Freezing of gait (FOG), detection, prediction and/or treatment

• US 10,231,648 B2
• Filed: 05/29/2017
• Issued: 03/19/2019
• Est. Priority Date: 10/09/2011
• Status: Active Grant

• Current Assignee: The Medical Research, Infrastructure And Health Services Fund Of The Tel Aviv Medical Center
• Original Assignee: The Medical Research, Infrastructure And Health Services Fund Of The Tel Aviv Medical Center
• Inventors: Plotnik-Peleg, Meir, Hausdorff, Jeffrey M., Giladi, Nir, Mirelman, Anat
• Primary Examiner(s): Hindenburg, Max
• Application Number:
  US15/607,548
• Publication Number:
  US 20170258370A1
• Time in Patent Office: 659 Days
• CPC Class Codes: A61B 2505/09 Rehabilitation or training
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/1104 induced by stimuli or drugs; A61B5/1102 takes precedence; investigating medicinal preparations G01N33/15
• CPC Class Codes: A61B 5/1117 Fall detection
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/112 Gait analysis
• CPC Class Codes: A61B 5/162 Testing reaction times
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/378 Visual stimuli
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: A61B 5/744 Displaying an avatar, e.g. an animated cartoon character

Abstract

A method and system for provoking gait disorders, such as freezing of gait; usable, for example, for diagnosing and/or treatment thereof. In an exemplary embodiment of the invention, displays of situations calculated to cause freezing of gait are presented to a subject, optionally using virtual reality displays. Optionally or alternatively, incipit freezing of gait is identified using changes in gait parameters, and optionally used to guide attempts at causing freezing of gait. Optionally or alternatively, a portable device is provided which detects incipit freezing of gait and generates a corrective signal to the subject.

Claims

1. A method to train a subject diagnosed with freezing of gait (FOG), comprising:

assessing FOG in a subject by presenting freezing provoking stimuli to said subject on a display of a training system, and wherein said display is fixed relative to a surface on which said subject walks;

identifying one or more freezing provoking stimuli from said presented stimuli, that increase a likelihood of FOG in said subject;

generating a training program by a controller of said training system comprising one or more tasks stored in a memory of said training system based on results of said assessing, wherein each of said tasks comprises one or both of cognitive or motor tasks;

and

training said subject to change said subject response to said freezing provoking stimuli using said one or more tasks.

2. The method according to claim 1, comprising measuring a status of said subject following said training and adjusting at least one parameter of said one or more tasks of said training program based on said status.

3. The method according to claim 1, wherein said assessing comprises assessing said FOG by performing a FOG stress test by said subject and wherein said identifying comprises evaluating a response of said subject to said FOG stress test.

4. The method according to claim 3, wherein said FOG stress test comprises presentation of scenarios designed to stress a cognitive ability and/or a perceptual ability of said subject related to FOG events in said subject.

5. The method according to claim 1, wherein said assessing comprises identifying FOG subtypes.

6. The method according to claim 5, wherein said FOG subtypes comprise start hesitation and/or turning hesitation.

7. The method according to claim 5, wherein said FOG subtypes comprise narrow passage freezing and/or open runway freezing.

8. The method according to claim 5, wherein said FOG subtypes comprise reaching destination freezing.

9. The method according to claim 1, wherein said training comprises presenting virtual scenarios to said subject using a VR system or on said display.

10. The method according to claim 9, wherein said training comprises presenting virtual obstacles to said subject using said VR system or on said display.

11. The method according to claim 10, wherein said display is a fixed display located at a distance from said subject position, and wherein said virtual scenarios and/or said virtual obstacles are presented on said fixed display.

12. The method according to claim 11, wherein said virtual scenarios and/or said virtual obstacles are presented to a virtual representation of said subject on said fixed display.

13. The method according to claim 11, wherein said one or more tasks of said training program comprise dual tasking.

14. The method according to claim 1, wherein said one or more tasks of said training program comprise walking while dual tasking.

15. The method according to claim 2, wherein said one or more tasks of said training program comprise reaction to one or more virtual obstacles presented to said subject.

16. The method according to claim 15, wherein said adjusting comprises adjusting the number of said one or more virtual obstacles presented to said subject and/or the appearance frequency of said obstacles.

17. The method according to claim 2, wherein said training program comprises presenting a virtual walking path to said subject.

18. The method according to claim 17, wherein said adjusting comprises adjusting a width of said virtual walking path based on said status of said subject following said training.

19. The method according to claim 18, wherein said virtual walking path comprises one or more turns, and wherein adjusting comprises adjusting the number of said one or more turns in said virtual walking path based on said status of said subject following said training.

20. The method according to claim 17, wherein said virtual walking path comprises one or more bifurcations, and wherein said adjusting comprises changing the number of said one or more bifurcations in said walking path based on said status of said subject following said training.

21. The method according to claim 15, wherein said adjusting comprises adjusting the size of said one or more virtual obstacles.

22. The method according to claim 1, wherein said assessing FOG in a subject is performed at least partially manually by an expert.

23. The method according to claim 1, wherein said assessing FOG in a subject is performed at least partially automatically by an assessing system.