1. GaitAid An Innovative Way to Treat Freezing of Gait and Shuffling in Parkinson’s Disease

2. What is the GaitAid?  A device that provides audio and visual feedback cues while walking.  Includes:  Head phones that play a sound with every step  Goggles that superimpose a pattern for the patient to step on in the real environment

3. Auditory Stimulation  The head phones make a sound with each of the patient’s steps.  This allows the patient to tell when their walking rhythm is regular and calls their attention back to cadence when they begin to shuffle or freeze.

4. Visual Stimulation  A checkerboard pattern is superimposed on the environment.  The pattern moves toward the patient as they walk, creating the illusion that they are stepping on floor tiles and giving them a target to step on.  Small glasses can be worn underneath the goggles. Patients with larger glasses may have difficulty fitting the goggles over glasses.

5. The Tiled Floor Projection

6. Traditional Treatment of Parkinson’s Disease  To treat patients with Parkinson’s Disease, therapists usually use open loop feedback systems:  Tape on the floor  Laser light  Metronome  These methods are difficult to use functionally outside the clinic.

7. GaitAid in Parkinson’s Disease  The GaitAid is a closed loop system, which has been proven to be more effective than the traditional open loop techniques.  The constant audio and visual feedback cues the patient with each step, preventing gait freezing.  The feedback also improves quality of gait, helping the patient go from characteristic shuffling gait to a more normal cadence.

8. Physical Therapy Implications  This device works best when used 20-30 minutes per day.  Studies have found that the GaitAid improves walking speed, cadence, and step length. It also decreases frequency of Gait Freezing.  GaitAid has been shown to have lasting effects so use in the clinic would be beneficial, especially for patients who cannot afford their own device.  Also shown to be effective in treating Multiple Sclerosis, Cerebral Palsy, and general gait abnormalities.

9. Use Out of the Clinic  The device is small, about the size of a cell phone, so it is very portable.  Surroundings are still visible, making it safe to use outside the clinic. Can be used in many different environments such as a walking trail, sidewalks, or around the house.  Can use just the auditory stimulation without goggles if desired. (Sometimes preferred when walking outside of the house).

10. Testimonials  “The GaitAid has become a mainstay of my treatments, as it provides visual and auditory cues during gait training…The biggest surprise is that it even helps chronic conditions and late- stage Parkinson's.“ - Ben Weinstock, PT, Weinstock Physical Therapy, Brooklyn, NY

11. Testimonials  “Before trying GaitAid, Dr. Sagnières would fall up to 25 times per day. She states, ‘Right on the first day, after using it for 5 minutes, I walked all day long without falling at all!’”  “Five months after beginning her use of the GaitAid, Dr. Sagnières points out, ‘For now I’m still not cured, since the symptoms will come back if I stop using it…but I’m able to live as though I was cured…All people who see me are astonished… I think it should become first aid for all people with Parkinson’s all over the world.’”

12. Costs and Insurance  The major drawback of the device is that it is not yet covered by insurance. (For this reason, having a GaitAid for the clinic would be beneficial for patients)  Can buy the device for $1995.00 (including shipping).  Can “Rent to own” $185.00 per month for 12 months. ($2220.00 total).

13. Links to Research on the GaitAid and Parkinson’s  Chong A, Closed-Loop VR-Based Interaction to Improve Walking in Parkinson’s Disease, Journal of Novel Physiotherapies, Dec 2011 Chong A, Closed-Loop VR-Based Interaction to Improve Walking in Parkinson’s Disease, Journal of Novel Physiotherapies, Dec 2011  ESPAY, A. J., BARAM, Y., DWIVEDI, A. K., SHUKLA, R., GARTNER, M., GAINES, L., DUKER, A. P., REVILLA, F. J., "At- home Training with Closed-Loop Augmented-Reality Cueing Device For Improvement OF Gait in Patients with Parkinson's Disease," Journal of Rehabilitation Research & Development (JRRD) Vol. 47, No. 6, pp. 573-582, 2010 ESPAY, A. J., BARAM, Y., DWIVEDI, A. K., SHUKLA, R., GARTNER, M., GAINES, L., DUKER, A. P., REVILLA, F. J., "At- home Training with Closed-Loop Augmented-Reality Cueing Device For Improvement OF Gait in Patients with Parkinson's Disease," Journal of Rehabilitation Research & Development (JRRD) Vol. 47, No. 6, pp. 573-582, 2010  Baram Y, Closed-loop Augmented Reality for Movement Disorders, Frontiers in Neuroscience, May 2009 Baram Y, Closed-loop Augmented Reality for Movement Disorders, Frontiers in Neuroscience, May 2009  Virtual reality cues for gait improvement in patients with idiopathic senile gait disorders and in patient with history of previous strokes (ESC 2009) Virtual reality cues for gait improvement in patients with idiopathic senile gait disorders and in patient with history of previous strokes (ESC 2009)

14. References  Medigait LLC. How The GaitAid Works. GaitAid Medical. http://www.gaitaid medical.net/howworks.html. Accessed October 9, 2012.  ESPAY, A. J., BARAM, Y., DWIVEDI, A. K., SHUKLA, R., GARTNER, M., GAINES, L., DUKER, A. P., REVILLA, F. J., "At-home Training with Closed- Loop Augmented-Reality Cueing Device For Improvement OF Gait in Patients with Parkinson's Disease." Journal of Rehabilitation Research & Development (JRRD) Vol. 47, No. 6, pp. 573-582. http://www.ncbi.nlm.nih.gov/pubmed/20848370. 2012. Accessed October 9, 2012.  Medigait LLC. Testimonials. GaitAid Medical. http://www.gaitaid medical. net/testimonials.html. Accessed October 9, 2012.  Haifa, I. Doctor with Parkinson's Disease Declares, "I'm Able to Live as Though I was Cured" with the GaitAid Portable Home-Use Device. PR Web. http://www.prweb.com/releases/2012/8/prweb9800160.htm. 2012. Accessed October 9, 2012.  Medigait LLC. GaitAid Frequently Asked Questions. GaitAid Medical. http://www.gait aidmedical.net/faq.html. Accessed October 9, 2012.