ABSTRACT
PURPOSE: Freezing of gait (FOG) is a disabling phenomenon defined by the periodic absence or reduction of forward progression of the feet despite the intention to walk. We sought to understand whether Google Glass (GG), a lightweight wearable device that provides simultaneous visual-auditory cues, might improve FOG in parkinsonism. METHODS: Patients with parkinsonism and FOG utilized GG custom-made auditory-visual cue applications: "Walk With Me" and "Unfreeze Me" in a single session intervention. We recorded ambulation time with and without GG under multiple conditions including 25 feet straight walk, dual task of performing serial 7's while straight walking, 180 degree turn after walking 25 feet, and walking through a doorway. FOG and patient experience questionnaires were administered. RESULTS: Using the GG "Walk With Me" program, improvements were noted in the following: average 25 feet straight walk by 0.32 s (SD 2.12); average dual task of serial 7's and 25 feet straight walk by 1.79 s (SD 2.91); and average walk through doorway by 0.59 s (SD 0.81). Average 180 degree turn after 25 feet walk worsened by 1.89 s (SD 10.66). Using the "Unfreeze Me" program, only the average dual task of serial 7's and 25 feet straight walk improved (better by 0.82 s (SD 3.08 sec). All other tasks had worse performance in terms of speed of completion. CONCLUSION: This feasibility study provides preliminary data suggesting that some walking tasks may improve with GG, which uses various musical dance programs to provide visual and auditory cueing for patients with FOG.IMPLICATIONS FOR REHABILITATIONFreezing of gait in parkinsonian syndromes is a disabling motor block described by patients as having their feet stuck to the floor leading to difficulty in initiation of gait and increased risk for falls.Wearable assistive devices such as Google Glass™ use visual and auditory cueing that may improve gait pattern in patients with freezing of gait.Augmented reality programs using wearable assistive devices are a home-based therapy, with the potential for reinforcing physical therapy techniques; this is especially meaningful during the COVID-19 pandemic when access to both medical and rehabilitative care has been curtailed.
ABSTRACT
PURPOSE: Observation of medical trainees' care performance by experts can be extremely helpful for ensuring safety and providing quality care. The advanced technology of smart glasses enables health professionals to video stream their operations to remote supporters for collaboration and cooperation. This study monitored the clinical situation by using smart glasses for remote cooperative training via video streaming and clinical decision-making through simulation based on a scenario of emergency nursing care for patients with arrhythmia. PARTICIPANTS AND METHODS: The clinical operations of bedside trainees, who is Google Glass Enterprise Edition 2(Glass EE2) wearers, were live streamed via their Google Glasses, which were viewed at a remote site by remote supporters via a desktop computer. Data were obtained from 31 nursing students using eight essay questions regarding their experience as desktop-side remote supporters. RESULTS: Most of the participants reported feeling uneasy about identifying clinical situations (84%), patients' condition (72%), and trainees' performance (69%). The current system demonstrated sufficient performance with a satisfactory level of image quality and auditory communication, while network and connectivity are areas that require further improvement. The reported barriers to identifying situations on the remote desktop were predominantly a narrow field of view and motion blur in videos captured by Glass EE2s, and using the customized mirror mode. CONCLUSION: The current commercial Glass EE2 can facilitate enriched communication between remotely located supporters and trainees by sharing live videos and audio during clinical operations. Further improvement of hardware and software user interfaces will ensure better applicability of smart glasses and video streaming functions to clinical practice settings.