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Freezing of Gait, HMW for Walker embodiment, Postural Instability - Coggle…
Freezing of Gait
Brain Chemistry
Maintain therapeutic levels of dopamine
Increase available dopamine
Increase neuronal response to dopamine
Efficacy of dopamine receptor response
Increase recycling of dopamine or its receptor
Increase dopamine persistence
replace the substantia nigra completely
Release more dopamine when there is loss of balance
leverage gene therapy to increase dopamine expression
reduce dopamine resistance/ tolerance
Reduce the dopamine threshold of action
deliver drug more efficiently across the BBB
Make dopamine transfer more efficient
reduce dopamine degradation
Provide targeted dopamine drug delivery
:question: Address dysfunction by increasing efficiency or expression of acetylcholine
:question: Use a neurotransmitter that is different than dopamine
Walking Mechanics
Augmenting Stride Length in FOG
Visual Cues (Exogenous)
Static Environmental
Pre-placed floor targets
Contrast-enhanced patterns (bold stripes)
"Step here" boxes
Tape or decals
Floor with distance-specific cues
Dynamic Projection
Laser light shoes
Downward-pointing LEDs
Projected target step distance
Dynamic floor projection
Ceiling/Wall-mounted spotlights (motion activated)
Immersive Tech
AR / VR Augmented Cues
Virtual Reality (VR) simulations
Somatosensory Feedback (Closed-Loop)
Haptic/Tactile
Haptic ankle bands
Vibrate on small leg angle
Stimulatory shoes
Pressure feedback on soles
Sensor Integration
Knee angle sensors
Step distance measurement
Wearable feedback devices
Mechanical & Kinetic Engineering
Active Assist (Robotic)
Mechanical prosthesis (stride extension)
Machine that augments step (Exoskeleton)
Passive / Kinetic Assist
Pulley system (lifts leg upward/forward)
Roller shoes (reduce friction)
Rhythmic oscillations (initiation assist)
Neuromodulation & Physiology
Electrical Stimulation
Sciatic Nerve stimulation
Muscle group stimulation (FES)
Nerve stimulation amplitude magnification
Physiological Targets
Relaxation of antagonistic muscle contraction
Cognitive Strategies
Step-Over Techniques
Encouraging stepping "over" vs "forward"
Target visual steps
HMW promote more fluid movement
HMW reduce hypokinesia
HMW promote steady walking cadence
AR glasses for doorway detection and gait cueing
Use natural body reflexes to trigger movement for walking
stimulus in feet to provide a feedback loop for walking
HMW encourage longer stride length
HMW provide continuous double support time
device that enables walking without picking up feet
HMW provide more double support time
HMW decrease double support time
Movement Initiation
HMW initiate the first step taken
Sensor that detects initiation of movement and delivers brain stimulation
Device that detects the initiation of movement and stimulates brain and muscles
Electrical firing of muscles
HMW encourage a large first step
HMW assist in endogenous muscle function
HMW get from A to B fully automated
HMW walk automatically without the use cog brain
HMW reduce the intertia required to move
Cognition
Improve focus during walking
HMW Utilize rhythmic stimulation
Hearing aid / auditory
Airpods
Wired headphones over the ears
In ear speakers
Speaker in the house
Feely gloves / haptics
Bone Conduction
Dentures that vibrate with sound or music
Headband - sound and vibration
Air pulse rhythmic stimulation
Heat pulse stimulation
Utilize the pulsatile nature of arteries
Actuating insoles in shoes
Back pad with actuators / massage pad
Vibration - at wrist or ankle or patch or in clothing
Electrical pain stim shock rhythm
Visual laser / light in contacts or glasses
Magnetic brain stimulation (TMS)
Stim - TENS, DBS, low amplitude electrical stimulation (dry needle)
Minimize cognitive load
Reduce Sensory Input Load (Perceptual)
Reduce visual processing burden
:fire: Clutter overlay filter (AR)
Contrast enhancement
Minimize conflict processing
Doorway "virtual lane" projection
Sensory Deprivation (Remove competing inputs)
Sensory deprivation to reduce distraction
Remove other olfactory sensation
Removal of taste while walking
:fire: Stimulate CN X
Offload Executive Function (Planning)
Reduce dual-task load
Auto-navigation prompts
Reduce movement planning load
Turn simplification assistant
Reduce motor sequencing complexity
Auto-initiation for transitions
Reduce memory load
(Sequencing & Timing support)
Modulate Internal State (Physiological)
Reduce emotional/cognitive stress load
Distraction exposure therapy
Promote automaticity
:fire: Treating with an ADHD medication
Sensory Interrupts (Reset)
Creates a pain sensation
improve capacity of cognition
Decrease Fear of Falling
Psychological & Cognitive Regulation
Reduce Anxiety & Hypervigilance
Biofeedback Wearable (Detects HR/Hesitation -> Calming cue)
Audio "Companion" (Rhythmic calming presence)
Mindfulness Interventions for Freezing of Gait (FoG)
Digital Therapeutics (DTx) & Technology
VR / AR Integration
VR-based relaxation while walking therapies
Treadmill + VR/AR (nature immersion walks)
App-Based Solutions
Hinge-health model adapted for Mindfulness/PD :fire:
