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Unveiling the Groundbreaking Solution for Parkinson’s Freezing of Gait

Parkinson’s disease affects over 9 million people worldwide and causes “freezing of gait,” which is one of the most debilitating symptoms. Recent research from the Harvard John A. Paulson School of Engineering and Applied Sciences and the Boston University Sargent College of Health & Rehabilitation Sciences has developed a soft, wearable robot that gently assists the wearer’s hip movement, enabling longer strides and eliminating freezing episodes indoors. The wearable garment uses cable-driven actuators and sensors, generating assistive moments in concert with biological muscles. The device’s impact was immediate, and the participant was able to walk without freezing indoors, and even outdoors, he experienced only occasional episodes. The device has the potential to deepen our understanding of gait freezing, a phenomenon that remains poorly understood. This soft robotic device offers a ray of hope for Parkinson’s patients worldwide, paving the way for further research into soft robotics and their potential to improve the lives of individuals grappling with this debilitating disease.

The study titled “Soft robotic apparel to avert freezing of gait in Parkinson’s disease” has been published in Nature Medicine (January 2024). The key findings of the study include:

  1. The soft robotic garment gently assists the wearer’s hip movement, enabling longer strides and eliminating freezing episodes indoors.
  2. The device’s impact was immediate, and the participant was able to walk without freezing indoors, and even outdoors, he experienced only occasional episodes.
  3. The study involved a 73-year-old man with Parkinson’s disease, who, despite undergoing surgical and pharmacologic treatments, experienced frequent and debilitating freezing episodes, leading to frequent falls and reduced mobility.
  4. The device’s sensors collected motion data and generated assistive forces in sync with muscle movement, effectively reducing freezing episodes.
  5. The study’s results offer a ray of hope for Parkinson’s patients worldwide, paving the way for further research into soft robotics and their potential to improve the lives of individuals grappling with this debilitating disease.

These findings support the potential of soft robotic devices in addressing the challenges faced by Parkinson’s patients, particularly in mitigating the effects of freezing of gait.

What is Freezing of Gait?

Freezing of gait is a common, disabling symptom of Parkinson’s disease (PD), but the mechanisms and treatments of FOG remain great challenges for clinicians and researchers. Freezing of gait (FOG) is defined as a brief, episodic absence or marked reduction of forward progression of the feet despite the intention to walk. During a freezing episode, a person with PD may feel like their feet are stuck in place, or glue to the ground. Freezing may also affect other parts of the body or speech. Some people are more likely to have freezing episodes than others. Freezing may occur when the person with PD is due for the next dose of dopaminergic medications. This is called “off” freezing — usually, until compensation strategies such as cueing is provided.

FOG is one of the most disabling yet poorly understood symptoms of Parkinson’s disease (PD). FoG is an episodic gait pattern characterized by the inability to step that occurs on initiation or particularly with perception of tight surroundings. This phenomenon impairs balance, increases falls, and reduces the quality of life. The exact cause of FOG is not known, but it is thought to be related to the degeneration of the basal ganglia, which is responsible for controlling movement.

FOG is not unique to PD and can also occur in other neurological conditions, such as, Higher Gait Disorders (HGD), multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration.

There are several treatment options for FOG, including pharmacological, surgical, and behavioral therapies. Pharmacological treatments include levodopa, dopamine agonists, and monoamine oxidase inhibitors. Surgical treatments include deep brain stimulation (DBS) and lesioning of the subthalamic nucleus (STN) or globus pallidus internus (GPi) with variable / suboptimal benefits for exclusive FOG. Behavioral therapies include cueing, which involves providing visual or auditory cues to help the patient initiate movement, and physical therapy, which can help improve balance and gait.

In recent years, researchers have developed a soft, wearable robot designed to combat freezing of gait in Parkinson’s patients. Worn around the hips and thighs, this innovative robotic garment gently assists the wearer’s hip movement, enabling longer strides and eliminating freezing episodes indoors. The device’s sensors collected motion data and generated assistive forces in sync with muscle movement, effectively reducing freezing episodes. The device’s impact was immediate, and the participant was able to walk without freezing indoors, and even outdoors, he experienced only occasional episodes.

In conclusion, FOG is a common and debilitating symptom of Parkinson’s disease that can also occur in other neurological conditions. The exact cause of FOG is not known, but it is thought to be related to the degeneration of the basal ganglia. There are several treatment options for FOG, including pharmacological, surgical, and behavioral therapies. Recent research has also shown promising results with a soft, wearable robot designed to combat freezing of gait in Parkinson’s patients.

