Performance of a Personalized Smart Cueing Device to Detect Freezing of Gait in Parkinson's Disease.

External cueing is a proven strategy to overcome freezing of gait (FoG) in Parkinson's disease (PD). However, manual activation of cueing is often too late and continuous cueing may be perceived as burdensome. Therefore, the Cue2walk, a medical device for FoG detection and provision of external cues, was developed. This study aimed to determine (1) the performance to detect FoG of the Cue2walk device and (2) the effect of personal optimization on its performance to detect FoG. Twenty-four people with PD and daily FoG completed a gait circuit including FoG-triggering tasks in their own home environment, while wearing a Cue2walk device to collect acceleration data. Two experienced independent raters rated the occurrence of FoG using video annotation. The data set of each participant was split into a training (60%) and test set (40%), obtaining an even distribution of FoG episodes. The training set was used to personalize the settings of the algorithm. The test set was subsequently used to assess the performance to detect FoG of the standard and personalized setting by calculating sensitivity, specificity, and latency (time between onset and detection of FoG). Sensitivity was 28.2% ± 31.6%, specificity was 96.0% ± 4.1%, and latency was 1.9 s ± 2.4 s on the test set with the standard settings. With personalized settings, sensitivity was 89.1% ± 14.8%, specificity was 93.3% ± 5.5%, and latency was 1.6 s ± 2.2 s. Sensitivity was significantly higher for the personalized settings (p < 0.001), while latency and specificity remained similar. The Cue2walk device showed good performance to detect FoG when using the personalized settings. The clinical effectiveness needs to be determined in future research.