Determining the Efficacy of a Vibration Induced Intervention on Improving Arm Swing and Subsequent Gait Stability in Parkinsonian Patients (P2.8-019)

Objective: To determine the capacity of an armband vibratory stimulus as a mnestic cue to induce arm swing in individuals with Parkinson’s disease (PD). Background: Decreased arm swing amplitude is a common motoric sign in Parkinsonism. Its association with reduced gait performance and fall risk is problematic. Enhancement of arm swing is suggested to improve ambulatory stability even in healthy males. Recent studies demonstrated cued arm swing can increase gait performance, reducing fall risk in individuals with PD. Design/Methods: 24 PD individuals. Tests: Unified Parkinson’s Disease Rating Scale (UPDRS), and the Montreal Cognitive Assessment (MoCA); GAITRite system (FAP); Vicon software (Armswing Magnitude). Vibronome iPhone application administered vibratory stimuli through exercise armband. Gait performance analysis was measured using the GAITRite walkway over 2 sessions totaling 22 walks. All participants completed baseline, verbally instructed arm swing, armband-prompted walks, and a randomization of walks. Results: There was a statistically significant increase in arm swing angles and FAP in participants who received verbal instruction (p=0.0005 and p=0.0019). There was also a significant increase in arm swing and FAP scores in armband intervention (p=0.047 and p=0.0289). The improvement seen between these two interventions was not significantly different, and were determined to be comparable (p=0.0559). There was also a clear relationship seen between a net increase in arm-swing angle and a higher FAP score. Conclusions: The reduction in fall risk seen in both the verbal instruction and armband intervention confirms the hypothesized positive effect of armband intervention on arm swing in PD patients. This further reinforces the idea that an increase in arm swing is correlated to an improvement in gait. Additionally, when comparing improvement in FAP relative to change in magnitude of arm swing, a general decrease in FAP (increased fall risk) was seen in most patients with an arm swing less than 20 degrees. Disclosure: Dr. Taber has nothing to disclose. Dr. Wu has nothing to disclose. Dr. Sterling has nothing to disclose. Dr. Billings has nothing to disclose. Dr. Peter has nothing to disclose. Dr. Koul has nothing to disclose. Dr. Pique has nothing to disclose. Dr. Golan has nothing to disclose. Dr. Ma has nothing to disclose. Dr. Cajuste has nothing to disclose. Dr. Bradley has nothing to disclose. Dr. Hartenstein has nothing to disclose. Dr. Maitland has nothing to disclose.