / Mobility / Movement disorders / Near infrared radiation / Near infrared spectroscopy / Neurodegenerative diseases / Parkinson Disease - physiopathology / Parkinson's disease / Pilot Projects / Prefrontal cortex / Risk factors / Sensors / Somatosensory cortex / Tactile stimuli / Touch - physiology / Turning gait / Vibrations / Walking / Walking - physiology / Wrist