Design and Performance Evaluation of Biofeedback Foot Orthosis to Inhibit Tremors on the Patients with Parkinson’s Disease

INTRODUCTION: Parkinson's disease (PD) is a progressive neurological disorder that affects the motor system, leading to symptoms such as tremors, rigidity, bradykinesia (slowness of movement), and postural instability. The incidence and prevalence increase with advancing in age, around 1% of people over the age of 60 years. As one of the hallmark features of Parkinson's disease which is most prevalent among majority of the people is the tremors and freezing of gait (FOG) which has a severe impact on the patient’s gait and mobility. Hence leading to the distinctive gait abnormalities that can affect person’s quality of life. With the progression in the severity and with the increasing age it has led to the dependency of the patients on the care givers and to the family members for the daily living activities. This paper presents a development of new low-cost biofeedback foot orthosis to suppress the tremors and freezing of gait (FOG) with the incorporation of vibration mechanism. As the vibration mechanism has a positive impact in suppressing tremors in the patients. AIM: To develop an orthosis that provides biofeedback through vibration mechanism to inhibit tremors and freezing of gait (FOG) on the patients with Parkinson’s disease. METHODOLOGY: In this study a patient with Parkinson’s disease has been taken and he has been prescribed with orthosis. After this the development of the prototype design, which includes design specifications, components and vibration mechanism after this an orthosis has been developed which has an incorporation of vibration motors which allows to send stimulus to the brain by which the patient get attentive enough so that they can perform their daily living activities and then the trial of the orthosis on the patient was done. The orthosis has been tested on one patient and he has been selected as per the Yohn & Yahr scale for determining the severity of the Parkinson’s disease and pretest data was taken using Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) without the biofeedback orthosis and then the orthosis has been installed into the patient’s footwear and after that post test data was taken and data analysis was done. RESULTS: The biofeedback foot orthosis has improved the patient’s gait cycle via suppression of tremors and also there has been a decrease in the freezing of gait episodes. By this, the patient’s quality of life has been increased drastically and has made them to lead a healthy lifestyle. DISCUSSION & CONCLUSION: This study showed improved results in user’s satisfaction and has also led to tremor suppression which has improved patient’s gait cycle and reduction in the freezing of gait (FOG) episodes. In this study we developed a biofeedback foot orthosis to inhibit tremors on the patients with Parkinson’s disease. With the incorporation of vibration mechanism it acts as a powerful proprioceptive stimulus, strongly affecting the motion perception of not only healthy people but also patients with Parkinson’s disease or various other neurological disorders. In this study, we investigated the effect of biofeedback foot orthosis made up of high temperature thermoplastic (HTTP) sheet and concluded that it is effective in improving patient’s gait cycle and also it can be worn with the normal footwear to their workplace. Further, the research can be conducted with a large sample size and increased intervention period. Key words: Parkinson’s disease, Vibration mechanism, tremors & Freezing of gait (FOG).