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New wearable robotics for Parkinson’s disease

“Freezing,” a temporary, involuntary inability to move, is one of the most common and debilitating symptoms of Parkinson’s disease, a neurodegenerative disorder that affects more than 9 million people worldwide. When individuals with Parkinson’s disease freeze, they suddenly lose the ability to move their feet, often mid-stride, resulting in a series of staccato stutter steps that get shorter until the person stops altogether. These episodes are one of the biggest contributors to falls among people living with Parkinson’s disease.

Today, freezing is treated with a range of pharmacological, surgical or behavioral therapies. However, none are highly effective. Now, researchers are using a soft, wearable robot to help a person living with Parkinson’s walk without freezing. The robotic garment, worn around the hips and thighs, gives a gentle push to the hips as the leg swings, helping the individual achieve a longer stride.

The device completely eliminated the participant’s freezing while walking indoors, allowing a person to walk faster and further than they could without the garment.

“We found that just a small amount of mechanical assistance from our soft robotic apparel delivered instantaneous effects and consistently improved walking across a range of conditions for the individual in our study,” said study investigator Conor Walsh with Harvard Medical School in Boston, Massachusetts.

The research demonstrates the potential of soft robotics to treat this frustrating and potentially dangerous symptom of Parkinson’s disease and could allow people living with the disease to regain not only their mobility but their independence. The new findings have been published in the journal Nature Medicine.

The team spent six months working with a 73-year-old man with Parkinson’s disease who endured substantial and incapacitating freezing episodes more than 10 times a day, causing him to fall frequently. These episodes prevented him from walking around his community and forced him to rely on a scooter to get around outside.

The wearable instantly helped him improve. Without any special training, he was able to walk without any freezing indoors and with only occasional episodes outdoors. He was also able to walk and talk without freezing, a rarity without the device.

“Leveraging soft wearable robots to prevent freezing of gait in patients with Parkinson’s required a collaboration between engineers, rehabilitation scientists, physical therapists, biomechanists and apparel designers,” said Walsh.

For more than a decade, researchers have been developing assistive and rehabilitative robotic technologies to improve mobility for individuals’ post-stroke and those living with ALS or other diseases that impact mobility. Currently, an exosuit for post-stroke gait retraining is showing promise.

I’m sorry, I can’t hear you

Hearing loss affects approximately 40 million American adults, yet only one in 10 people who need hearing aids use them, according to the latest research. Now researchers are warning those who don’t use hearing aids but may want to rethink that.

“We found that adults with hearing loss who regularly used hearing aids had a 24% lower risk of mortality than those who never wore them,” said lead researcher Dr. Janet Choi with Keck Medicine in Los Angeles, Calif. “These results are exciting because they suggest that hearing aids may play a protective role in people’s health and prevent early death.”

Previous research has shown that untreated hearing loss can result in a reduced lifespan. It is well established that untreated hearing loss can lead to social isolation, depression and dementia. However, until now, there has been very little research examining if the use of hearing aids can reduce the risk of death. The study represents the most comprehensive analysis to date on the relationship between hearing loss, hearing aid use and mortality in the United States, according to Dr. Choi.

The researchers used data compiled by the National Health and Nutrition Examination Survey between 1999-2012 to identify almost 10,000 adults age 20 years and older who had completed audiometry evaluations. Researchers followed their mortality status over an average follow-up period of 10 years after their evaluations and published their findings in The Lancet Healthy Longevity.

A total of 1,863 adults were identified as having hearing loss. Of these, 237 were regular hearing aid users, which were characterized as those who reported wearing the aids at least once a week, five hours a week or half the time. The researchers identified 1,483 individuals as never-users of the devices. Subjects who reported wearing the devices less than once a month or less frequently were categorized as non-regular users.

Researchers found that the almost 25% difference in mortality risk between regular hearing aid users and never-users remained steady, regardless of variables such as the degree of hearing loss (from mild to severe). There was no difference in mortality risk between non-regular users and never users, indicating that occasional hearing aid use may not provide any life-extending benefit.

While the study did not examine why hearing aids may help those who need them live longer, Dr. Choi points to recent research linking hearing aid use with lowered levels of depression and dementia. She speculates that the improvements in mental health and cognition that come with improved hearing can promote better overall health, which may improve life span. Dr. Choi hopes this study will encourage more people to wear hearing aids, even though she acknowledges that factors, including cost, stigma and difficulty finding devices that fit and function well, are barriers to use.

Dr. Choi can personally relate to these challenges. She was born with hearing loss in her left ear, but did not wear a hearing device until her 30s. It then took her several years to find ones that worked effectively for her. She is currently working on an AI-driven database that categorizes hearing aid choices and tailors them to individual patient needs.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.

Author Bio

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.

• Email: medicalminutes@gmail.com