Auditory cueing strategy for stride length and cadence modification: a feasibility study with healthy adults

People with Parkinson’s Disease experience gait impairments that significantly impact their quality of life. Visual, auditory, and tactile cues can alleviate gait impairments, but they can become less effective due to the progressive nature of the disease and changes in people’s motor capability. In this study, we develop a human-in-the-loop (HIL) framework that monitors two key gait parameters, stride length and cadence, and continuously learns a person-specific model of how the parameters change in response to the feedback. The model is then used in an optimization algorithm to improve the gait parameters. This feasibility study examines whether auditory cues can be used to influence stride length in people without gait impairments. The results demonstrate the benefits of the HIL framework in maintaining people’s stride length in the presence of a secondary task.Clinical relevance— This paper proposes a gait rehabilitation framework that provides a personalized cueing strategy based on the person’s real-time response to cues. The proposed approach has potential application to people with Parkinson’s Disease.

I. INTRODUCTION

Parkinson’s Disease (PD) is a progressive neurological disorder that affects movement. In advanced stages of the disease, a common lower body symptom is Freezing of Gait (FoG), where a breakdown of the person’s existing stride-length-cadence relationship (SLCrel) occurs. In unimpaired gait, an increase in cadence (i.e. steps per minute) is typically accompanied by an increase in stride length (i.e. the distance travelled by the same foot) [1]. SLCrel can exhibit a positive linear, negative linear, or negative quadratic relationship (ibid.). When participants walk at different self-selected speeds, 90-100% of the participants across different age groups exhibit a SLCrel (ibid.). A freezing episode manifests as an abnormal increase in cadence with a noticeable decrease in step length, i.e. the SLCrel breaks down [2].