Development of posterior walker with adjustable visual cues to improve gait performance for patients with Parkinson's disease

Background: To improve gait performance and safety for patients with Parkinson's disease, external stimuli or walking aids are used. It was found that external visual stimuli were most effective. However, external visual stimuli mostly were applicable in particular places only. Therefore in daily life, there is no effective walking aid for PD patients to use in daily environment. Purpose: This study developed a wheeled posterior walker equipped with a visual cue generating system. This system can provide visual cue with multiple "ground-fixed" transverse lines, such that, we can test its performance and apply it in daily life for patients with Parkinson's disease. Methods: Optical rotary encoder was used to measure the moving distance for adjusting the angle of the laser projector to produce the ground-fixed lines. To understand the actual performances, we recruited three participants with PD. Experiments were performed with different projection location and different numbers of lines. Result: The new visual cue device system was implemented. Results showed that the gait performances of PDs using the visual cue device improved. The proximally projected laser lines induce a remarkable increase in stride length and velocity. Two of the participants increase their stride length, cadence and velocity when using the distally projected laser lines.