Combined auditory and visual cueing provided by eyeglasses influence gait performance in Parkinson Disease patients submitted to deep brain stimulation: a pilot study


  • Carolina de Oliveira Souza Universidade de São Paulo
  • Mariana Callil Voos Universidade de São Paulo
  • Hsin Fen Chien University of São Paulo
  • Alessandra Ferreira Barbosa University of São Paulo.
  • Rachael Brant Rodrigues University of São Paulo
  • Fernanda Colucci Fonoff University of São Paulo
  • Fátima Aparecida Caromano University of São Paulo
  • Luiz Carlos de Abreu Faculdade de Medicina do ABC. Departamento de Saúde da Coletividade. Disciplina de Metodologia Científica.
  • Egberto Reis Barbosa University of São Paulo
  • Erich Talamoni Fonoff University of São Paulo.



Parkinson disease, deep brain stimulation, gait


Background: Auditory-visual cueing using portable cueing devices has been effective for gait training in rehabilitation programs with Parkinson patients. However, it is possible that some gait problems arise due to interference from chronic high frequency stimulation with the gait and balance neural networks in patients with Parkinson Disease. Thus, it should be useful to test whether advanced Parkinson Disease patients experiencing gait problems (despite the treatment with medication and high frequency deep brain stimulation) would benefit from therapy using cueing. Methods: Eyeglasses combining auditory-visual cueing were used with 18 patients with advanced Parkinson Disease and treated with medication and deep brain stimulation. Patients were assessed using the Dynamic Gait Index, Timed Up and Go and Six-Minute Walking Test and performance was measured with and without the cueing (with and without eyeglasses on). Results: One way ANOVA on the performance measures indicated that Dynamic Gait Index and Six-Minute Walking Test significantly improved in the cued condition. Since cueing was task specific, and Timed Up and Go includes subtasks such sitting and standing, the combined auditory-visual cueing did not improve performance on such tasks. Conversely, the combined cueing may have worked as distractors during these subtasks. Conclusion: Combined auditory-visual cueing provided by this wearable technology may have practical applicability in rehabilitation therapy. It provided additional benefits on gait in patients with advanced Parkinson Disease with deep brain stimulation in the subthalamic nucleus.

Author Biographies

Carolina de Oliveira Souza, Universidade de São Paulo

Department of Neurology. Hospital das Clínicas.

Mariana Callil Voos, Universidade de São Paulo

Department of Physical Therapy, Speech disorders and Occupational Therapy. Faculty of Medicine.

Hsin Fen Chien, University of São Paulo

Faculty of Medicine. Hospital das Clínicas.

Alessandra Ferreira Barbosa, University of São Paulo.

Department of Physical Therapy, Speech disorders and Occupational therapy

Rachael Brant Rodrigues, University of São Paulo

Faculty of Medicine. Hospital das Clínicas

Fátima Aparecida Caromano, University of São Paulo

Department of Physical Therapy, Speech Disorders and Occupational Therapy.

Egberto Reis Barbosa, University of São Paulo

Hospital das Clínicas. Faculty of Medicine. USP.

Erich Talamoni Fonoff, University of São Paulo.

Hospital das Clínicas. Faculty of Medicine.



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