caa a22 4500 445807598 CHVBK 20180317145201.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00415-010-5866-z doi (NATIONALLICENCE)springer-10.1007/s00415-010-5866-z The effect of real and virtual visual cues on walking in Parkinson's disease [Elektronische Daten] [H. Griffin, R. Greenlaw, P. Limousin, K. Bhatia, N. Quinn, M. Jahanshahi] Patients with Parkinson's disease (PwPD) have a slow, shuffling gait, marked by sporadic freezing of gait (FoG) during which effective stepping ceases temporarily. As these gait problems are not commonly improved by medical and surgical treatments, alternative approaches to manage these problems have been adopted. The aim of this study was to evaluate the effect of real and virtual visual cues on walking in PD. We assessed 26 mid-stage PwPD, on and off medication, on a laboratory-based walking task which simulated real world challenges by incorporating FoG triggers and using appropriate placebo conditions. Cueing interventions were presented via virtual reality glasses (VRG rhythmic, visual flow and static placebo cues), and as transverse lines (TL) on the walkway. Objective measures of gait (task completion time; velocity, cadence, stride length; FoG frequency) and self-rated fear of falling (FoF) were recorded. Cueing intervention affected task completion time only off medication. Whereas placebo VRG cues provided no improvement in walking, visual flow VRG cues marginally reduced the task completion time. TL on the floor elicited more substantial improvements in gait with reduced cadence, increased stride length and reduced FoG frequency. VRG rhythmic cueing impaired overall walking. Notably, a final no-intervention condition yielded quicker task completion, greater walking velocity, increased stride length and less frequent FoG. Although the VRG produced modest improvements only in the visual flow condition, their flexibility is an advantage. These results endorse the use of TL and justify further testing and customisation of VRG cues for individual PwPD. Springer-Verlag, 2011 Parkinson's disease nationallicence Freezing nationallicence Gait nationallicence External cueing nationallicence Paradoxical kinesis nationallicence FoF : Fear of falling nationallicence FoG : Freezing of gait nationallicence H&Y : Hoehn and Yahr nationallicence PD : Parkinson's disease nationallicence PwPD : Patient/people with Parkinson's disease nationallicence QoL : Quality of life nationallicence TL : Transverse lines nationallicence VRG : Virtual reality glasses nationallicence Griffin H. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen's Square, WC1N 3BG, London, UK aut Greenlaw R. Oxford Computer Consultants Ltd, 23-38 Hythe Bridge Street, OX1 2EP, Oxford, UK aut Limousin P. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen's Square, WC1N 3BG, London, UK aut Bhatia K. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen's Square, WC1N 3BG, London, UK aut Quinn N. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen's Square, WC1N 3BG, London, UK aut Jahanshahi M. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen's Square, WC1N 3BG, London, UK aut Journal of Neurology Springer-Verlag 258/6(2011-06-01), 991-1000 0340-5354 258:6<991 2011 258 415 https://doi.org/10.1007/s00415-010-5866-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-010-5866-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Griffin H. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen's Square, WC1N 3BG, London, UK aut NATIONALLICENCE 700 1- Greenlaw R. Oxford Computer Consultants Ltd, 23-38 Hythe Bridge Street, OX1 2EP, Oxford, UK aut NATIONALLICENCE 700 1- Limousin P. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen's Square, WC1N 3BG, London, UK aut NATIONALLICENCE 700 1- Bhatia K. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen's Square, WC1N 3BG, London, UK aut NATIONALLICENCE 700 1- Quinn N. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen's Square, WC1N 3BG, London, UK aut NATIONALLICENCE 700 1- Jahanshahi M. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen's Square, WC1N 3BG, London, UK aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/6(2011-06-01), 991-1000 0340-5354 258:6<991 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer