External visual cueing is a well-known means to target freezing of gait (FOG) in Parkinson's disease patients. Holocue is a wearable visual cueing application that allows the HoloLens 1 mixed... Show moreExternal visual cueing is a well-known means to target freezing of gait (FOG) in Parkinson's disease patients. Holocue is a wearable visual cueing application that allows the HoloLens 1 mixed-reality headset to present on-demand patient-tailored action-relevant 2D and 3D holographic visual cues in free-living environments. The aim of this study involving 24 Parkinson's disease patients with dopaminergic "ON state " FOG was two-fold. First, to explore unfamiliarity and habituation effects associated with wearing the HoloLens on FOG. Second, to evaluate the potential immediate effect of Holocue on alleviating FOG in the home environment. Three sessions were conducted to examine (1) the effect of wearing the unfamiliar HoloLens on FOG by comparing walking with and without the HoloLens, (2) habituation effects to wearing the HoloLens by comparing FOG while walking with HoloLens over sessions, and (3) the potential immediate effect of Holocue on FOG by comparing walking with HoloLens with and without Holocue. Wearing the HoloLens (without Holocue) did significantly increase the number and duration of FOG episodes, but this unfamiliarity effect disappeared with habituation over sessions. This not only emphasizes the need for sufficient habituation to unfamiliar devices, but also testifies to the need for research designs with appropriate control conditions when examining effects of unfamiliar wearable cueing devices. Holocue had overall no immediate effect on FOG, although objective and subjective benefits were observed for some individuals, most notably those with long and/or many FOG episodes. Our participants raised valuable opportunities to improve Holocue and confirmed our assumptions about current and anticipated future design choices, which supports ongoing Holocue development for and with end users. Show less
Geerse, D.J.; Roerdink, M.; Marinus, J.; Hilten, J.J. van 2020
Purpose: The ability to adapt walking is important for safe ambulation. Assessments of impairments in walking adaptability with the Interactive Walkway may aid in the development of individualized... Show morePurpose: The ability to adapt walking is important for safe ambulation. Assessments of impairments in walking adaptability with the Interactive Walkway may aid in the development of individualized therapy strategies of stroke patients. The Interactive Walkway is an overground walkway with Kinect v2 sensors for a markerless registration of full-body kinematics, which can be augmented with (gait-dependent) visual context to assess walking adaptability. This study aims to evaluate the potential of the Interactive Walkway as a new technology for assessing walking adaptability in stroke patients. Materials and methods: 30 stroke patients and 30 controls performed clinical tests, quantitative gait assessments and various walking-adaptability tasks on the Interactive Walkway. Outcome measures were compared between stroke patients and controls to examine known-groups validity. Pearson's correlation coefficients were calculated to assess the relationship between walking-adaptability outcomes and commonly used clinical test scores of walking ability and spatiotemporal gait parameters of unconstrained walking. Results: Good known-groups validity for walking-adaptability outcomes was demonstrated. In addition, the vast majority of walking-adaptability outcomes did not or only moderately correlate with clinical test scores of walking ability and unconstrained walking parameters. Conclusion: Interactive Walkway walking-adaptability outcomes have good known-groups validity and complement standard clinical tests and spatiotemporal gait parameters. Show less
Geerse, D.J.; Roerdink, M.; Marinus, J.; Hilten, J.J. van 2019
Neurological disorders may impair various aspects of walking ability that are needed for safe and independent walking. A comprehensive assessment addressing the key components of walking ability... Show moreNeurological disorders may impair various aspects of walking ability that are needed for safe and independent walking. A comprehensive assessment addressing the key components of walking ability may help to tailor management strategies to the individual needs of each patient. The aspect of walking adaptability is usually not assessed in clinical tests, but seems important for safe walking and is related to fall risk. The Interactive Walkway is a promising, unobtrusive, low-cost and comprehensive assessment tool of walking ability in daily practice. It is a walkway instrumented with an integrated multi-Kinect v2 set-up for markerless registration of 3D full-body kinematics. Besides performing quantitative gait assessments, the Interactive Walkway may also be used to assess walking adaptability. The Interactive Walkway is equipped with a projector to augment the entire walkway with (gait-dependent) visual context, such as obstacles, sudden-stop-and-start cues and stepping targets, demanding step adjustments under time pressure demands in a safe manner. The aim of this thesis was to examine if 1) this approach can provide a valid assessment of walking ability and, if so, 2) if it has clinical potential in the assessment of walking ability and fall risk in patients with stroke and Parkinson’s Disease. Show less
Geerse, D.J.; Roerdink, M.; Marinus, J.; Hilten, J.J. van 2018
The ability to adapt walking to environmental circumstances is an important aspect of walking, yetdifficult to assess. The Interactive Walkway was developed to assess walking adaptability by... Show moreThe ability to adapt walking to environmental circumstances is an important aspect of walking, yetdifficult to assess. The Interactive Walkway was developed to assess walking adaptability by augmentinga multi-Kinect-v2 10-m walkway with gait-dependent visual context (stepping targets, obstacles) usingreal-time processed markerless full-body kinematics. In this study we determined InteractiveWalkway’s usability for walking-adaptability assessments in terms of between-systems agreementand sensitivity to task and subject variations. Under varying task constraints, 21 healthy subjectsperformed obstacle-avoidance, sudden-stops-and-starts and goal-directed-stepping tasks. Variouscontinuous walking-adaptability outcome measures were concurrently determined with the InteractiveWalkway and a gold-standard motion-registration system: available response time, obstacle-avoidanceand sudden-stop margins, step length, stepping accuracy and walking speed. The same holds fordichotomous classifications of success and failure for obstacle-avoidance and sudden-stops tasks andperformed short-stride versus long-stride obstacle-avoidance strategies. Continuous walking-adapt-ability outcome measures generally agreed well between systems (high intraclass correlationcoefficients for absolute agreement, low biases and narrow limits of agreement) and were highlysensitive to task and subject variations. Success and failure ratings varied with available response timesand obstacle types and agreed between systems for 85–96% of the trials while obstacle-avoidancestrategies were always classified correctly. We conclude that Interactive Walkway walking-adaptabilityoutcome measures are reliable and sensitive to task and subject variations, even in high-functioningsubjects. We therefore deem Interactive Walkway walking-adaptability assessments usable forobtaining an objective and more task-specific examination of one’s ability to walk, which may befeasible for both high-functioning and fragile populations since walking adaptability can be assessed atvarious levels of difficulty. Show less
Geerse, D.J.; Roerdink, M.; Coolen, B.; Marinus, J.; Hilten, J.J. van 2016
