Murielle U.Ferraye, Post-doctoral fellow, University of Twente (Enschede, Netherlands)
Submitted July 19, 2018
We thank van Gerpen et al. for their comment on our laser shoes article, [1], and for sharing the lasting cueing experience of their patient using laser light on a rolling walker. [2] In the accompanying article in Neurology Today, Prof. Horak raised doubts with respect to the lasting effects of cueing in general, and of laser shoes in particular. [3] Habituation remains a recurring concern when it comes to continuous cueing. [4] This is why observations—like this—are most welcome, especially because on-demand cueing remains challenging, and true clinical utility depends on further development of automated methods able to detect freezing prior to its occurrence or within short enough latencies to allow the patients to react in time to prevent freezing. [5] Both freezing and falls are, indeed, very sudden and unpredictable events. This is why it is of extreme importance that external cueing devices not only help the patients overcome freezing but also prevent its occurrence. Our study capitalized on the laser shoes’ unique way of alternately delivering cueing to each foot at a crucial moment of the gait cycle, [1] to enhance cue saliency and further reduce possible habituation effects, although this remains to be tested.
Barthel C, Nonnekes J, van Helvert M, et al. The laser shoes: a new ambulatory device to alleviate freezing of gait in Parkinson disease. Neurology 2018;90:e164-e171.
van Gerpen JA, Rucker CT, Matthews M, Saucier MA. Lifting the “FOG” with laser generated visual-cueing. Neurologist 2012;18:298-301.
Hurley D. Neurotech-Parkinson's Disease: Shoe-Mounted Laser Found to Help Overcome Gait Freezing in PD. Neurol Today 2018;18:9-13
Ekker MS, Janssen S, Nonnekes J, Bloem BR, de Vries NM. Neurorehabilitation for Parkinson's disease: Future perspectives for behavioural adaptation. Parkinsonism Relat Disord 2016;22 Suppl 1:S73-S77.
Mazilu S, Calatroni A, Gazit E, et al. Prediction of Freezing of Gait in Parkinson's From Physiological Wearables: An Exploratory Study. IEEE J Biomed Health Inform 2015;19:1843-1854.
We thank van Gerpen et al. for their comment on our laser shoes article, [1], and for sharing the lasting cueing experience of their patient using laser light on a rolling walker. [2] In the accompanying article in Neurology Today, Prof. Horak raised doubts with respect to the lasting effects of cueing in general, and of laser shoes in particular. [3] Habituation remains a recurring concern when it comes to continuous cueing. [4] This is why observations—like this—are most welcome, especially because on-demand cueing remains challenging, and true clinical utility depends on further development of automated methods able to detect freezing prior to its occurrence or within short enough latencies to allow the patients to react in time to prevent freezing. [5] Both freezing and falls are, indeed, very sudden and unpredictable events. This is why it is of extreme importance that external cueing devices not only help the patients overcome freezing but also prevent its occurrence. Our study capitalized on the laser shoes’ unique way of alternately delivering cueing to each foot at a crucial moment of the gait cycle, [1] to enhance cue saliency and further reduce possible habituation effects, although this remains to be tested.
For disclosures, please contact the editorial office at journal@neurology.org.