Currently, a variety of pharmaceutical, surgical, and behavioral interventions are used to treat freezing, but none of them are very successful.
What if there was a method to completely avoid freezing?
To assist people with Parkinson's disease in walking without freezing, researchers from Boston University Sargent College of Health & Rehabilitation Sciences and Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS) used a soft, wearable robot that is placed around the tightened hips to gently press the hips when the leg swings.The patient may walk with a longer stride thanks to the robotic garment, which is placed around the thighs and hips and gently presses the hips when the leg swings, helping the patient to achieve a longer stride.
The wearer was able to walk faster and farther than they could have without the assistance of the garment because the technology totally removed their freezing while they were indoors.
Conor Walsh, the Paul A. Maeder Professor of Engineering and Applied Sciences at SEAS and co-corresponding author of thestudy,y stated that it was found that the small amount of mechanical assistance from the wearable robot made an intermediate effect and consistently helped improve walking across a range of conditions for the individual.
The research showed the potential of soft robotics used to treat the dangrous symptoms of Parkinson disease, giving people the ability to regain both their mobility and independence.
The research is published in Nature Medicine.
Walsh's Biodesign Lab at SEAS has been developing technologies to improve life.The Wyss Institute for Biologically Inspired Engineering supported some of those technologies, including an exosuit for post-stroke gait retraining, and Harvard's Office of Technology Development arranged a license arrangement with ReWalk Robotics to commercialize the technology.
SEAS and Sargent College received a grant from the Massachusetts Technology Collaborative to support the development and translation of next-generation robotics and wearable technologies in 2022. The Move Lab's goal is to support advancements in human performance and enhance them by providing the R&D infrastructure, funding, collaborative space, and experience needed to transform promising research into mature technologies that can be translated through industry partnerships, which serves as the focal point for the research.
Three months were spent by the team working with a 73-year-old man who had Parkinson’s disease and had significant and incapacitating freezing episodes more than ten times a day. Despite using both surgical and pharmaceutical treatments, he still had frequent falls, making him rely on a scooter to move around and prevent him from walking around his community.
In previous research, Walsh and his team made use of human-in-the-loop optimization to demonstrate that a soft, wearable device can be used to augment hip flexion and assist in swinging the leg forward to provide an efficient approach to reducing energy expenditure during walking in healthy individuals.
The researchers addressed freezing using the same approach. It is worn around the waist and thighs, and it is powered by actuators and sensors. With the motion data collected by the sensor, algorithms determine the phase of gait and produce assistive forces in sync with the muscle contraction.
The result was immediate. The patient was able to walk without freezing indoors and with just sporadic episodes outdoors without the need for any extra training. Without the gadget, he was also able to walk and talk without freezing, which was unusual.
The team was quite thrilled to observe how the technology affected the subjects' gait," stated Jinsoo Kim, a co-lead author of the study and a former Ph.D. candidate at SEAS.
Ellis went on to say, "We don't really know why this approach works so well because we don't really understand freezing." This study, however, points out the potential benefits of approaching gait freezing from the "bottom-up" rather than the "top-down" perspective. The recovery to nearly normal biomechanics alters the peripheral gait dynamics and may influence the processing of central gait control.
Andrew Chin, Teresa Baker, Nicholas Wendel, Hee Doo Yang, Jinsoo Kim, and Franchino Porciuncula were co-authors of the study. Ada Huang, Asa Eckert-Erdheim, and Dorothy Orzel also contributed to the technology's design, and Sarah Sullivan oversaw the clinical research.
It was supported by the Massachusetts Technology Collaborative's Collaborative Research and Development Matching Grant, the National Institutes of Health's NIH U01 TR002775, and the National Science Foundation's CMMI-1925085.
