Cue X as a Treatment for People With Parkinson's Disease

Parkinson's disease is a condition that affects the brain. It is the world's fastest growing neurological condition which affects more than 145,000 people in the United Kingdom (UK) today. No one knows exactly why the condition develops and there is currently no cure for Parkinson's.

The symptoms associated with Parkinson's are usually mild at first, but can become worse over time. The main symptoms are tremor (uncontrolled shaking), slowness of movement and difficulty starting movements. People with Parkinson's often have problems with walking and balance because of these. This can make normal daily activities more difficult.

It is generally recommended that adults are physically active every day to reduce the effects of sedentary behaviour. UK Department of Health and Social Care guidelines for the adult population recommend 150 minutes of moderate intensity physical activity (equivalent to 30 minutes per day, 5 days a week) or 75 minutes of vigorous intensity physical activity a week (gov.uk, 2019). This is no different for people living with Parkinson's. Indeed, people living with Parkinson's are encouraged to engage in a daily exercise programme to maintain their mobility, independence, and quality of life. However, it can be difficult to do exercises because of the disabling symptoms affecting movement. In addition, as gait and balance ability deteriorate, and the fear of falls increases, maintaining an exercise programme becomes more difficult, leading to being less able to do everyday activities and declining quality of life.

Rehabilitation can help people living with Parkinson's to maintain their mobility and independence, as well as assisting in preventing falls. People usually attend outpatient appointments with a specialist rehabilitation team for assessment and are commenced on a treatment programme of advice, exercises and activities. People are reviewed regularly at face-to-face appointments, with treatment plans adjusted as needed.

One particular problem that many people report with their mobility is 'freezing' when walking (termed 'freezing of gait' or FoG). This is when a person stops and is unable to take their next step. Previous research has shown that there are ways to help people when they freeze using visual or auditory cues to provide 'prompts' to take the next step. For example, putting taped lines on the floor to step over, a light on a walking stick or listening to the beat of a metronome. Most of the existing technology relies on someone else being present, carrying a walking aid or the lines being in fixed places on the floor.