Efeitos do treinamento de marcha com o aprimoramento de um dispositivo de biofeedback visual sobre parâmetros da marcha de pacientes com doença de Parkinson

Abstract

The objective of this study was to evaluate the effect of visual biofeedback provided by a wearable technology as a strategy for gait training in patients with Parkinson’s disease (PD). For this purpose, we used a single-subject quasi-experimental design. Three participants with a PD diagnosis and similar disease characteristics took part in the study. All participants underwent 40 gait training sessions, including 10 Adaptation sessions, 10 Control training sessions (“A”), 10 training sessions in the Intervention phase (“B”), and 10 training sessions in the Retention phase (“A”). The training sessions lasted 20 minutes, always at the same speed defined in the first session of the Control phase (“A”). Participant 01, in the Intervention phase (B), received verbal feedback from a therapist. Participant 02, in the Intervention phase (B), received visual biofeedback from a mobile device. Participant 03 completed all 30 gait training sessions (A-B-A) without biofeedback. Biofeedback was provided by sensors attached to the ankle region, which recognized gait patterns performed during the warm-up (first 1 minute) and considered these values as a reference. Subsequently, during the main part of the training (14 min), gait parameters, such as step frequency, were compared to the reference values. Increases in frequency, relative to the reference values, were indicated by a red light. The therapist, in possession of this information, provided verbal feedback to participant 01.Meanwhile, participant 02 had only visual biofeedback, needing to adjust the gait pattern himself. To evaluate the effects of time (A-B-A) of each participant, we used one-way Anova (we compared the number of steps and the length of steps.). For this, we used the statistical software package GraphPad Prism, version 8.4.3, considering a significance level of 5%. Our results indicated that all participants showed improvement in the 10 MWT test. We conclude that the provision of biofeedback, whether verbal, visual or the absence of feedback (control group), did not result in statistically significant differences in gait parameters. However, clinical improvements were identified, suggesting that these interventions can positively influence the gait pattern of patients with PD.