Ankle Bracelet Laser as a Novel Portable Device to Improve Walking in Patients With Parkinsonism: Randomized Crossover Controlled Trial
Issued Date
2025-01-01
Resource Type
eISSN
23692529
DOI
Scopus ID
2-s2.0-105038313916
Journal Title
Jmir Rehabilitation and Assistive Technologies
Start Page
1
End Page
12
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SCOPUS
Bibliographic Citation
Jmir Rehabilitation and Assistive Technologies (2025) , 1-12
Suggested Citation
Ruthiraphong P., Srisilpa K., Ratanasutiranont C., Mres Ankle Bracelet Laser as a Novel Portable Device to Improve Walking in Patients With Parkinsonism: Randomized Crossover Controlled Trial. Jmir Rehabilitation and Assistive Technologies (2025) , 1-12. 12. doi:10.2196/70209 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116761
Title
Ankle Bracelet Laser as a Novel Portable Device to Improve Walking in Patients With Parkinsonism: Randomized Crossover Controlled Trial
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Author's Affiliation
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Abstract
Background: Freezing of gait (FOG) is a common and debilitating symptom of parkinsonism. Although visual cues have proven efficacy in alleviating FOG, most current visual cues are fixed in place, restricting their use to controlled environments such as clinics or homes. Mobile open-loop cueing devices have been developed to address this limitation; however, they typically require manual activation to deliver the visual cues, which can be particularly challenging for patients with attention or cognitive impairments, leading to equivocal results in improving gait performance. Objective: The aim of the study is to assess the efficacy of an ankle bracelet laser, a new mobile visual cue designed for practical use, in improving gait performance in patients with parkinsonism and FOG. Methods: A randomized controlled 2-period crossover trial was conducted from June 15, 2020, to October 1, 2020, at Ramathibodi Hospital. In total, 10 patients with parkinsonism and FOG were enrolled in 2 conditions: walking with laser-off first and walking with laser-on first. Gait speed, the timed up and go test, stride length, and the locomotor rehabilitation index were assessed twice in each trial with a 10-minute washout period. Results: The results showed favorable improvement in all parameters. Gait speed and stride length improved by 0.07 m/s (95% CI 0.04-0.09 m/s; P<.001) and 0.17 m (95% CI 0.11-0.23 m; P<.001), respectively, with laser-on. The timed up and go test duration was reduced by 7.69 seconds (95% CI 2.82-12.55 seconds; P=.002). The locomotor rehabilitation index improved by 4.46% (95% CI 2.56%-6.36%; P<.001). When using the device, there were no adverse effects, such as dizziness or blurred vision. Conclusions: The ankle bracelet laser cue produced immediate improvements in gait speed, stride length, and balance in patients with parkinsonism and FOG, suggesting that the device can acutely enhance gait performance. Further research is needed to determine whether these benefits are sustained and applicable to daily life activities.