LASER-assisted device (LAD) for start hesitation and freezing in Parkinson's disease

Abstract

Background: We performed a pilot study to assess the utility of a LASER-assisted device (LAD) in improving the gait of patients with Parkinson's disease. Case Report: We modified a hand-held scanner, powered by a 6-volt lantern battery, to project a transverse beam of laser light 1 meter wide onto the floor ahead. 3 patients with start hesitation and/or freezing of gait were assessed on each of 2 separate clinic visits (Session A and B). On each visit, 3 trials were carried out for each patient. In trial 1, we assessed our patients as they walked to and fro along an imaginary line 10 meters long. In trial 2, we provided visual cues in the form of transverse lines of colored tape six inches wide placed 10 centimeters apart. In trial 3, the patients used the LAD as a walking aid when they encountered start hesitation or freezing. We timed them, and counted the number of steps taken in all 3 trials. Patients were allowed time to familiarize themselves with the use of the device prior to the trials. The total duration and number of steps taken in trials 1 to 3, during sessions A and B, were averaged. Conclusions: All patients benefited from the use of visual aids. The benefits observed with the LAD were not as robust as with transverse lines of colored tape. The LAD produced best results in dim lighting and against dark flooring. Visual aids can improve gait in PD with start hesitation and freezing. Larger trials should be undertaken.