Laser-Guided Visual Cueing Modulates Spatiotemporal Gait Dynamics During Transitions in Parkinson's

This study investigated the impact of real-time laser-guided visual cues on spatiotemporal gait parameters during initiation and termination in people with Parkinson's (PwP). Fifteen PwP walked a 5-m path under uncued and laser-cued conditions while gait kinematics and center of pressure (CoP) data were collected. Results revealed that laser-guided visual cues significantly increased anterior-posterior CoP displacement during the propelling phase of gait initiation (p = .016) and improved dynamic stability, evidenced by reduced lateral asymmetry (p = .007) and decreased fractal dimension of lateral gait variability (p = .001). Conversely, step time increased (p = .005) and step velocity decreased (p < .001) with cueing, while step length remained unchanged. No significant effects of cueing were observed during gait termination. These findings suggest that laser-guided visual cues enhance gait initiation in PwP by promoting propulsion and stability, likely by facilitating an external focus of attention and improving anticipatory postural adjustments. The lack of effect on gait termination may reflect differing neural control mechanisms. This study contributes to the understanding of laser-guided visual cueing mechanisms in PwP gait and supports its potential as a targeted intervention for improving functional mobility, particularly during the challenging phase of gait initiation.