Visual Cues for Turning in Parkinson’s Disease

Das, Julia, Vitorio, Rodrigo, Butterfield, Allissa, Morris, Rosie, Graham, Lisa, Barry, Gill, McDonald, Claire, Walker, Richard, Mancini, Martina and Stuart, Sam (2022) Visual Cues for Turning in Parkinson’s Disease. Sensors, 22 (18). p. 6746. ISSN 1424-8220

sensors-22-06746.pdf - Published Version
Available under License Creative Commons Attribution 4.0.

Download (845kB) | Preview
Official URL:


Turning is a common impairment of mobility in people with Parkinson’s disease (PD), which increases freezing of gait (FoG) episodes and has implications for falls risk. Visual cues have been shown to improve general gait characteristics in PD. However, the effects of visual cues on turning deficits in PD remains unclear. We aimed to (i) compare the response of turning performance while walking (180° and 360° turns) to visual cues in people with PD with and without FoG; and (ii) examine the relationship between FoG severity and response to visual cues during turning. This exploratory interventional study measured turning while walking in 43 participants with PD (22 with self-reported FoG) and 20 controls using an inertial sensor placed at the fifth lumbar vertebrae region. Participants walked straight and performed 180° and 360° turns midway through a 10 m walk, which was done with and without visual cues (starred pattern). The turn duration and velocity response to visual cues were assessed using linear mixed effects models. People with FoG turned slower and longer than people with PD without FoG and controls (group effect: p < 0.001). Visual cues reduced the velocity of turning 180° across all groups and reduced the velocity of turning 360° in people with PD without FoG and controls. FoG severity was not significantly associated with response to visual cues during turning. Findings suggest that visual cueing can modify turning during walking in PD, with response influenced by FoG status and turn amplitude. Slower turning in response to visual cueing may indicate a more cautious and/or attention-driven turning pattern. This study contributes to our understanding of the influence that cues can have on turning performance in PD, particularly in freezers, and will aid in their therapeutic application.

Item Type: Article
Additional Information: Funding information: This study was funded by a Parkinson’s Foundation postdoctoral fellowship for basic scientists (PI: Samuel Stuart) (PF-FBS-1898), a Parkinson’s Foundation clinical research award (PI: Samuel Stuart) (PF-CRA-2073) and a National Institutes of Health (NIH) career development award (PI: Martina Mancini) (5R00HD078492-04).
Uncontrolled Keywords: Parkinson’s disease; turning; visual cues; wearable sensor; mobility
Subjects: C600 Sports Science
Department: Faculties > Health and Life Sciences > Sport, Exercise and Rehabilitation
Depositing User: Elena Carlaw
Date Deposited: 08 Sep 2022 08:05
Last Modified: 13 Oct 2022 12:45

Actions (login required)

View Item View Item


Downloads per month over past year

View more statistics