Smartphone app aids Parkinson's patients

A Joint TAU/European Union project focuses on a major cause of disability

30 June 2015
CuPID app
TAU smartphone app is a rehabilitation tool for Parkison's patients suffering from FoG.

Many patients in the latter stage of Parkinson's disease are at high risk of dangerous, sometimes fatal, falls. A major reason is the disabling symptom referred to as Freezing of Gait (FoG) — these are brief episodes when a person is unable to step forward, usually occurring when a person begins to walk or while he is turning. This problem further impacts a Parkinson's patient's ability to live independently. In the absence of effective pharmacological therapies for FoG, technology-based solutions to alleviate the symptom and prolong the patients' ability to live independently are desperately being sought.

 

CuPID is a smartphone app that is the result of a project three years in the making and the product of an eight-member European Union-funded consortium including researchers from Tel Aviv University. This app provides personalized rehabilitation for patients with Parkinson's disease who experience FoG or other gait disturbances. It utilizes small sensors placed on a patients' shoes that measure a person’s gait in real-time. If certain deviations from a pre-set norm emerge, an audio message alerts the patient to change his or her walking pattern immediately to avoid a dangerous situation.

 

"FoG is a leading cause of disability in patients with Parkinson's disease," said Prof. Jeffrey Hausdorff of TAU's Sackler Faculty of Medicine and the Center for Movement, Cognition, and Mobility at Tel Aviv Sourasky Medical Center (TASMC). Prof. Hausdorff is the lead investigator on the Israeli team. "It often occurs during 'walking transitions' associated with turning, starting, stopping, and moving in open spaces. It can also occur when people approach narrow spaces, such as doors or elevators, and in crowded places. Recognizing such situations is a very powerful key for prevention — and this is one of the features of this program."

 

Dr. Anat Mirelman from TAU is the co-director of the project. She explained, "FoG reduces patients' independence. Patients become afraid of walking by themselves and this leads to self-imposed restrictions in mobility. When their feet get stuck to the ground, their bodies lunge forward — it's very frightening. People often end up in wheelchairs, and this is a vicious cycle, as it places more reliance on the assisted-living infrastructure."

 

"There are two modes to the app," explained Dr. Anat Mirelman. "The first improves the overall gait pattern — 'keep it up, you are walking well,' says a virtual physical therapist — and the positive feedback while walking actually helps the patient emotionally as well as functionally. If the gait pattern needs adjustments, the app will let the user know. The second mode helps patients avoid and free themselves of FoG if they are already stuck. We believe, and we have already seen in clinical trials here at the hospital, that this has the potential to improve the quality of life for these patients quite dramatically."

  

Prof. Hausdorff and his team at Tel Aviv Medical Center conducted a pilot study on 40 subjects: 20 patients with Parkinson's disease who used the CuPid app and 20 patients who carried out conventional exercises and did not use the app. The results are promising. CuPID is home-based and unobtrusive, and it has the potential to reduce dependence on Parkinson's medication and avoid detrimental side effects. The investigators are currently exploring the possibility of a larger follow-up study to further demonstrate the app's efficacy. 

 

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