By Dr. Corinna Weber and Sinah Dittmann, SNAP GmbH.
Digital assistance systems in the prevention of Parkinson’s disease
Parkinson’s disease – gait pattern changes
A pathological gait pattern usually occurs in the case of disease- and/or age-related changes in the organism and leads to a loss of mobility as well as the associated autonomy. Parkinson’s disease is one of the most common neurodegenerative diseases in Germany. The initial stage is characterized by a reduction in walking speed with small, often shuffling step sequences and a decrease and increasing asymmetry of the arm swing. In the context of prevention, therapy (or training) initiated at an early stage can help to favorably influence the time course of the decline in performance. Therapy should begin in a timely, age-appropriate, and efficient manner when the disease is diagnosed, and should be aimed at counteracting the increasing impoverishment of movement. Although the disease is not curable to date, appropriate preventive training can delay care dependency.
Sensor-based therapy approaches for preventive gait training
In the everyday therapy and training of people with PD, training methods in which large-amplitude movements, movement rhythm and speed are practiced are particularly suitable. Physiotherapeutic approaches can be roughly classified according to Ebersbach, G. & Ceballos-Baumann, A. (2008) as follows: Training with sensory cueing stimuli, triggering (English cueing), balance training (such as learning to balance steps), strength and endurance training, and cognitive movement strategies. In modern complex therapy approaches, the physiotherapeutic approaches mentioned here play a fundamental role today and in the future – both rehabilitative and prophylactic. The aforementioned use of special, external cue stimuli (cue) help decisively in overcoming movement blockages in PD. Today, sensor-based assistance systems, such as the IRhythmic®, are used in modern therapy approaches. As a rhythm generator, they have a motivating effect on training in the early stages of PD and can be used independently for training in any location. Sensor-based, digital assistance systems can be used to stabilize the gait pattern and, via modern interfaces, specialist staff can support, monitor, evaluate and motivate the training process and make any necessary corrections to the training concept.
Sensor-based digital assistance system
The IRhythmic® Go is a digital assistance system that is used to train a symmetrical and rhythmic gait. It consists of two portable systems that can be placed either on the arm or on the leg. Depending on the frequency setting, the system emits alternating vibration pulses. For a rhythmic gait, the trainee must adjust his gait speed to the pulse. This trains him to keep the beat. If the two systems are placed on the upper arm, the vibrating pulse provides an additional reminder to swing the arm along with the beat. The system is controlled via an app. The user can view the training progress digitally via the Go app and is encouraged to continue training in the long term through playfully designed motivational strategies (“gamification”).
Modern, digital interfaces for therapy support
The IRhythmic® Pro is the extension of the IRhythmic® Go for the trainer or therapist. The Pro app, which is available to the therapist for their therapy treatment, is the more comprehensive app as it can store and show the training status of multiple exercisers. The app of the “Pro” version therefore has the ability to view the data of different exercisers. This gives the trainer / therapist the opportunity to supervise the training and discuss it with his client in the appointments. The trainer / therapist gets the data with desired level of detail (e.g. course of the angle of the arm swing during the training). In summary, the IRhythmic-Pro app can be used to document the training status via the measured movement, processed data and evaluated by the therapist / trainer in order to adapt further forms of therapy. Accordingly, the IRhythmic can be used for digitally assisted movement therapy and offers a holistic system solution.
Therapy support of the future
With innovative systems, such as the IRhythmic, it can be demonstrated in the future that digitalization, artificial intelligence and technical assistance are excellent instruments to serve the topics of movement, prevention and health in triad.