Objective: To evaluate a novel method of visual cueing using patterned alternating-coloured strips made of electrical tape for freezing of gait.

Background: Freezing of gait [FoG] is an episodic abnormal gait pattern characterised by inability to step or taking small steps while initiating gait or while turning. It is mostly seen in patients with advanced Idiopathic Parkinson’s disease and in atypical Parkinsonian disorders. It is one of the most disabling symptoms for patients as conventional treatments including Levodopa and Deep Brain Stimulation are not very effective. Factors that are helpful in relieving FoG are auditory cueing, visual cueing, etc.

Method: Based on these principles, a novel method of visual cueing was devised using electrical tapes placed equidistant for a Parkinson’s Disease patient. Electrical tapes were used since are inexpensive [ 0.15 US Dollars for 7 metres], adhere well to floor, are durable and are easily available in a variety of bright colours. Initially solid black coloured tapes were used (Fig.1), and patient’s FoG improved by 50%. After 10-15 days of using black tapes, FoG reoccurred as patient probably had started developing habituation to the cue. A modification using coloured tapes arranged in a sequentially alternating pattern of 4 different colours (black, blue, yellow, red) equally apart (Fig.2) was tried. Patient again improved by 50%-60%. After around a month, the patient began experiencing habituation to the alternating colour patterns. Following this episode, a new randomised pattern of tapes was applied which was made of bright iridescent material (i.e. radium) that show multiple bright colours with change in movement (Fig.3) therefore providing a stronger visual cue. Along with this random pattern, visual cues carrying affirmative/encouraging phrases were printed onto the tapes to motivate the patient (Fig.4).

Results: This method yielded improvement in FoG by 70-80% .Partial habituation did occur leading to 25% reduction in efficacy after 3 months at the time of last recorded follow-up but habituation was much lesser as compared to previous tape patterns used.

Conclusion: Using patterned alternating-coloured strips as visual cues is a inexpensive, effective treatment for FoG, a symptom otherwise difficult to treat. More studies are needed to see the degree of habituation which may occur over long-term use.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/patterned-alternating-coloured-strips-for-freezing-of-gait-novel-solution-for-a-disabling-symptom/