Interactive app with real-time coaching when sensing FOG :fire:
Interactive AI that responds to EEG changes
App for daily life integration
App for practicing walking at home
Formal meditative app
Bio-Feedback & Cues
Mindfulness biofeedback (HR monitoring for fear of falling)
Mindfulness audio triggered by movement detection
Psychological & Cognitive Frameworks
Therapeutic Modalities
CBT + Mindfulness (Cognitive distortions & goal setting)
ACT + Mindfulness (Cognitive diffusion)
Therapy to reduce rumination
Mental Imagery
Visualization (imagining smooth walking in calm setting)
Physical & Clinical Integration
Multidisciplinary Care
Pair strategies with Physical Therapy (confidence building) :fire:
In-person coach / Physical Therapist
Physical Preparation
Mindful stretching (before initiating trigger tasks)
Specific Techniques & Somatic Practices
Breathwork
Breathing for Parasympathetic activation
Task-specific breathwork (thresholds, sitting down)
Attentional Focus
Verbal / Mantra techniques paired with tasks
Body scan meditation
Programmatic & Community Delivery
Group & Social
Community Mindfulness walking groups :fire:
Community center (safe environment)
Structured Education
Course taken at diagnosis or progression
Therapist-led course
Audio Resources
CD/Audio for start of day
Clinical & Therapeutic Approaches
Exposure Therapy (Gradual desensitization)
CBT/Therapy with specialist
Family or Couple joined therapy
Radical Biological Intervention
:fire: Turn off the Amygdala
Physical Training & Mastery (Competence)
Graded Activity Progression
Structured progression (Hallway -> Open room -> Public)
Active Rehabilitation
Tai Chi (Balance & Mindfulness)
:fire: Community-based workout sessions
Increase physiotherapy time
Online exercise therapy
Creating a stronger body (Resilience to injury)
Harm Reduction & Safety Engineering
Minimize Physical Consequence
Low-profile wearable hip protection
"Balloons in house" (Soft environment modification)
Reduce fall height distance (Postural training)
Active Prevention Tech
Shoes that warn to catch steps
Motivation & Positive Reinforcement
Visualizing Success
App showing "Safe Walk" streaks
Visualizing work and progress
Incentive Systems
Motivational bribery
Reward for every distance walked
Brain Waves
Restore coupling of the substantia nigra and cortex
Use electrical stimulation to imitate movement
Balance neural connection
Bypass the dysfunctional parts of the brain
Activate the globus pallidus external to increase direct pathway signaling
Rigidity/ Flexibility
Reduce rgidity
Increase flexibility of back muscles
HMW reduce physical tension while walking
Surgery
Spinal
Removal muscles that are not necessary
Removal of amygdala
Distraction technique used in tics
Distraction VR
Muscle relaxants
Botox
Cognitive behavioral therapy (CBT)
Myosin decoupling agents
Opioids
Stretching
Mindfulness techniques
Breathing patterns
Loosen the knees
Cold therapy
Water / float therapy
Heat therapy
Warm compress on muscles
Heated clothing
Devices
Calf device that prevents getting stuck on toes
Therapeutic shoes
Stimulation
Low frequency stimulation to muscles
Parasympathetic nerve stimulation
Vagus nerve stimulation
Nerve-muscle stimulation
Muscular modulation
Acupuncture techniques
Improve axial rigidity
Confidence
HMW build confidence walking in a social setting
Education
HMW distribute tips & tricks for specific tasks for PD patients
HMW for Walker embodiment
HMW handle loud environments
HMW make it discreet
HMW make sure it doesn't get lost
HMW prevent interference with pacemaker
HMW measure brain activity
HMW accommodate different hair styles/ head shapes
HMW accomodate hearing aids
HMW accommodate glasses
HMW detect postural instability
HMW allow for continuous use
HMW charge the device
Postural Instability
Compensatory
Robotic Support
exoskelenton
HMW use arms to aid walking
HMW ensure more rapid rapid respose to loss of balance
walking sticks
shoes that measures/gair size
measure gravity to prevent falls
HMW prevent loss of balance prior to fall
Proprioception
HMW improve spatial awareness
Glasses that will predict a fall
HMW inform when destination is reached (depth perception not needed)
HMW use SONAR to inform where you are at in space
HMW improve depth perception / distance from destination
Balance
HMW measure posture and balance
WMH provide auto feedback of Center of Balance to maintain proper balance
HMW promote better center of gravity control
Gyroscope to improve balance
Correct trunk/posture position
Shock device when off balance
electrical balance feedback
Inner ear for gyroscope to push center of gravity to midline
HMW improve vestibular system integration
Biomimicry
Mimic animal movement and balance
Gorrillas distributes its weight throough its arms
redistribution of weight
4 legged persons
sonic location of objects
use of wings to fly
Use of Tails for balance
use of geko's mechanism of walking (suction feet)
use of cat balancing and gyroscope
added legs and foot
Use of Tails for balance
VR targeted bugs to step on
Brazillian takwendo,Taichi training
Seal/dolphin/fish propioception