1509 - Neuroergonomic Assessment of Assistive Gait Device in Parkinson’s Disease

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

SJ

Shawn Joshi, MD, PhD

PGY-3
Spaulding Rehabilitation Hospital/Harvard Medical School
Boston, Massachusetts, United States

Co-Author(s)

PE

Pavlos E. Evangelidis, PhD

NIHR Exeter BRC Translational Fellow
University of Exeter / NIHR Exeter Biomedical Research Centre (BRC)
Exeter, England, United Kingdom
GM

Garry Massey, PhD

Technical Development Officer
University of Exeter
Exeter, England, United Kingdom
HL

Hatem Lazem, n/a

PhD researcher
University of Exeter
Exeter, England, United Kingdom
TR

Thomas C. Richards, BSc, PhD

Postdoctoral Research Associate
University of Exeter
Exeter, England, United Kingdom
MM

Maedeh Mansoubi, PhD

Senior Fellow
Medical School/University of Exeter
Exeter, England, United Kingdom
GW

Genevieve K.R. Williams, PhD

Associate Professor
University of Exeter
Exeter, England, United Kingdom
DL

Dongli Li, PhD

Chief Scientific Officer
gaitQ Limited
OXFORD, England, United Kingdom
HD

Helen Dawes, PhD

Professor of Clinical Rehabilitation
University of Exeter
Exeter, England, United Kingdom

Submitter(s)

SJ

Shawn Joshi, MD

Spaulding Rehabilitation Hospital/Harvard Medical School
Boston, Massachusetts, United States

Objectives:
Parkinson’s disease (PD), the second most common neurodegenerative disorder, affects over 10 million people worldwide and is marked by motor and cognitive impairments contributing to gait disturbances, fall risk, and hospitalizations. Assistive rhythmic cueing has shown promise in improving gait in people with PD (PwPD), but its effects on neural activity related to motor-cognition remain unclear due to challenges of neuroimaging during active movement. We assessed the effects of rhythmic vibrational cueing on prefrontal cortex (PFC) activity in PwPD using functional Near Infrared Spectroscopy (fNIRS) during a one-minute walking task.

Design:
Eighty-four participants (30 healthy controls [CON], 54 PwPD) used a vibrational cueing device placed over both gastrocnemii and performed duplicate one-minute walks under two randomized, counterbalanced conditions: with (On) and without (Off) vibrational cues delivered at a self-selected rate. Thirty PwPD repeated the tasks one month later. Raw light intensity fNIRS data (844nm, 759nm) across eight PFC optodes were transformed to concentration changes of oxygenated/deoxygenated hemoglobin via the modified Beer-Lambert approach. In total, 407 measurements were processed using autoregressive modeling and wavelet filtering to reduce noise and physiological artifacts.

Results:
In Off, PwPD showed decreased PFC activity from baseline across the superior PFC when compared to CON, suggesting impaired motor-cognition. In On, PwPD demonstrated increased left PFC activity from baseline, while CON exhibited a smaller increase. Additionally, CON-On showed decreased left inferior-lateral PFC activity compared to PwPD-On, indicating differential neural responses to rhythmic cueing.

Conclusions:
Rhythmic vibrational cueing is an effective non-pharmacological intervention that enhances PFC activity in PwPD, particularly in the left hemisphere. This strategy may improve motor planning and compensate for cognitive-motor gait deficits. Future work will link neural findings with physical performance using accelerometry and kinematics, supporting development of targeted rehabilitation strategies and assistive devices.