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Effect of a Kinematic Gait Parameter-Based Haptic Cue on Toe Clearance in Parkinson's Patients
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  • Rohan Khatavkar ,
  • Priyanka Bhat ,
  • Deepak Joshi
Rohan Khatavkar
Indian Institute of Technology Delhi

Corresponding Author:[email protected]

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Priyanka Bhat
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Deepak Joshi
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Recurrent falls are a major cause of disability in patients with Parkinson’s disease (PD). A reduced minimum toe clearance (mTC) is primarily responsible for these recurrent falls in PD patients. Preventing such falls by enhancing toe clearance has become one of the most important goals in gait training among PD patients. However, in the past, manual gait training for improving mTC has not been proven effective in a real-life environment outside laboratory settings. Thus, in this paper, we propose an automated cueing-based novel gait training intervention in anticipation of improved mTC. The cueing scheme records the foot strike angle (FSA) and cues the participants if the FSA is observed above a threshold. The patients with PD (n = 8) were recruited and asked to walk under two conditions: a) with cue and b) without cue at a self-selected speed during the ON medication state. Kinetic and kinematic gait parameters such as vertical ground reaction force, the center of pressure, toe clearance, and FSA were recorded using indigenously developed wearable instrumentation. A Mann-Whitney U test showed a significant increase (p<0.001) in the minimal toe clearance and FSA with cue compared to without cue walking except in one subject. This finding provides evidence favoring the potential incorporation of an FSA-based cueing device for gait rehabilitation among PD patients. In addition, the wearable setup supports the present cueing scheme applicable outside laboratory and home settings.