Spotted this yesterday and found it interesting. I hadn’t seen cycling mentioned as a treatment option to curb Parkinson’s symptoms before. Below, see a full length version of the study participant from NEJM.
In this video, the therapist seems to be giving a visual cue with her foot of something to step over to bypass the gait freezing. I’ve seen several things provide a visual cue like that for a patient including:
Both of these work on the same idea of creating a continuous stepping pattern similar to the cycling motion. I’ve been wondering for a while if a plain laser pointer attached to a walker could replicate the UStep, because I have yet to convince the CFO at my place we need one. My clinic won’t allow us to put tape on the floor (which drive me crazy. I have several balance, coordination, agility things I’d like to do, but some big wig will have a cow it I even put paper tape down.) I’ve also seen therapists use plain tape strips on the floor. I’ve also been seeing a lot about using auditory cuing by way of a metronome to bypass the defective basal ganglia to make the frontal lobe in charge of gait initiation. Personally, I use this app: Pro Metronome.
It was free and makes more adjustments than I really need, but it works for Parkinson cuing and intensity management on cardio exercise too, which is all I need really. I do like to play with the different tones it makes to make for better cuing. Anyway, in all the stuff I read about auditory cuing only ONE article mentioned what bpm to put the metronome at: “the patient’s average gait speed” or some such non-sense. That never made sense to me, because if they’re freezing all the time, their speed will be super slow and the cuing will play into that speed. So I went for average “normal” speed which is 96-120 bpm. I don’t recall how I figured that, but that’s what I got after some math and it works for me. I usually start at 100 bpm and adjust for the patient’s comfort.
But after seeing that news blip, I may add cycling to the repertoire as well. Must keep adding to the tool box! Anyone else have anything to the Parkinson’s specific treatment tool box? I’d love to learn about BIG sometime.