Sensory feedback in Parkinson's disease patients with “on”-predominant freezing of gait

Freezing of gait (FOG) often occurs during the course of Parkinson’s disease (PD), generating substantial disability (Giladi et al., 2001). Auditory, visual or tactile stimuli have been shown to improve FOG in PD and cueing-assisted modifications of gait have been proposed (Thaut et al., 1996) including a closed-loop augmentedreality device we reported for use in patients with “off”-related FOG (Baram et al., 2002; Espay et al., 2010). The two main limitations of prior studies were (1) the focus on “off”-only FOG, which arguably could have also been improved by pharmacotherapeutic strategies aimed at minimizing “off” time, and (2) the uncertainty of long-term residual benefits. We therefore sought to evaluate the immediate and longer-term effects of a one-month at-home training with the previously reported closed-loop augmentedreality cueing device on PD patients with predominantly “on” FOG.