Reference:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233405/
  2. https://translationalneurodegeneration.biomedcentral.com/articles/10.1186/s40035-020-00191-5
  3. https://www.nature.com/articles/s41591-023-02731-8
  4. https://www.thebrighterside.news/post/revolutionary-soft-robotic-exosuit-offers-hope-for-9-million-parkinson-s-patients-worldwide
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Dance for PDnews

Dance for Parkinson’s Disease – Learn Online

The COVID-19 breakout has lead to a significant limitations in mobility of people across the world. This is primary concern for People with Parkinson disease and Parkinsonism disorders. In these disorders people need to do workouts on daily basis to have a good quality of life. Many people require supervised care and some require a group to motivate the exercise schedules. This has been significantly hindered by the current #pandemic outbreak and #Lockdown. To over come this modern day problem, people have adapted and improvised to bridge the current issues. In this context “Hirshikesh’s Center for Contemporary Dance” in Pune, has been successfully working on online dance programs for Parkinson’s Disease and Parkinsonism Disorder patients. The dance program for Parkinson’s disease facilitators integrate movement from Indian classical and modern dance, and choreographic repertory. This initiative has been helping many Parkinson’s Disease people from across India.

Difficulties with gait and balance are common among individuals with Parkinson disease (PD), contributing to an increased incidence of falls. Gait changes include slowness of walking with short, shuffling steps and a flexed posture, and may also include festination and/or freezing of gait. Aspects of walking that appear to be particularly impaired include dual tasking, turning and walking backward

Given the potential benefits of exercise for those with PD, recommendations have been made regarding key components of an exercise program designed for those with PD. The recommendations include four key areas: 1) cueing strategies to improve gait, 2) cognitive movement strategies to improve transfers, 3) exercises to improve balance, and 4) training of joint mobility and muscle power to improve physical capacity. Emerging evidence also suggests that aerobic training, such as walking on a treadmill, may result in improved quality of life, reduced disease severity as reflected by lowering of UPDRS-III scores, and improved aerobic capacity

Dance as a group-based treatment for Parkinson’s disease (PD) incorporates physical exercise, cognitive tasks, sensory experience (music), emotional expression, and social interaction. As such a multidimensional activity, dance has the potential to address many of the challenges faced by patients. Indeed, in addition to significant motor and cognitive impairment, patients are troubled by mood changes and social isolation. Therefore, dance may highly impact the quality of life in patients with PD.

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Parkinson Disease Treatmentnews

Opicapone, New medication for Parkinson’s Disease got FDA approval

Opicapone, got FDA approval for Parkinson’s Disease Treatment

Parkinson’s disease treatment got a new drug for its management. Opicapone a newer once a day medication helps in better functioning of levodopa/carbidopa (Syndopa / LCD / Madopar / Sinemet). It got Food and Drug Administration (FDA) of USA approval under the brand name of ONGENTYS. It comes with 25mg and 50mg capsules. It helps to treatment and improvement of ON periods in Parkinson’s disease. The company Neurocrine Biosciences plans to launch ONGENTYS later this year.

Opicapone blocks the enzyme catechol-O-methyltransferase (COMT) effectively (>90% at therapeutic doses), selectively and reversibly, and only outside the central nervous system. It dissociates slowly from COMT, resulting in a duration of action longer than 24 hours despite its short blood plasma half-life. As COMT and DOPA decarboxylase are the main enzymes for degrading levodopa, blocking the two effectively increases its concentrations in the bloodstream. More levodopa reaches the brain, where it is activated to dopamine. This helps to improve the symptoms of Parkinson’s disease, such as stiffness and slowness of movement.In June 2016, it was authorised for use in the European Union. It was authorised for use in the United States in April 2020.

This drug is contraindicated in people with cancers that secrete catecholamines (for example epinephrine), such as phaeochromocytoma or paraganglioma, because as a COMT inhibitor it blocks catecholamine degradation. Other contraindications are a history of neuroleptic malignant syndrome (NMS) or non-traumatic rhabdomyolysis, and combination with monoamine oxidase inhibitors that are not used as antiparkinsonians, because of possible drug interactions

People taking opicapone very commonly (18%) experience dyskinesia. Other common side effects (in 1 to 10% of patients) include dizziness, strange dreams, hallucinations, constipation, dry mouth, orthostatic hypotension (low blood pressure), and muscle spasms. Apart from spasms, these side effects are also known from tolcapone and entacapone

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